Eli Lilly and Company: The Right Remedy - Patrizia Carlevaro

The success of Eli Lilly and Company's treatment of multi-drug resistant tuberculosis is based on strong corporate social responsibility objectives, and close partnerships with leading health bodies. Steve Coomber talks to Lilly’s Patrizia Carlevaro about the push to provide greater healthcare.

Corporate social responsibility (CSR) can be a controversial issue. Some argue it is not in the interest of shareholders to spend corporate funds on non-core activities. Others suggest CSR is not much more than a cosmetic PR exercise for many organisations. However, the thousands of patients treated by pharmaceutical giant Eli Lilly and Company's multidrug resistant tuberculosis (MDR-TB) partnership programme may disagree.

For, as Lilly has shown, the right approach to CSR activities can make a difference to the quality of people's lives, and benefit the business too. Lilly got involved with MDR-TB in the 1990s when it emerged in Peru, and later in the prison populations of the former Soviet Union. Initially, the company was asked to donate TB drugs, but it was apparent that having the drugs was not enough; there needed to be an infrastructure and system in place to support any treatment programme.

‘We wanted to make sure that someone was going to follow up on the ground, and that there was not going to be a problem at the local level, through misuse of the drugs, for example, creating even greater resistance,’ says Patrizia Carlevaro, head of the international aid unit at Lilly.

The result was the creation of the World Health Organisation's Green Light Committee (GLC), which decided where and how the drug was to be used. At the same time Lilly agreed to provide Medecins Sans Frontieres and the World Health Organisation with two anti-TB drugs at concessionary prices. Soon afterwards, says Carlevaro, there was an issue around the connection between HIV, TB and malaria. TB is strongly associated with HIV; in Africa one-third of people with HIV die of TB. Lilly felt a more strategic approach was required, and in 2003 set up the MDR-TB partnership, an innovative approach to dealing with the disease.

‘It is a 360-degree partnership where we are responsible for taking steps to create a better system for the management of tuberculosis in developing countries and MDR-TB in particular,’ says Carlevaro. ‘We are involved in drug supply, technology transfer, community support, healthcare professional training, workplace activities, research, and awareness and prevention programmes.’ Lilly is focusing on healthcare professionals, training doctors and nurses, but also educating the community, ensuring that families take care of patients when they are released from hospital.

Another important element is the technology transfer that allows TB medicines to be produced in developing countries. ‘We identified four companies in China, South Africa, India and Russia, and are giving them our commercial production expertise so they can reproduce the drugs at the same level as we do,’ says Carlevaro. The partnership consists of 22 partners including the International Council of Nurses, the International Federation of Red Cross and Red Crescent Societies, the World Economic Forum and the World Health Organisation.

And in terms of what has been achieved so far by the $135 million-funded MDR-TB partnership, the facts are equally impressive: activities in over 80 countries; 60,000 patients approved for treatment worldwide through the GLC; 16,000 nurses trained; and over 1,900 MDR-TB patients receiving direct supervision from the Red Cross.

It has been an informative exercise for Lilly, says Carlevaro. ‘We needed to get people working together if we wanted credible results. Putting together the partners and ensuring that they break the ice, share information and create joint activities creates practical experiences that could be useful in other areas within Eli Lilly such as diabetes, for example, which is another disease requiring a long-term commitment.’

The MDR-TB battle is far from over, but Carlevaro is already thinking about what more Lilly can do. ‘We would like to see our partnerships more as an agent of change in terms of better delivery of care in poor countries,’ she says. ‘Because if you only address one disease in a country you are not going to solve the problem, you need to attend to the overall health situation.’