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Governing Board sets out hopes for IHI

The joint undertakings are about creating public-private partnerships (PPPs) – and IHI is no exception. In an interview, the European Commission’s Irene Norstedt, chair of the Governing Board of the IHI, along with Salah-Dine Chibout, co-chair for the industry representatives, explain why the expanded scope of the IHI better reflects the current and future reality for healthcare.

06 July 2022
Irene Norstedt and Salah-Dine Chibout
Irene Norstedt and Salah-Dine Chibout

The Innovative Health Initiative (IHI) represents a ‘third generation’ of healthcare PPPs for the EU, following on from the Innovative Medicines Initiative programmes IMI1 and IMI2. It also sees a broadening of the scope, now embracing a range of medical and imaging technologies as well as purely medicines. Why do you feel this type of broad cross-sectoral collaboration is important?

Irene Norstedt: The reason for the expansion is quite straightforward; the wider scope of IHI reflects the current evolution in healthcare. Until recently, healthcare operated in distinct sectors - diagnostics, radiotherapy, medical devices and medicines. The landscape has changed; the increase in digitalisation in healthcare has been a driver, as has the shift to more integrated approach – screening, diagnostics, therapeutics, connected devices working together. This emerging trend was apparent even during the time of IMI, so it was time for these sectors to come together; it’s going in the direction of personalised medicine.

Salah-Dine Chibout: I think this is an accurate overview. Indeed, in industry, this process is also already happening. If you look at cancer treatments, it’s now standard practice. Therapies are increasingly patient specific, so the diagnostics play a vital role. Imaging is essential in monitoring the progress of tumours during treatment, radiotherapy may be needed as well as therapeutics; all these aspects need to be integrated into treatment. IMI 1 and 2 pushed the pharmaceutical industry to work together at a time when they weren’t used to it; it wasn’t easy at first. With IHI, we’re now moving to a level of cross-sectoral cooperation. Until now, we only worked together on the margins, despite similar objectives in similar areas. By changing this – in the way IMI did - it will give Europe’s industry a competitive advantage. It’s been a great initiative by the European Commission, one that will keep European industry one step ahead.

Irene Norstedt: One of the strengths of the model used in IMI and IHI is the presence of a ‘neutral broker’, who can bring these sectors together in a safe environment – even involving HTA [health technology assessment] bodies, patient organisations and regulators. This makes it a unique benefit.

One of the strengths of the model used in IMI and IHI is the presence of a ‘neutral broker’, who can bring these sectors together in a safe environment

 - Irene Norstedt

What tangible outcomes do you hope to see from IHI in the medium and long term. How will patients – and EU citizens – stand to benefit?

Salah-Dine Chibout: Most likely, it will be in specific diseases where there are existing unmet medical needs, in areas like oncology and cardiovascular disease. There are limits to what an individual company can do; IHI should allow us to build the larger datasets needed to understand these diseases in more depth, to understand the different subtypes of patient. We need to create an ecosystem, where the best clinical research centres in Europe as well as SMEs [small and medium-sized enterprises] can work together with companies to maximise the outputs. Patients will also be vital – they have a better insight into what’s important to them than anyone.

Patients will be vital – they have a better insight into what’s important to them than anyone.

 - Salah-Dine Chibout

While new therapeutic approaches are extremely welcome – especially in addressing unmet need – they can be expensive. However, with healthcare systems facing increasing financial pressure, will these solutions be affordable?

Irene Norstedt: We’re fully aware of the challenges facing healthcare systems; IHI can help by improving how we predict, prevent and treat illnesses. This will be one of the benefits of better understanding the nature of these diseases. Where we can, we will prevent diseases, but we will also seek to identify treatments as quickly as possible, treatments that will avoid peoples’ conditions from getting worse and allowing them to return to day-to-day life. This move to ‘upstream’, prioritising prevention and avoiding disease progression will help maintain the sustainability of healthcare systems.

Since IHI was originally conceived, the world of healthcare has been radically reshaped by the battle to find solutions to the COVID-19 pandemic. Yet - for all the havoc it has wrought, it highlighted the essential nature of partnerships in healthcare delivery and brought about new ways of working – particularly how countries work together across borders. Have these events altered the future direction of IHI?

Irene Norstedt: In fact, not really; the system was already agile and flexible -something we demonstrated with Ebola during IMI2. The lessons we learned during that time gave us the knowledge in how to act to deal with this challenge.

Salah-Dine Chibout: IHI was indeed conceived before the COVID-19 crisis, so the concept of cross-sectoral collaboration was already in preparation. So what the pandemic has done is not change the nature of IHI, but rather it has reinforced the belief in the value of partnerships. To give this perspective, let’s not forget that this is the largest PPP in world! The benefits of this are that the infrastructure for collaboration is already in place; and those involved know where to go for what they need, what to expect and how to make things happen more quickly. When there’s a problem, the partners know how to react - quickly. This differs from the rest of the world; that level of cooperation does not exist yet, and it takes a long time to establish the processes. This is the essence of the EU; multiple countries working together to solve issues. That’s how it should be – tackling complex issues needs joint effort. It allows us to go deeper than working in isolation.

What do you hope the legacy of IHI will be?

Salah-Dine Chibout: That IHI establishes infrastructures within Europe capable of making Europe stronger from a science perspective, particularly clinical networks examining gene therapy, for example. It should also create an incubator for start-up companies. What this means is that when companies are searching for somewhere to undertake research on important products, Europe will be the first place they look to for clinical trials; this will help to reinforce the competitive advantage.

Irene Norstedt: That it will strengthen Europe’s capacity for conducting clinical trials. When a finding is ready for a clinical trial, then everything you need is already there – the protocols, the centres, everything is ready to start straight away. We have already made some progress in this area, and we’re looking at other areas that we wish to develop, such as in paediatric medicines.