About

Bill Gates and Jamie Dimon at an eventcelebrating the launch of GHIF in 2013

Our History: A Marriage of Social and Commercial Objectives

The Bill & Melinda Gates Foundation and J.P. Morgan created the Global Health Investment Fund (GHIF) in 2012. These organizations sought to test the idea of building an impact investment portfolio from the most promising drug, vaccine, diagnostic, and medical device technologies that address high-burden public health challenges, neglected infectious diseases, and maternal/infant mortality. An emerging track record of success suggests it is possible to have one’s cake and eat it too, as GHIF technologies are being commercialized at scale and improving public health in historically overlooked markets. Over a relatively short period of time, the GHIF team has built a portfolio of 15 high-impact global health R&D programs that is on track to exceed the fund’s original financial return targets.

Adjuvant was incubated at GHIF and now stands as an independent investment platform designed to scale the most promising investment strategies developed within the original portfolio.

Interior of a relatively full Indonesian subway or train car.

The Adjuvant Investment Strategy

Adjuvant’s strategy aims to drive meaningful improvements in the public health of low- and middle-income countries while pursuing top-tier financial returns. Adjuvant’s focus areas include:

Neglected, high-burden, and emerging infectious diseases, including antimicrobial resistance and pandemic threats
Maternal, newborn, and child health challenges
Reproductive and sexual health
Improving nutrition in undernourished populations in the developing world

Adjuvant directs the majority of its investment activity to opportunities that have human efficacy data from a phase II trial or similar arm’s-length evaluations. We look for compelling proof-of-concept data to support our investment decisions.

Investment Opportunities Hiding in Plain Sight

We have identified compelling risk/return dynamics in several overlooked market segments where a lack of competition, leverage from non-dilutive funding sources, enormous, recurring volumes, and unique lump-sum return opportunities will deliver value for Adjuvant investors:

The Emerging Middle

We have relationships with more than 50 emerging and established biopharmaceutical companies and medical technology groups working where the need to service the public health demands of the growing middle class present investment opportunities with strong financial returns. The world’s largest vaccine manufacturer, for example, is a privately held Indian company with close ties to the Adjuvant team.

Commodity Procurement Networks

Billions of dollars flow through sovereign and multilateral commodity procurement networks each year to source essential public health products such as rapid diagnostic tests for malaria, antiretroviral therapies for HIV, and measles vaccines. However, traditional investment circles pay very little attention to these markets. We leverage our relationships with major funders and buyers such as the Government of India, Gavi, and PEPFAR to inform and support Adjuvant investments.

Emergency Stockpiles

Sovereign and multilateral public health agencies around the world have stockpile programs to ensure ready access to drugs, vaccines, and diagnostics for major threats. Wealthy and middle-income countries routinely stockpile for perils such as anthrax, cholera, yellow fever, pandemic influenza, meningitis, and emerging infectious diseases. We have relationships with the decision-makers at many of these government agencies and organizations.

Pay-for-Results Contracts / InnoFin

Pay-for-results contracts, social impact bonds, development impact bonds, and other “innovative financing” tools for global development have been slow to take hold with commercial investors. The public health sector offers enormous opportunities to deploy these models at scale—with the potential to earn attractive financial returns. The long-term savings associated with preventing or eradicating disease allow for the public and private sector to realize enormous net present value savings in true win-win-win scenarios.

Multi-Use Technology Platforms

CRISPR gene editing, mRNA or DNA medicines, and viral vectored vaccines are all examples of emerging technology platforms with enormous profit potential and significant implications for a broad spectrum of public health challenges. Although still early stage, many of these technologies have already achieved unicorn status as a result of platform-level economics. There are many opportunities to finance overlooked indications on these platforms and participate in the anticipated upside.

R&D Incentive Programs

Although the USFDA’s priority review voucher (PRV) program may face unfavorable supply/demand dynamics in the coming years, the outlook is bright for similar incentive schemes and pull mechanisms to catalyze R&D investments that better align with population-level health needs. The Adjuvant team is tracking several initiatives to launch such incentive programs, including iterations on PRVs and prizes, tax- and intellectual property-based frameworks, advance market commitments, and volume guarantees.