The Economist on Neglected Diseases

The Economist has an article in the September 8th 2005 Edition on drugs for neglected diseases, which quotes new research by Mary Moran, published today in PLOS Medicine:Unfortunately, paid subscription is required to access the article. Here is a gist:

“BIG pharmaceuticals...right up there with the arms dealers,” says a character in “The Constant Gardener”, a newly released film of John le Carré's novel about drugmakers' dodgy dealings in Africa (see article). In fact, as well as fiction, pharmaceutical firms have been lambasted for their approach towards the developing world—be it prices and patents hampering access to existing medicines, or negligible investment in new drugs for diseases that mainly afflict the poorer parts of the planet.But research by Mary Moran and her colleagues at the London School of Economics, published in Public Library of Science Medicine, paints a brighter picture. Dr Moran's team looked at the state of drug research and development for ten “neglected” diseases of the developing world, including malaria and tuberculosis, which kill roughly 3m people a year and debilitate millions more. These have not been particularly interesting markets for big pharmaceutical firms to spend their R&D cash on, compared with, say, new anti-cancer drugs for the rich world. Between 1975 and 1999, only 13 new drugs for neglected diseases were developed, and many big drugmakers got out of the business of tropical disease altogether.According to Dr Moran, however, there has been a significant increase in activity since 2000. There are now at least 63 active drug-development projects for neglected diseases, with 18 potential drugs in clinical trials. Given normal levels of success (drug development has a high attrition rate), this could mean that eight or nine new drugs will be ready for use over the next five years, a distinct improvement on past performance. Indeed, two are already sitting in the “in” trays of the regulators, awaiting their blessing. ...At the moment, government funding accounts for less than 20% of the partnerships' finance. Indeed, in Dr Moran's opinion, current proposals—such as advanced-purchase commitments, in which governments try to create a paying market by promising to buy large amounts of new products designed to combat neglected diseases—run the risk of swaying industry toward for-profit, do-it-yourself drug development. It is indeed an irony that, in the area of tropical disease, the wicked drug firms have discovered the value of not-for-profit business at precisely the point when governments are contemplating the idea that the best way forward is the use of incentives more attuned to red-in-tooth-and-claw capitalism.

Owen comments: I am not convinced by Mary Moran's optimism that public-private partnerships can develop vaccines without substantial, for-profit private investment. Dr Moran's research specifically excludes vaccines, which she rightly notes are quite different because of the hugely expensive clinical trials and investment in production, compared to drugs. It is striking that in the case of vaccines, the Malaria Vaccine Initiative and the International Aids Vaccine Initiative, public private partnerships of the kind that Dr Moran advocates, both say that public and philanthropic funding, without commerical funding, is not enough to bring new vaccines to market.Dr Moran says that "If big companies tell us that public 'commercial' markets are not a catalysing factor in their decision to engage in neglected-disease R&D, then we need to listen carefully to them." This is right, except that for the most part the big companies tell us the opposite. (via PSD Blog)