DRUG RESEARCH: PharmCos Focus on ‘Affluent’ Diseases
Despite the fact that "diseases of the developing world" -- malaria, tuberculosis and sleeping sickness -- kill an estimated 6 million people annually, pharmaceutical companies continue to focus the vast majority of their research on "combating diseases of the affluent developed world," David Pilling writes in a Financial Times column. Pilling indicates that advances made in scientific research have only served to widen the gap between the have and have-nots. Although some diseases effect significantly more people worldwide, they effect those who cannot afford to pay for them, making it more difficult for pharmaceutical companies to recover the estimated $300-$500 million in research and development costs for each new drug. Patrice Trouiller, a consultant to Nobel Peace Prize recipient Medicins sans Frontieres (MsF), said that is why only 13 of the 1,233 drugs licensed between 1975 and 1997 treated tropical diseases. Further, two of the 13 were modified versions of old drugs, two were manufactured by the U.S. military and five were the result of veterinary research. "That means drug companies, which last year spent a total of $40 billion on research, have in two decades come up with only four medicines specifically for tropical disease," Pilling writes.
Amir Attaran of the Washington-based Center for Study of Responsive Law says, "Pharmaceutical companies have simply abandoned research in diseases of poverty." But the companies are quick to refute those claims, arguing that drugs such as antibiotics are "equally relevant for the developing world." In addition, pharmas assert that most developing counties lack the necessary health care systems to oversee proper use of the medications.
Pilling discusses several proposed solutions. One World Health Organization-supported idea is to strengthening "orphan drug" legislation, currently in use in Japan and the U.S., which offers such incentives as tax credits, development grants and fast-track approval for drugs for "global diseases where market incentives are inadequate." But, writes Pilling, orphan drug measures have done little to encourage research for diseases common to developing countries, with only 3% of orphan treatment projects specific to those diseases. Another idea, favored by WHO and the World Bank, would create a market by making "contingency money" available. The public sector would fund a prize for any company developing a treatment. That idea has piqued the interest of the Bill Gates Foundation in its effort to develop an AIDS vaccine. The Medicines for Malaria Venture, a WHO public-private partnership, would provide scientists access to "the vast libraries of chemicals" internationally, in an effort to avoid the need to start from scratch. And MsF has proposed an "indigent drug act," an initiative that would fund public-private research efforts and the purchase of drugs through a tax on pharmaceutical sales. That plan is unlikely to find support in the industry. Another plan, capturing the interest of some at the WHO and a possible boon for pharmas, is a patent extension on biggest-selling western drugs of companies that conduct research on tropical diseases. The plan would essentially subsidize that research. Pilling concludes that although the idea is "fraught with political and operational complexities ... if substantial inroads are to be made into tropical diseases ... it may be the best proposal there is" (10/22).