Funding Research for neglected diseases

Pharmaceutical companies currently have little financial incentive to develop the drugs most urgently needed by the world’s poor. Instead, they maximize profits by altering already existing medicines -and thus extending the time they can collect royalties on their production- or by developing drugs that target the ailments of those who can most afford them.

Wealthy governments have been slow to fund research that would benefit the poor of other nations, and diseases such tuberculosis, malaria, sleeping sickness and a host of others have gone largely ignored, while funds are poured into honing treatments for diabetes, anxiety and sleeplessness—ailments associated with the rich.

Although patents and high medicines prices have traditionally been the incentive for R&D investment, there is a growing awareness of the associated problems. High prices mean many people cannot afford them. Developing countries face a serious challenge combating killer diseases such as tuberculosis, HIV, sleeping sickness, typhoid fever, etc, as there is a scarcity of patented products on the essential drugs list of the World Health Organization (WHO). The current system has failed quite dramatically in Africa. Even in industrialized countries, high prices and limited insurance coverage for the newest medicines also limit access. Using product prices as an incentive leads to too much investment in new medicines that offer only minor incremental benefits over existing medicines, while products that open up new paths for treatment are relatively under-rewarded.

Yet developing medicines for neglected diseases is not enough. The treatments must be made available, and a tangle of patent laws and international treaties often stand between crucial new medicines and those who need them.

Research & Development (R&D) for new medicines is expensive particularly for clinical trials involving people, and product development can be a lengthy process — two unattractive features for most investors. Public sector and donor investments in the form of grants are important for the non-profit drug development partnerships, where government support is essential.

But these make sure that development efforts are focused on the projects with the highest probability of success. Under patent laws, many of the scientific benefits of R&D, including those generated by failures, are difficult or impossible to appropriate. Actually investors are also deterred by patent thickets. The great number of patents they have to face to carry their research constitutes also a barrier to R&D. New mechanisms to develop new medicines for neglected diseases have to be found.

Big pharmaceutical companies are making an argument for more comprehensive reform on R&D. The World Health
Assembly in May 2007 urged the WHO to encourage the development of new incentive mechanisms that address "the linkage of the cost of research and development and the price of medicines."

As part of the solution the pharma industry proposes longer patent protection to recover R&D costs. Others want governments to provide for government subsidies towards public and non-profit research (which already accounts for a substantial amount of the research these companies use). In fact, if governments were to fund the research that the branded pharmaceutical companies now carry out, and allow the results to be used for generic drugs, the research would more than pay for itself. The Western governments would save more than the cost of this research through lower prices for the drugs.

And the drugs would be available immediately as generics to the rest of the world. Others propose passing from monopolies to cash prizes to reward for innovation products that improve healthcare outcomes. This would allow separating the market for innovation from the market for products.

Such economically sensible reforms may be some years off, given the power of the pharmaceutical lobby. But the least we can do right now is to stop this lobby from bullying other governments that are trying to do the right thing for their citizens.

A panel of public health officials and experts gathered in March at UN Headquarters to discuss new ways to motivate medical research for the development of new drugs to treat the world’s most devastating illnesses.
As to prize money, “so much the better,” he said, stressing that the relative unpopularity of tuberculosis among researchers hasn’t stopped the disease from killing 4,500 people a day. “We have to have those who are keen on developing new research tools have the appropriate compensation,” he said.


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