- Home
- Mission Statement
- Daily Vaccine News
- Daily News Archive
- Sandy's Column
- Sandy, Other
- Adverse Reactions
- Age of Autism - UPI
- Archived Sections
- Blogs
- Books
- Contact
- Donate
- Hilary and Ginger
- Important Notices
- Medical Journals
- Other Websites
- Political Action
- Privacy Statement
- RedFlags Archive
- State Laws
- Testimonials
- Unconventional Wisdom
- Vaccination Council
- Vaccine Research Library
- Vaccines, Pipeline
- Videos
- Video Archive
The world's most neglected diseaseshttp://bmj.com/cgi/content/full/325/7357/176
EditorialsThe world's most neglected diseasesIgnored by the pharmaceutical industry and by public-private partnerships
Infectious diseases can be considered "neglected" when there is a lack of
effective, affordable, or easy to use drug treatments. As most
patients with such diseases live in developing countries and are too
poor to pay for drugs, the pharmaceutical industry has traditionally
ignored these diseases. Over the past decade, however, the public
sector, by creating favourable marketing conditions, has persuaded
industry to enter into public-private partnerships to tackle
neglected diseases such as malaria, HIV, and tuberculosis. Yet some
infectious diseases Why have these partnerships ignored the most neglected diseases, such as kala-azar, Chagas' disease, and sleeping sickness? This question was explored at a recent meeting in New York, organised by Médecins sans Frontières.1 The answer lies in the social contract that exists between the public and private sectors. The public sector has decided to make it public policy to leave drug
development in the hands of the pharmaceutical industry. This
industry in turn invests almost exclusively in developing drugs that
are likely to be marketable and profitable The pharmaceutical industry only enters into public-private partnerships when it sees at least some potential market for its drug. For example, although people with malaria in the world's poorest countries cannot afford to pay for new malaria drugs, Western travellers can. Similarly, patients with tuberculosis or HIV in Africa or India cannot afford to purchase new treatments. However, many patients in the United States or Europe, whose health expenditure is covered partly by government run health insurance programmes, can pay for these treatments. When the pharmaceutical industry sees enough of a market, the public sector then has sufficient leverage, or bargaining power, to persuade the private sector into a partnership. The bargaining power involves creating favourable conditions that make it attractive for industry to invest in drug development. For example, the public sector might reduce the costs of research and development through grants, tax credits, or public support for clinical trials, or it might create a purchase fund, in which donors ensure that there is a pot of gold ready to buy the new drug once it is developed. Examples of this type of approach are the Medicines for Malaria Venture, the International AIDS Vaccine Initiative, and the Global Alliance for TB Drugs Development. When it comes to the world's most neglected diseases, however, these present
absolutely no market opportunities. Without such opportunites, there
is no incentive for the pharmaceutical industry to invest in drug
research and development. The patients have no purchasing power, no
vocal advocacy group is pleading for their needs, and no strategic
interests
For example, sleeping sickness, which claims thousands of lives annually in
Africa, can be considered as a most neglected disease. Current drug
treatments are in scarce supply, difficult to administer, and often
toxic. Melarsoprol, which was developed over 50 years ago, kills up
to 10% of people who are given the drug, and in some regions drug
resistance means it is ineffective in a third of patients.3
An effective, less toxic drug, has been developed Médecins sans Frontières believes that the best hope of treating the world's most neglected diseases is for the public to accept responsibility for drug development, taking it out of the marketplace and into the public sector. The organisation has launched an initiative on drugs for neglected diseases, founded only by public sector and non profit partners, such as the Pasteur Institute, the Special Programme for Research and Training in Tropical Diseases (a project undertaken jointly by the United Nations Development Plan, the World Bank, and the World Health Organization), the Indian Council for Medical Research, and the Brazilian government pharmaceutical organisation Fiocruz. The initiative is testing the idea that a drug research and development network can be established in the developing world, with a centralised management structure, and its feasibility study will be published later this year. Philippe Kourilsky, the director general of the Pasteur Institute, believes that the initiative will do "nothing short of creating a global, not-for-profit pharmaceutical industry." If the initiative proves viable, it is likely to engage with the pharmaceutical industry on specific projects, since industry has great expertise in the development of drugs. The initiative, however, will not rely on market forces; it will define its needs, and then rely on public investment to meet them. Will the strategy of taking medicines out of the marketplace work? Few
precedents for truly international public initiatives exist (the
Human Genome Project is an example), and the public investment will
need to be massive. There will need to be concerted political
attention to make available the necessary financial and technical
resources. Right now there is little other hope for those dying of
the world's most neglected, yet curable, infectious diseases. BMJ, (gyamey@bmj.com)
Rapid Responses:Read all Rapid Responses
ALL INFORMATION, DATA, AND
MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION
PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS
OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR
LEGAL ADVICE. THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND
COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH
YOUR HEALTH CARE PROVIDER.
DISCLAIMER: All information, data, and material contained, presented, or provided here is for general information purposes only and is not to be construed as reflecting the knowledge or opinions of the publisher, and is not to be construed or intended as providing medical or legal advice. The decision whether or not to vaccinate is an important and complex issue and should be made by you, and you alone, in consultation with your health care provider.
Copyright 2012 by Vaccination News, A Non-Profit Corporation. All Rights Reserved. This content may not be copied unless permission in writing from Sandy Gottstein has been obtained. 
|
 "A foolish faith in authority is the worst enemy of truth." -- Albert Einstein, letter to a friend, 1901 "I know of no safe depository of the ultimate powers of the society but the people themselves, and if we think them not enlightened enough to exercise control with a wholesome discretion, the remedy is not to take it from them, but to inform their discretion by education." -- Thomas Jefferson, letter to William C. Jarvis, September 28, 1820 "What's the point of vaccination if it doesn't protect you from the unvaccinated?" -- Sandy Gottstein "Who gets to decide what the greater good is and how many will be sacrificed to it?" -- Sandy Gottstein |
the
world's "most neglected" diseases
