E-drug: Drug development for neglected diseases
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[Copied as fair use. Available online for free. KM]
Lancet 2002; 359: 2188-94 (22 June)
http://www.thelancet.com/journal/vol359/iss9324/full/llan.359.9324.editorial
_and_review.21486.1
Drug development for neglected diseases: a deficient market and a
public-health policy failure
Patrice Trouiller, Piero Olliaro, Els Torreele, James Orbinski, Richard
Laing, Nathan Ford
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Centre Hospitalier Universitaire, BP 217, 38043 Grenoble cedex 9, France (P
Trouiller PharmD); UNDP/World Bank/WHO Special Programme for Research and
Training in Tropical Diseases (TDR), WHO, Geneva, Switzerland (P Olliaro
PhD); Department of Immunology, Parasitology and Ultrastructure, VIB-Free
University Brussels, St-Genesius Rode, Belgium (E Torreele PhD); Munk Centre
For International Studies, University of Toronto, Toronto, Canada (J
Orbinski MD); Boston University School of Public Health, Boston, MA, USA (R
Laing MD); M�decins Sans Fronti�res, London, UK (N Ford MSc); Drugs for
Neglected Diseases (DND) Working Group, M�decins Sans Fronti�res, Geneva (P
Trouiller, P Olliaro, E Torreele, J Orbinski, R Laing, N Ford)
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Correspondence to: Dr Patrice Trouiller (e-mail:PTrouiller@chu-grenoble.fr)
Drug development over the past 25 years
Current incentives and technology transfer
Public-private partnerships
Conclusions
References
Abstract
There is a lack of effective, safe, and affordable pharmaceuticals to
control infectious diseases that cause high mortality and morbidity among
poor people in the developing world. We analysed outcomes of pharmaceutical
research and development over the past 25 years, and reviewed current public
and private initiatives aimed at correcting the imbalance in research and
development that leaves diseases that occur predominantly in the developing
world largely unaddressed. We compiled data by searches of Medline and
databases of the US Food and Drug Administration and the European Agency for
the Evaluation of Medicinal Products, and reviewed current public and
private initiatives through an analysis of recently published studies. We
found that, of 1393 new chemical entities marketed between 1975 and 1999,
only 16 were for tropical diseases and tuberculosis. There is a 13-fold
greater chance of a drug being brought to market for central-nervous-system
disorders or cancer than for a neglected disease. The pharmaceutical
industry argues that research and development is too costly and risky to
invest in low-return neglected diseases, and public and private initiatives
have tried to overcome this market limitation through incentive packages and
public-private partnerships. The lack of drug research and development for
"non-profitable" infectious diseases will require new strategies. No
sustainable solution will result for diseases that predominantly affect poor
people in the South without the establishment of an international
pharmaceutical policy for all neglected diseases. Private-sector research
obligations should be explored, and a public-sector not-for-profit research
and development capacity promoted.
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