Dear e-druggers,
Please find an abstract of a presentation that I prepared for the Pharma
Selecta Meeting in the Netherlands in 2003 regarding the issue of lack of
research and development for neglected diseases. The information used to
prepare this abstract mainly comes from, Drugs for Neglected Diseases (DND)
working group, "Drug development for neglected diseases: a deficient market
and a
public-health policy failure", Trouiller, Olliaro, Torreele, Orbinski, Laing
and Ford.
Best wishes,
Ans Timmermans
Ans Timmermans, PharmD
Global Technical Advisor Pharmaceuticals and Medical Logistics
Health Unit
International Rescue Committee
IRC Regional Office
Life Ministry Building 2nd floor
Jabavu Road, Kilimani, Nairobi, Kenya
Cell phone: +254 734 749 867
Office: +254 20 271 8692 or +254 20 271 9559
Fax: +254 20 271 9559
anst@theIRC.org
www.theIRC.org
----
Drug research and the demand of the market
Ans Timmermans, PharmD
Clinical trials -once led by academic medical centers- aim to provide
physicians with new diagnostic and therapeutic tools for the management of
their patients. As more and more funding for clinical research has come from
the pharmaceutical and biotechnology industries, that leadership role has
changed. At the same time there are concerns that rather market mechanisms
like purchasing power and market size as opposed to patient needs are
dictating priorities in drug research. The public sector has insufficiently
fulfilled its regulating role in this matter.
Rare diseases and their potential treatments (orphan drugs) illustrate the
conflict of interest in Western healthcare. Although patients with a rare
disease are as entitled as anybody else to prompt and proper treatment, drug
companies often choose not to invest in research for these diseases because
of
a limited potential market. Most new chemical entities are not innovative,
but
are for drug companies lucrative "me-too" drugs, offering patients little or
no therapeutic gain over existing therapies.
Most health orphans are patients in low/middle income countries that are not
suffering from rare diseases, but from prevalent infectious diseases like
malaria, tuberculosis, pneumonia, sleeping sickness and diarrhea. 60 years
after the introduction of the antibiotics and with a death toll of 15
million
people a year, these diseases are among the world's leading causes of
mortality. Poor people, especially those living in regions plagued by
famine,
war, natural disasters or severe economic crises, are disproportionately
affected by communicable diseases (infectious and parasitic diseases account
for 25% of the disease burden in low- and middle-income countries compared
to
only 3% in high-income countries) while the rate for non-communicable
diseases
is very similar in high- and low/middle-income countries. Although difficult
access to existing essential drugs is part of the problem, there is also the
element of the lack of research and development for these neglected
diseases.
While it might be expected that health research would concentrate on the
areas
where the needs are greatest, the reality is quite different. Only 10 % of
the
annual global health research (56 billion US dollar estimated for 1992) is
devoted to conditions that account for 90 % of the global disease burden -
an
imbalance that has been referred to as the 10/90 gap. Of 1393 new chemical
entities marketed between 1975 and 1999, only 13 (or 1%) were specifically
for
tropical diseases. There is no indication that drug development for
neglected
diseases will significantly improve in the near future.
[well, let's hope you're wrong! See www.dndi.org which has other plans...
WB]
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