/ 6 June 2006

World needs renewed focus on ‘neglected diseases’

Medicines to treat common diseases in poorer countries tend to be old and are often ineffective. But the pharmaceutical industry has little incentive to research new drugs: patients in developing countries can’t afford them.

All that may change, as ”needs-driven” research on diseases that particularly afflict developing countries gathers momentum, according to a report on the Science and Development Network’s website, SciDev.Net.

The recent World Health Organisation (WHO) resolution is a ”breakthrough agreement”, says the non-governmental activist organisation Médecins sans Frontières.

A resolution in favour of tackling neglected diseases was adopted during the 2006 World Health Assembly, which gathered all member nations of the organisation in Geneva, Switzerland.

The agreement takes into account the findings of a two-year inquiry by the WHO’s Commission on Intellectual Property Rights, Innovation and Public Health.

In line with the commission’s findings, and to the satisfaction of the pharmaceutical industry, the resolution acknowledges that intellectual property rights provide an incentive for innovation. But it points out that this is not enough to encourage companies to develop products to fight diseases that primarily affect the poor in developing countries.

The WHO will now convene a working group to identify priority areas. The resolution follows a proposal made in January by Brazil and Kenya to create a new global framework for essential health research and development.

The diseases, which include leishmaniasis transmitted by sandflies, malaria from mosquitoes and sleeping sickness from the tsetse fly, kill more than 35 000 people each day in developing countries but get little attention from the global scientific community.

”Only 10% of research investments go to the diseases that affect 90% of the

population,” said Paul Buss, president of the Brazilian research centre known as the Oswaldo Cruz Foundation, at a meeting of the international Drugs for Neglected Diseases Initiative in Rio de Janeiro in April.

The situation is so dire that earlier this year, researchers proposed a new way of rewarding and encouraging companies to develop drugs against ”neglected diseases”.

They suggested rewarding companies that do so by accelerating approval of other drugs they produce for Western markets.

David Ridley, Henry Grabowski and Jeffrey Moe of Duke University in the United States say their proposal would provide a ”market mechanism” to encourage drug development for diseases such as the mosquito-born virus that causes dengue fever.

At the moment, drug companies in industrialised nations, where such diseases are rare, have little incentive to work on these illnesses.

Under their proposal, discussed in the journal Health Affairs, a company that develops a new drug for a neglected disease, forgoes its patent rights and finds at least one manufacturer for the drug would receive a voucher.

This would entitle it to get one of its ”blockbuster” drugs for the Western market approved by the US Food and Drug Administration in six months instead of the usual 18 months.

Ridley and colleagues suggest that the companies should bear the extra cost of accelerated drug review as a fee for using the voucher, but that shortening the procedure by a whole year could still be worth more than $300-million to them.

”If it promotes and prioritises development of drugs for neglected diseases, it is an incentive in the right direction,” says Mark Muscat, a researcher at Denmark’s Statens Serum Institut. — SciDev.Net