When market forces determine drugs development, neglected diseases take a back-seat

Published: Wednesday 31 July 2002

it no longer makes news that infectious diseases in poor countries kill over 12 million people each year and play a significant role in keeping countries destitute. Yet, what continues to shock is that the illnesses that make up 90 per cent of the global disease burden get only 10 per cent of the research money because they primarily affect poor countries. It's a sad reflection on the global fraternity that virtually no new drugs are being researched and developed for fatal diseases that mainly affect the poor.

Drug development has been so skewed towards the needs of rich countries that a mere one per cent of new treatments over the last 25 years was for diseases found mainly in developing countries. Consider this report that appeared recently in the prestigious British medical journal Lancet: out of 1393 new chemical entities marketed between 1975 and 1999, only 13 were for tropical diseases and another three for tuberculosis. Infectious diseases account for one third of the disease burden in the world but only five per cent in the developed world. In any case, the vast majority of poor countries' population is today deprived of access to essential drugs, or life saving medicines. Sadly, a large number of lives could be saved if accessibility to treatment of these diseases depended upon something other than pure commercial interest.

On the one hand, research and development on treatment of transmissible diseases that are specific to poor countries have been practically abandoned by multinational pharmaceutical companies because these medicines do not generate a profit for them. In other words, market logic means that in terms of r&d, billions of dollars are spent on Viagra but not a cent to find new treatment against malaria, which kills around 1.8 million people each year. On the other hand, the fact that production and marketing of drugs only obey market logic makes drugs inaccessible to the vast majority of the sick in poor countries.

Unfortunately, even in countries like India, where companies venture into the field of drug discovery, profit motive seems to prevail. They too mostly work on what could be termed as "diseases of the rich".

What is needed is a change in mindset of the drug companies. Mandates must be framed in a global treaty to correct the imbalance between private sector rights and obligations. Ultimately, not-for-profit drug development initiatives should be explored to take drug research and development out of the market.

Is medicine a merchandise and can life saving treatment be left to pure market logic?

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