Tackling neglected diseases

Pharmaceutical companies do not have many fans among development workers.

This is a shame, because the development of effective pharmaceuticals has been one of the most transformative new technologies of the last century, increasing life expectancy and the quality of life in industrialised countries and developing countries.

One reason that pharmaceutical companies get a bad rap is that there are some diseases in tropical countries which have been “neglected” – in the sense that there is not much investment in research and development in these diseases, partly because the people who suffer from these conditions are very poor, so there is unlikely to be a commercial return to finding new drugs.

We spend ten times as much looking for cures for baldness as we do looking for cures for malaria.

I can see why this pursuit of profit leaves a bad taste in the mouths of some activists.  Personally I don’t blame drugs companies for this.  They are responding to the economic incentives we set for them.  Indeed, they have a legal duty not to waste their shareholders’ money.  If we don’t like the priorities that emerge from these incentives, we should set them different incentives rather than gripe about it.

So here is some good news.  The World Health Organisation today published a new report on neglected diseases, Working to overcome the global impact of neglected tropical diseases, which covers 17 neglected tropical diseases.

Some of the diseases you will have heard about (such as sleeping sickness and guinea worm).  Some, I guess, you may never have come across: but the burden of suffering they cause across the developing world is immense.

And what is really cool is that drugs companies today announced some important new commitments to provide drugs for these diseases free of charge:

  • Novartis renewed its commitment to donate an unlimited supply of multidrug therapy and loose clofazimine for leprosy and its complications.
  • GlaxoSmithKline announced a new five year commitment to expand their donation of albendazole through WHO beyond lymphatic filariasis to treat school-age children for soil transmitted helminthiases in Africa. The commitment includes 400 million doses per year for this purpose.
  • Sanofi-aventis has agreed to renew its support for the WHO programme against sleeping sickness for the next five years.
  • Bayer has started discussions with WHO on how to expand their current commitment to fight sleeping sickness and Chagas disease.
  • EISAI has committed to work towards the global elimination of lymphatic filariasis by providing diethylcarbamazine (DEC) and
  • Johnson&Johnson has recently also announced expanding its donation of mebendazole to supply up to 200 million treatments per year for treatment of intestinal worms in children.

This is a big deal. Though this WHO statement is wrapped up in medical language, it means, for example, that GSK have just announced they will give away drugs which prevent intestinal worms in children.  This is one of the most cost effective development interventions we know of.  Worms infect more than one third of the world’s population, especially children and the poor. These worms do not normally cause acute illness, but rather a long term, chronic malaise which damages almost all aspects of a child’s development, including health, nutrition, learning and access to education.  A few years ago Miguel and Kremer showed that deworming is a very cost-effective way to increase school participation.  Deworming all the world’s children will make a huge difference to their life chances and their well-being.

There are no magic bullets in development.  Free drugs does not mean that they will reach the poor. There will need to be investment in health systems and logistics to make sure these drugs reach people.  For example, the UK Department for International Development has given £25 million to the Schistosomiasis Control Initiative.   As a result of today’s announcement by drugs companies, SCI will not have to buy drugs, so all that money can be used to ensure that drugs reach people who need them.

Hats off to the drugs companies.  Credit where it is due.

4 thoughts on “Tackling neglected diseases”

  1. Peter Mertens, Mozambique

    If somebody employs a good number of people in half legal business and provides housing to some communities, does that make up for the fact this person is a major (illegal) drug trafficker?
    Because after all, if ‘we’ wouldn’t buy his products (eg cocaine), he wouldn’t be a trafficker in the first place.
    Same reasoning as above.

    Drugs companies have been exposed to manipulate research results, definitions of diseases and government decisions, to make serious profits regardless the health of their consumers.

    Below just two very recent stories directly incriminating pharmaco’s, and a third one where you can feel their presence in the background. They all suggest we have little to no reason to applaud them.

    “Was it appropriate for WHO to take advice from experts who had declarable financial and research ties with pharmaceutical companies producing antivirals and influenza vaccines?
    Why was key WHO guidance authored by an influenza expert who had received payment for other work from Roche, manufacturers of oseltamivir, and GlaxoSmithKline, manufacturers of zanamivir?
    And why does the composition of the emergency committee from which Chan sought guidance remain a secret known only to those within WHO?”

    “A commercial medical writing company is employed by a drug company to produce papers that can be rolled out in academic journals to build a brand message. After copywriters write the articles, in collaboration with the drug company, to their specifications, the ghostwriting company finds some academics willing to put their names to them, perhaps after modest changes.”

    “He zoomed in on 49 of the most highly regarded research findings in medicine over the previous 13 years (…)
    Of the 49 articles, 45 claimed to have uncovered effective interventions. Thirty-four of these claims had been retested, and 14 of these, or 41 percent, had been convincingly shown to be wrong or significantly exaggerated. If between a third and a half of the most acclaimed research in medicine was proving untrustworthy, the scope and impact of the problem were undeniable.”

  2. Owen,

    On the Deworming > as you have read in The White Man’s Burden from Easterly the Deworming research from Kremer and Miguel started in Busia (Kenya) with a Dutch NGO called ICS (in those days Internationaal Christelijk Steunfonds under management from – in those days – Jos Huizinga and Chip Bury).
    That research was then funded largely by Liberty Foundation, a grant giving trust fund from The Netherlands.
    And now DFID pitches in 25 million on deworming (see http://www.guardian.co.uk/global-development/poverty-matters/2010/oct/08/aidanddevelopment ).

    Or: how it takes a long time before what works gets funded seriously (thanks to people like Kremer & Miguel who patiently keep moving at it) …..

    Rgds Hnk.

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