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Broken System: The Research & Development Crisis

May 1, 2006

The R&D system is still not delivering on neglected diseases
Between 1975 and 1999, a total of 1,393 new chemical entities were marketed globally. Less than 1 percent of these were for neglected diseases and tuberculosis — diseases which account for 12 percent of the total disease burden.Many argue that the situation has changed since then — but the facts disprove them. An article published in the Lancet this month shows how, updated to include the years from 1999 through 2004, of the 1,556 new chemical entities, only 20 new drugs — again a mere 1 percent — were for tropical diseases and TB.

The current medical research and development (R&D) system, which relies on patents to stimulate innovation, does not foster the necessary research to address the needs of billions of people in developing countries. This is because the R&D system provides greater rewards for developing drugs that sell well, rather than drugs that meet unaddressed health needs. Pharmaceutical companies therefore largely ignore the needs of patients in developing countries, while gearing their research towards wealthy markets. A new analysis by MSF shows that only one percent of the drugs reaching the market in the three decades between 1974 and 2004 address neglected diseases such as kala azar, sleeping sickness, or tuberculosis.

Governments Must Move Forward with Global R&D Framework at World Health Assembly

As health ministers met in Geneva at the World Health Assembly (WHA) in May 2006, Doctors Without Borders/Médecins Sans Frontières (MSF) called on governments to overhaul the way medical research and development (R&D) is prioritized and financed, and support a resolution proposed by Kenya and Brazil for a "global framework on essential health R&D."

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Why it's High Time to Change the Rules of the Game

The HIV/AIDS pandemic has vividly brought to the world's attention the fact that an increasing percentage of the world's population lives without access to essential medicines. The access crisis is twofold–on the one hand, crucially needed diagnostics, drugs, and vaccines that safely and efficiently respond to diseases affecting the world's poorest do not exist; and on the other, patients living in poverty cannot afford their own treatment, as those medicines that do exist are priced beyond their reach.

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AIDS: Helping Develop a Quick and Easy Viral Load Test

Caring for children living with HIV/AIDS is charged with obstacles. The struggle begins with doctors not being able to tell whether antibodies found in a small baby's blood are from the mother or whether they suggest the child itself is infected with the virus. Frustrated with the situation, MSF has been cooperating with scientists working on a new technology. This is why MSF and the Diagnostics Development Unit at Cambridge University, UK, are entering into an agreement to develop a simple, cheap and rapid HIV viral load test for use in resource-poor settings.

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"Fire in the Veins": Still Injecting Arsenic-derivatives to Treat African Sleeping Sickness

Much More R&D Needed to Make the Disease History

Human African Trypanosomiasis, also known as African Sleeping Sickness, is a fatal and much neglected disease that continues to plague parts of Africa. The drug most commonly used to treat the disease is so toxic that it kills one in 20 patients. While a better drug exists, it is too complex to use in resource-poor settings. In the Democratic Republic of Congo (DRC), sleeping sickness has made a disturbing comeback over the past few decades.

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Tuberculosis Treatment: Needed Breakthrough Won't Happen Without Much Greater Public Investment

With tuberculosis (TB) killing 1.7 million people and newly infecting nine million each year, this curable disease is far from being curbed. The HIV/AIDS pandemic exacerbates TB's scourge through co-infection, as does the increasing emergence of drug-resistant TB. The standard TB treatment available today is long and complex. It relies on drugs developed over forty years ago and takes six months for patients to complete, and the last four decades have brought nothing in the way of improvement.

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Tags: Access to Medicines

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MSF midwife, Rebecca Ullman, talks about the difficult decisions she had to make in Ivory Coast.

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