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Ending the R&D Crisis in Public Health: Promoting pro-poor medical innovation

17 Nov 2008

Paul Chinnock

The last few years have seen the launch of many initiatives to promote medical research that addresses the needs of the majority of the world’s population, rather than focusing on the health priorities of the most developed countries. However, in a new report, Oxfam International says that governments and the pharmaceutical industry are still failing to develop new medicines and vaccines to address diseases of the developing world.

Tropical diseases such as dengue fever or sleeping sickness affect millions of people in developing countries and yet only receive $1 out of every $100,000 spent globally on medical research and development (R&D). Only three new medicines for neglected diseases emerged out of global R&D activities between 1999 and 2004, a situation which the Oxfam report describes as ‘woefully inadequate’. Rich countries are continuing to lag seriously behind in providing resources for funding research for neglected diseases. Germany, for example, only provided $20 million in 2007 towards medical innovation benefiting the poor, a mere 0.12% of its overall research budget.

The agency argues that the current R&D system is uncoordinated and industry-led, and that a complete revamp of the system is now necessary. Oxfam’s Rohit Malpani, co-author of the report says, ‘R&D that focuses on the developing world’s urgent needs is still highly dependent and driven by intellectual property, even though this system is demonstrably failing the poor.’

The 50-page report explores new models which will harness R&D to improve human health more sustainably and affordably. Insufficient financing, lack of bold and creative thinking, and an absence of coordination are described as the main barriers to be overcome.

The report alleges that, even when governments do spend to improve R&D, their initiatives have often been ineffective and wasteful, with little coordination and transparency. As an example it discusses the first attempt at using the idea of the ‘advanced market commitment’ (AMC), a mechanism devised to stimulate innovation for vaccines for neglected diseases. The plan was to develop a vaccine to prevent pneumococcal disease, responsible for the deaths of 1.6 million children every year. Donors including Canada, the UK, Russia, Italy, Norway and the Gates Foundation handed over more than $1.5 billion to pharmaceutical companies Wyeth and Glaxo-Smith Kline. However, according to Oxfam, the money was spent to modify and deliver a vaccine that was already being developed for rich markets, failing to contribute to any real innovation.

Oxfam points out that there is no shortage of ideas to improve research and development, such as prize funds and patent pools. The agency says the World Health Organization (WHO) should establish a ‘Global Fund for Research and Development’ that would be dedicated to stimulating additional innovation in order to address the massive burden of diseases that primarily affect poor people in developing countries.

The issues raised in the report are the same as those discussed at the 2008 Global Ministerial Forum on Research for Health (Bamako 17-18th November). For TropIKA.net’s detailed coverage of this important meeting see here.