Jill Wechsler
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In the last few years it has become good business and good politics for pharmaceutical companies to develop drugs and
vaccines to treat deadly diseases plaguing poorer nations of the world. The Bill & Melinda Gates Foundation deserves much
of the credit for moving third-world diseases to the top of the research agenda, while donor nations have often ignored these
opportunities (see "Public Money Is Tight").
Fueling this development is a group of non-profit organizations with expertise in drug development and knowledge of third-world
nations and diseases. They are encouraging public-private partnerships (PPPs)—a new drug-research model that promises to reduce
costs for industry and produce affordable treatments that meet local needs.
New Landscape
PPPs replace the more recent "push-pull" strategy for boosting industry research on treatments that have little market value
in industrial states. US and European governments have offered tax breaks and patent extensions to "push" R&D, as well as
advance-purchase commitments (APCs) to "pull" new products to market. But some analysts consider these only minimally effective
tactics, which yield treatments with low value for patients in poor countries. Some products still are too expensive for developing
nations, and have dosing and distribution requirements that undermine access and compliance.
While governmental and international agencies continue to back the push-pull drug-development model, these new collaborative
arrangements have already altered the R&D landscape for drugs that treat neglected diseases, according to an important study
by researchers at the London School of Economics, headed by Dr. Mary Moran, now based in Australia. This September 2005 report
published by the Wellcome Trust shows how in the last five years PPPs have spurred R&D to seek new treatments for malaria,
tuberculosis, leprosy, leishmaniasis, schistosomiasis, dengue fever, and other diseases of the developing world. The report
can be obtained from publishing@wellcome.ac.uk
From 2000 to 2004, partnerships such as Medicines for Malaria Venture (MMV), the TB Alliance, Drugs for Neglected Diseases
(DNDi), and the Institute for One World Health (iOWH), launched 63 new research projects that should translate into nine or
10 new drugs by 2010. And the funding has come primarily from Gates, the Rockefeller Foundation, and other private donors,
as opposed to national health programs.
Public Money Is Tight
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This new trend represents an important shift from the previous 25 years, when pharma companies developed only a handful of
new drugs to treat neglected diseases, and gave away many of these treatments. In the 1990s, multinational pharma companies
were actively closing down neglected-disease research, says Moran. Now pharma and biotech companies are joining PPPs and investing
their own resources in this area, as seen in moves by multinational pharma companies, such as GlaxoSmithKline, Novartis, AstraZeneca,
and Sanofi-Aventis, to form their own neglected-disease R&D units. These corporate investments do not expect to make a profit,
but seek to conduct research in a way to avoid large losses. In addition to developing useful drugs, these initiatives may
deflect criticism over past inaction in this area, and also help multinational companies reach major emerging markets in India
and China.
For a growing number of niche biotech companies, PPPs provide prime opportunities to expand research programs, similar to
developing orphan drugs for small patient populations at home. R&D partnerships enable these firms to parlay expertise in
genomics, bioinformatics, and other innovative technologies into new development programs, as well as to gain opportunities
to license intellectual property to larger partners. And both pharma and biotech companies anticipate that these no-profit
R&D efforts eventually may yield spin-off products with commercial value in the West.
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