Perspectives on Stimulating Industrial Research and Development for Neglected Infectious Diseases

By Webber, David; Kremer, Michael | Bulletin of the World Health Organization, August 2001 | Go to article overview

Perspectives on Stimulating Industrial Research and Development for Neglected Infectious Diseases


Webber, David, Kremer, Michael, Bulletin of the World Health Organization


Voir page 740 le resume en francais. En la pagina 740 figura un resumen en espanol.

Introduction

While 50% of global health research and development (R&D) in 1992 was undertaken by private industry, less than 5% of the money was spent on diseases specific to less developed countries (1, 2). Of the 1223 new chemical entities marketed worldwide between 1975-96, only 13 were developed specifically for tropical diseases (3). Despite this, private industry has discovered several drugs for serious disease threats in less developed countries, including malaria, tuberculosis, hepatitis B, river blindness, meningitis, leprosy, sleeping sickness, and trachoma. Moreover, the development of globally applicable medicines and vaccines has led to important advances in public health in developing countries.

At the same time, every biopharmaceutical company has a limited number of R&D programmes in their portfolio, which are regularly reviewed against each other. Fundamentally, the process tends to favour those projects with a higher probability of success and which, if successful, would serve markets with a larger monetary value. Consequently, there is lower investment in diseases such as tuberculosis and malaria, despite their high global disease burden, compared with the level of investment in "industrialized-country" diseases. As a result, there is general agreement that new mechanisms and incentives are needed to encourage industrial R&D in underresourced diseases. In this paper, some recent thinking about ways to stimulate industrial R&D for neglected infectious diseases is examined, and it is argued that enlarging the value of the market for medicines and vaccines through, for example, global purchase funds, is a critical step toward stimulating R&D in these diseases.

Barriers to R&D

A joint working group of WHO and the pharmaceutical industry identified five barriers limiting industry engagement in new R&D on neglected infectious diseases (4), as described below.

The state of the science

The lack of understanding of some diseases, coupled with the complexity of the science and technology involved, makes the prospect of finding new medicines and vaccines uncertain and therefore risky. This lack of understanding limits the investment that it is prudent for industry to make. Publicly-funded basic research, often carried out by research institutions and universities, has been important in stimulating the applied work undertaken by the pharmaceutical industry, although industry is increasingly performing basic scientific research as well.

Insufficient access

Weaknesses in country-level physical, medical, financial, and political infrastructure mean that many existing products needed by people in developing countries are not being purchased by patients, health care facilities, governments, or nongovernmental organizations. There is a very real danger that even if new products are developed, they will not be purchased and made available to those who need them. While some existing products suited to developing countries are widely purchased and used, many others are not. In many cases, weaknesses in health infrastructure in developing countries mean that patients never see a health care provider and receive a diagnosis or prescription, let alone the care necessary to make effective use of some medicines. While this paper focuses exclusively on medicines and vaccines, it is often the case that other interventions are more appropriate and this fact should not be minimized.

Thus, there is the prospect that many patients with acquired immunodeficiency syndrome (AIDS) in Africa, for example, would not automatically benefit from antiretrovirals, even at dramatically lower prices. Antiretrovirals require diagnosis, monitoring, and long-term maintenance of demanding treatment regimens that are difficult to sustain without adequate infrastructure and support. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Perspectives on Stimulating Industrial Research and Development for Neglected Infectious Diseases
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.