DENVER —Information on new malaria vaccines and HIV treatments circulates the news on a nearly daily basis, zapping all of the public attention and private sector funding, while many other highly fatal diseases go unacknowledged and untreated. At its most basic level, the problem comes down to what pharmaceutical companies perceive as a lack of a viable market for the neglected diseases.
Diseases like anthrax, brucellosis, bovine tuberculosis and sleeping sickness claim millions of lives every year in developing countries, and because of the impoverished conditions characterizing these countries, pharmaceutical companies, which operate in the private sector, refuse to develop drugs for these diseases.
In 1998, 6.1 million lives ended because of malaria, tuberculosis and lower-respiratory infections — a statistic to be added to the number of preventable deaths that year. Ken Silverstein points out, “People died because the drugs to treat those illnesses are nonexistent or are no longer effective. They died because it doesn’t pay to keep them alive.”
While some negotiations have recently been made to merge the private and public sectors to develop drugs for things like HIV and malaria, there remain infectious diseases that receive little to no attention and continue to take lives. Because the public sector has decided to leave drug development to the pharmaceutical industry, there has been a dangerous line drawn between the public and private sectors — one that is hazardous to the lives of millions.
In analyzing this problem, Gavin Yamey of the British Medical Journal observed that “As a result [of this dynamic], out of 1393 new drugs marketed between 1975 and 1999, only 16 were for neglected diseases, yet these diseases accounted for over 10 percent of the global disease burden.” Further, the only reason that the private sector has agreed to developing drugs for HIV and malaria is that while those in dire need of those drugs in developing countries cannot pay for them, those who are susceptible to the infections in developed countries can and will provide the private sector with a profit.
Isabel Hilton from The Guardian commented on the argument that there is no market for drugs in developing countries, making the point that “There is, of course, a market in the sense that there is a need: millions of people die from preventable or curable diseases every week. But there is no market in the sense that, unlike Viagra, medicines for leishmaniasis are needed by poor people in poor countries.”
And so it goes that drugs are developed for widespread diseases but are only accessible to people in developed countries. The private sector doesn’t see a market for the diseases that are more concentrated in solely developing countries. So without a profit to be made, the diseases are left untreated. Yamey notes, “The patients [in developing countries]have no purchasing power, no vocal advocacy group is pleading for their needs, and no strategic interests military or security are driving concern about these conditions.”
An additional problem lies in the emphasis by pharmaceutical companies and the media on coming up with a cure rather than encouraging preventative measures. Prevention does not lead to profit, so the private sector has little incentive to educate people about keeping themselves healthy.
It has not been all bad, however, with organizations like Doctors Without Borders recognizing the need for the public sector to assume responsibility for drug development rather than leaving the decision making up to the pharmaceutical companies. Back in 2002, the organization endeavored to start an initiative that rested solely in the public sector and was aimed at “testing the idea that a drug research and development network can be established in the developing world, with a centralized management structure.”
As Doctors Without Borders has partnered with other non-profit organizations, they have had success in bringing some drug development out of the marketplace, as well as raising awareness about the importance of spreading the resources around.
If more non-profit organizations strive to continue this effort, progress will continue. But that will not be enough. The public will have to get behind the initiatives so that the organizations have the funding they need to spread the movement. The public would also have to join in on the effort of raising awareness about the many diseases that are neglected.
Reducing poverty would also have a huge impact on starting the transition to giving neglected diseases the attention they need. As economies in developing countries begin to stabilize, there is the opportunity for better healthcare systems, and those countries will be able to afford more drugs. With that incentive, the private sector may begin to develop desperately needed drugs and start to reduce the numbers of preventable deaths.