Join Elena Coupal as she investigates the world of neglected diseases, medical research, orphan drugs and the pharmaceutical industry in a multi-part series: The Fight Against Neglected Diseases.
Part I: Private-Public Partnerships
Imagine your body racked with fever and chills, shaking uncontrollably from coughs that bring up anemic blood. The parasite Plasmodium falciparum has all but destroyed your red blood cells. Your parents, both long dead from AIDS, cannot help you. A sibling quickly rushes you to the village doctor, only to be given a grim prognosis: Malaria and tuberculosis. We do not have the medicine. Sorry; we can’t help you.
In a few days your body, overcome with disease, will give up the fight. You have now become a statistic, one of millions of children who die every year from treatable, preventable diseases. These diseases, which have been all but eradicated by vaccines and treatment in industrialized nations, include malaria, tuberculosis, dengue fever, and a host of other tropical diseases.
These tropical diseases thrive in the climates south of the Sahara and in Southeast Asia, which also include some of the most poverty-stricken regions in the world. This staggering loss of life occurs predominantly among the most at-risk groups: pregnant women, whose immunity is lowered by their pregnancy; young children, whose bodies haven’t yet developed any immunity; and migrants, who are susceptible to foreign diseases they have no immunity against. The mortality statistics seem almost unreal amidst the glitz and glamour of the modern science we enjoy today.
After all, if we can find treatments for cancer and develop drugs that alleviate the effects of Alzheimer’s and Parkinson’s, then what’s stopping us from removing diseases such as malaria and tuberculosis from the list of major world-wide problems? The answers all boil down to the main issue of cost.
According to the Drugs for Neglected Diseases Initiative (or DNDi):
•Tropical diseases and tuberculosis account for 11.4% of the global disease burden
•1,556 new drugs were approved between 1975 and 2004
•However, only 21 (1.3%) were specifically developed for tropical diseases and tuberculosis
Because of the extreme poverty in regions where these diseases are endemic, there is no local capital available for disease control or for the research and development of new drugs. The process of producing and distributing drugs is extremely expensive. It can cost anywhere from $400 million to $800 million to cover research and development, clinical trials, registration, manufacturing, and distribution of a new medicine.
Since the people who need these drugs the most cannot afford to pay for them, any pharmaceutical companies and organizations that provide these medicines to poorer regions do not see one cent of profit. This fact is especially problematic for big pharma companies that have obligations to their profit-seeking shareholders.
However, the arrival of public-private partnerships, or PPPs, has resulted in a multitude of benefits for all. Top scientific experts from academia and industry teaming up with non-profits and philanthropy groups provide a vast new pool of resources from which drugs can be developed and disturbed to those most in need.
Such partnerships include the Novartis Institute for Tropical Diseases (NITD), Johnson & Johnson with the TB Alliance, Merck with Wellcome Trust to form MSD Wellcome Trust Hilleman Laboratories, and the PATH Malaria Vaccine Initiative (MVI) which was formed from donations from the Bill & Melinda Gates Foundation, just to name a few.
The corporate, for-profit organizations provide the latest technology and techniques, as well as extensive libraries of “starter molecules” for making drugs. They also provide professional advice about which projects would be best for non-profits to pursue.
Nonprofits have access to funds that do not require a return of capital. Nonprofits also have the freedom to focus on “the bigger picture,” and can gather a variety of results from the most recent clinical breakthroughs to assist and direct the process of drug discovery in the private sector. Also, partnering with a non-profit can be great PR for private corporations.
Although relatively new on the scene, PPPs have already shown early success. For instance, according to a 2005 London School of Economics report sponsored by Wellcome Trust, from 2000 to 2004 PPPs developed 46 new drug projects with only $112 million dollars, an astonishingly low number in comparison to what big pharmaceutical companies will usually spend on a similar number of projects (see the $800 million statistic above).
PPPs have a promising future, and with further collaborative efforts, will continue to succeed.
So far, PPPs have proven to be our best ally against these neglected diseases that cripple entire populations and hinder development and education efforts in unindustrialized nations. With help, support, and collaboration amongst many private, public, and philanthropic organizations, it has become more possible than ever to bring these neglected illnesses out of the shadows, so they can be conquered and eradicated.
But first you must get to know your opponents before you can fight them.
Come back for more on neglected diseases in the next few weeks!