Virtually no new drugs are being developed for diseases that predominantly affect the poor, according to a report released by Medecins Sans Frontieres (MSF). The report, “Fatal Imbalance” claims among others that from 11 companies surveyed, only one new tuberculosis (TB) drug was brought to the market in the last five years.

Eight of the 11 companies reported no research activities in the last year for fatal diseases that almost exclusively affect the poor such as sleeping sickness, Chagas disease and leishmaniasis while many drugs are being developed for sleeping disorders, impotence and obesity. The companies surveyed represent combined sales of nearly U$117-billion, MSF said.

Statistics reveal that people in developing countries, who make up about 80% of the population, only represent about 20% of worldwide medicine sales. In 30 years of work, MSF has witnessed first-hand the human impact of the lack of drugs for infectious diseases. Until very recently, patients suffering from sleeping sickness had to undergo painful treatment with an arsenic-based medicine, because more effective treatment was unavailable.

Yet the disease afflicts up to 500 000 people and threatens another 60-million in Africa. The dire lack of drug research and development into unprofitable diseases is also demonstrated in the new data showing that, of the 1 393 new drugs approved between 1975 and 1999, just 13 (one percent) were for tropical diseases.

“Tropical diseases alone account for almost 10% of the global disease burden, but virtually no new medicines are being developed and drug resistance is wiping out the drugs we have,” said Dr Bernard Pecoul, Director of MSF’s Campaign for Access to Essential Medicines.

“Fatal Imbalance” explains that the current global system works well when it comes to developing drugs for diseases like cancer and heart disease of even conditions such as baldness, impotence or obesity. But it also explains why diseases that affect people with low purchasing power will not attract investment to develop new drugs. Responsibility for correcting “fatal imbalance” lies with governments, who must become directly and proactively involved in searching for solutions at a global level, MSF said.

“Drugs are not developed according to public health need, but according to profitability,” said Pecoul. Of the 137 medicines for infectious diseases in the pipeline during 2000, only one mentioned sleeping sickness as an indication and only one mentioned malaria. There were no new medicines in the pipeline for TB or leishmaniasis.

The Pharmaceutical Research and Manufacturers of America’s current “New Medicines in Development” list shows eight drugs in development for impotence and erectile dysfunction, seven for obesity, and four for sleep disorder. But there is some hope. Together with partners from wealthy and developing countries, MSF is actively exploring the creation of a Drugs for Neglected Diseases Initiative (DNDi), which will focus exclusively on drug development for neglected diseases.

The aim of the initiative is to harness funding and new science and technology, foster public-private co-operation and strengthen pharmaceutical research and development capacity in developing countries. The ultimate aim is to develop new drugs that are affordable to those who need them. As part of this exploration, MSF is funding three pilot drug development projects on drugs for malaria, leishmaniasis and sleeping sickness.

Andy Gray of the School of Pharmacy and Pharmacology at the University of Durban-Westville points out that the concept of the research/funding gap is not new. He said there was also renewed attention being given to TB, with major companies again starting to direct some resources.

– Health-e News Service