Patients' needs are what must drive drug research

Patients' needs, not profits, are what must drive drug research say Rowan Gillies and Ellen T Hoen of Médecins Sans Frontières in today's FT.

"Médecins Sans Frontières' experience in our field programmes shows how neglected diseases continue to wreak their deadly toll. In the absence of a reliable and suitable test for tuberculosis, patients continue to go undetected and die. Those who are diagnosed are treated with a lengthy and increasingly inefficient regimen dating from the 1950s and 1960s. The most common treatments for sleeping sickness and the parasitic disease kala-azar both rely on drugs with potentially lethal toxic side-effects. Even Aids is a neglected disease - we still have no suitable diagnostic tool for infants and no appropriate medicines for children.

This is because the system that drives research and development today steers investment towards areas of guaranteed profitability. It is a system in which governments fail to set the priorities for medical research. It is a system in which there is no attempt to find a balance between global medical need and resource allocation. And it is a system entrenched in intellectual property regulation and trade agreements, which a World Health Organisation commission concluded in April show no evidence of boosting R&D in pharmaceuticals for diseases affecting developing countries.

But patients in rich countries are losing out, too. For this is also a system in which those doing the R&D are rewarded more for developing a drug that will sell than one that will meet unaddressed health needs...

It is high time for the WHO to address this problem. As health ministers gather in Geneva for the World Health Assembly this week, they will discuss a resolution proposed by Kenya and Brazil for a "global framework for essential health R&D". The resolution calls on governments to establish mechanisms that ensure medical research addresses the health needs of patients and not commercial dictates; that it delivers affordable products; and that it attracts sustainable long-term funding that is equitably shared among countries. When the system is broken, you fix it - now is the chance for governments and the WHO finally to do so."

There are a range of studies all over the world which suggest that of the thousands of 'new' drugs developed by the pharmaceutical industry over the past twenty five or thirty years, most of them haven't really brought anything new in the way of treatment. Pharmaceutical companies are profit driven and will therefore focus on drugs that make money. That's the nature of business. They have no incentive to invest in R&D to produce treatments for neglected diseases because the people and communities suffering from those diseases largely don't have the means to contribute sufficiently to the drug industries' bottom lines. When the market fails in an area of overwhelming public interest, it is time, as Gillies and Hoen say, for governments to step in.

The Consumer Project on Technology have some further details on the draft resolution proposed by Kenya and Brazil for a "global framework for essential health R&D" is available anywhere but