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Abstract
BackgroundThere is general agreement, including from the pharmaceutical industry, that current market based methods of generating research into the development of pharmaceutical products that are relevant for developing countries do not work. This conclusion is relevant not just for the most neglected diseases such as leishmaniasis but even for global diseases such as cancer and cardiovascular disease.DiscussionStimulating research will mean overcoming barriers such as patent thickets, poor coordination of research activities, exclusive licensing of new technologies by universities and the structural problems that inhibit conducting appropriate clinical trials in developing countries. In addition, it is necessary to ensure that the priorities for research reflect the needs of developing countries and not just donors. This article will explore each of these issues and then look at three emerging approaches to stimulating research -paying for innovation, priority review sales or vouchers and public-private partnerships, - and evaluate their strengths and weaknesses.SummaryAll of the stakeholders agree that there is a pressing need for a major expansion in the level of R&D. Whatever that new model turns out to be, it will have to deal with the 5 barriers outlined in this paper. Finally, none of the three proposals considered here for expanding research is free from major limitations.
Highlights
There is general agreement, including from the pharmaceutical industry, that current market based methods of generating research into the development of pharmaceutical products that are relevant for developing countries do not work
Whatever that new model turns out to be, it will have to deal with the 5 barriers outlined in this paper
Research and development (R&D) of new medicines is driven by the market where the market typically means large numbers of potential patients with chronic diseases who live in first world countries
Summary
Barriers to expanding research capacity Barriers to expanding research capacity exist at many levels. Once the legal and salary costs are considered (and all other costs are ignored) a university technology transfer office with the median income, number of employees, and legal fees expended would generate an annual net income of only about US$30,000[21] Despite this marginal amount of money, many universities have restricted access to the products and knowledge of publicly funded research in the hopes of gaining revenue windfalls from exclusive licensing of patents to large commercial entities such as pharmaceutical companies. Pogge and colleagues [39] recognize the problems with funding and propose that 10% of the HIF annual budget or $600 million be put aside to measure health impact Even with this money there are significant obstacles to gathering reliable data in developing countries including making accurate diagnoses, ensuring that the medicines are being used correctly, having the necessary technology to assess health status and accessing health outcomes in patients living in remote areas. Competing interests The author declares that he has no competing interests
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