Solutions to the R&D crisis for neglected diseases

Abstract

At this year's World Health Assembly in May, WHO's member states finally agreed on a global strategy and plan of action on public health, innovation, and intellectual property to improve research and development for neglected diseases. Finalising the strategy, which took 18 difficult months to negotiate, was a great achievement. However, the strategy's success depends upon its implementation, and little concrete action seems to have happened since May to move the agenda forward. The publication of a new report by Oxfam—Ending the R&D crisis in public health: promoting pro-poor innovation—is, therefore, a welcome step. The report's authors, who gauged the opinions of different stakeholders, identify three key problems that hamper innovation for neglected diseases: insufficient financing, lack of bold and creative thinking about incentive mechanisms, and the absence of coordination in research and development efforts. Oxfam's solutions to these obstacles include the establishment of a Global Fund for Research and Development of medicines. More money is clearly needed to develop medicines for neglected diseases. But, in addition, incentive mechanisms that are based on intellectual property rights need a rethink, says Oxfam. For example, orphan drug schemes in the USA and Europe reward manufacturers with tax benefits and extended patents but might encourage companies to charge exorbitant prices for new drugs to make profitable returns. Oxfam argues that incentives for drug companies that do not rely on intellectual property—such as those being discussed in the global strategy—should be implemented and evaluated. They give two examples: prize funds, in which manufacturers are required to surrender monopoly rights for a lump sum, and patent pools, in which two or more companies agree to license their patents to a collective pool. So, while WHO's global strategy has yet to make its mark, Oxfam has offered some tangible solutions to improve medical innovation for the world's poorest people. Their recommendations deserve serious consideration.