Landscape for R&D

Over the past thirty years, global health has transformed at an unprecedented rate, with life expectancy increasing at an average of four months every year in developed countries. However, with few exceptions, people living in developing countries have not benefited from this revolution. Millions continue to die from preventable and treatable diseases, such as HIV/AIDS, malaria and tuberculosis, and many tropical diseases have been all but forgotten.

Tropical diseases, such as malaria, human African trypanosomiasis (HAT), Chagas disease, leishmaniasis, lymphatic filariasis, dengue fever and schistosomiasis, continue to cause significant morbidity and mortality. Yet, of the 1,556 new drugs approved between 1975 and 2004, only 21 (1.3%) were specifically developed for tropical diseases and tuberculosis, even though these diseases account for 11.4% of the global disease burden.

Proportion of new drugs developed over the period from 1975 to 2004 that were for neglected tropical diseases and tuberculosis.
Source: Chirac P., Torreele E. Lancet. 2006 May 12; 1560-1561.

With progress made in the basic knowledge of many tropical diseases, drug discovery R&D for these diseases has significantly improved but has had little impact in development of new drugs. Most drugs currently used to treat kinetoplastid diseases were discovered decades ago. With few exceptions, the wealth of knowledge related to basic research of these parasites is not being translated into practical applications.

Why are some diseases more neglected than others?

Due to a combination of market and public policy failures, drug development has largely been confined to the R&D-based pharmaceutical industry. In neglected disease-endemic regions, the public sector has not been able to adequately cultivate drug development expertise and capacity. The dynamics of the market and public policy failures show that a distinction between “neglected” and "most neglected" diseases can be made. For the “most neglected” diseases, patients are so poor that they have virtually no purchasing power and cannot spark market interest in drug R&D among pharmaceutical companies.

 
Global pharmaceutical market and disease R&D targets.
Source: Médecins Sans Frontières Access to Essential Medicines Campaign and the Drugs for Neglected Diseases Working Group. (2001).
Fatal Imbalance: The Crisis in Research and Development for Drugs for Neglected Diseases.
Available:www.msf.org. Accessed 24 September 2007.

Click here to download the report The New Landscape of Neglected Disease Drug Development, a study from the London School of Economics coordinated by Dr. Mary Moran