In this Health Policy Outlook, Bate and Tren argue that increased bureaucratic control of international drug research and development will only harm the citizens of poor nations who are most in need of health care innovation.
In recent years, increasing attention has been given to the problem of developing medicines for so–called neglected diseases or diseases of poverty. An apparent lack of research into these diseases has prompted a range of potential solutions. Kenya and Brazil have suggested one approach, which they will offer as a draft resolution at the fifty–ninth World Health Assembly (WHA) in May 2006. The resolution demands "new policy rules to stimulate essential research and development in health, especially for the most neglected diseases."
The resolution calls for WHA member states to prioritize research and development "according to the needs of patients" and to establish "a framework for defining global health priorities in supporting essential medical research and development based on the principle of equitable sharing of the costs of research and development by all those who benefit from it and incentives to invest in useful research and development in the areas of patients' need and public interest."
This resolution dovetails neatly with activist proposals for global R&D, such as the Medical Research and Development Treaty (MRDT), which has been widely promoted and seeks to expand public expenditure on drug development, weaken intellectual property rights, and increase flexibility in issuing compulsory licenses to manufacture generic versions of medicines. While such ideas may prove politically popular within the WHO, the R&D treaty is likely to be unworkable and impractical...
Practical solutions to most poor–country health problems exist, yet the political will and financial resources to implement them may be lacking on both sides of the donor–recipient equation. For a few diseases, increased research into new medicines and diagnostics is essential and urgent. However, much of this research and the mechanisms to sustain it are already in place.
On the one hand, there is scant evidence to suggest that greater state or intergovernmental agency control of the R&D process and limitations to intellectual property will either deliver the medicines required or respond to patients' needs and the social costs of suffering from a disease. On the other hand, PPPs have a well–developed and successful framework, which has already produced valuable drugs for diseases of poverty and is showing promise in vaccine research.
The world's poor and those in need of medicines would be better off if the WHO gave wholehearted support to multipartner initiatives that realize the value of market–friendly and private sector–driven initiatives to develop medicines. The need for new drugs and the burden of diseases such as HIV/AIDS and malaria is simply too serious to be left in the public sector's hands.