Big Pharma Ignoring Diseases Of Poorest Nations

by Peter Deselaers

(IPS) BERLIN -- The big pharmaceutical companies spend little money in developing treatment for diseases peculiar to developing countries, leading researchers say.

And there is no more poignant illustration of this than the development of antiretrovirals used in treatment of HIV/AIDS, says Tido von Schon-Angerer of the international aid organization Doctors Without Borders.

Antiretrovirals can slow down the progress of AIDS, even if they cannot cure it. They normally consist of a combination of several active agents produced by different companies.

Combining different medicines in one pill and producing this as a generic drug has simplified treatment and cut costs, but this treatment is still not available to all who need it.

"We are slowly seeing a progress in the access to treatment," UNAIDS head Peter Piot told a meeting here. But lack of availability of treatment universally means AIDS is still "a death sentence in the developing world."

The drug Tenofovir produced by the U.S. based company Gilead is an example of such difficulties, says Schon-Angerer.

The drug is being offered through an "expanded access program" at costs that represent no profit to Gilead in 95 countries, a company spokesperson told IPS. The program was organized by the U.S. branch of Gilead "following the specific regulations of each individual country," the spokesperson said.

But Schon-Angerer says that while the medication was offered at low cost, it was not possible to get it in most countries because the company had to register the drug in each country. "And that is what they did not do," he told IPS.

According to the latest UN report on HIV/AIDS, only one in ten people who need antiretroviral treatment receive it.

As the HIV virus changes, it becomes resistant to given medication in two to three years. A patient must then change to a second line of treatment. In the developed countries antiretroviral medication is available in several lines.

It is necessary to combine active agents in the second line in one pill, "but we do not see any efforts from the industry," said Schon-Angerer.

A second-line treatment costs about $2,000 a year per patient. "At the moment only the first-line therapy is really affordable," said Schon-Angerer. With second-line treatment people being treated for HIV could live five or six years longer.

Schon-Angerer said the developing world is not a market of interest to the pharmaceutical industry. "The companies do not get the same profits they are used to," he said, adding that compared to other industries pharmaceutical companies have very high profits.

Christian Wagner from the non-governmental organization BUKOpharma told IPS that 90 percent of all research and development activities are focused on drugs for the western markets such as anti-allergics, cancer therapies and drugs lowering cholesterol levels. "In the last 25 years around 1,400 new active agents were developed, but only 13 were to treat tropical diseases that a majority of the world's population is suffering from."

The United States represents about 41 percent of the global pharmaceuticals market, Wagner said. Europe represents 25 percent and Japan 11 percent. Africa and Asia together account for 16 percent of medicine sales, and Latin America just 7 percent.

When the anti-impotency pill Viagra entered the market, other companies developed similar products within three years, Wagner said. "If there was the same vigor in research on tropical diseases, we would be advancing in huge steps."

Developing a new medicine can cost up to $500 million, several companies claim. That enables companies to sell them at high prices. But Wagner says other studies show that development costs are far less.

He also pointed out that a lot of the research funds come from taxpayers' money because basic research is conducted by public institutions such as universities. Many costly clinical studies are often financed by government institutes. "We think that if the research is publicly funded, the results should be publicly available, too," said Wagner.