Spring 2002 Policy Roundtable Series:

On Tuesday, the 28th of February, Harvard Health Caucus (Harvard Medical School) held a panel discussion entitled the “Crisis of Neglected Diseases: Creating R&D Incentives for Diseases of Developing Countries.” The panel featured Lincoln Chen, Director of Global Equity Initiative at Harvard University, Linda Distlerath, VP of Global Health policy at Merck & Co., Onesmo Mpanju from FDA, and the moderator, Diana Barrett from HBS.

Several issues emerged from the discussion but the main focus was on the crucial role private-public partnerships play in developing health solutions for poor and underdeveloped countries. Despite all the myths surrounding this issue, the fact remains that most of the funding allocated to addressing health needs in developing countries has come either from philanthropic organizations or the concerned governments themselves.

Given that diseases like Malaria, Tuberculosis, Measles, and Hepatitis have largely disappeared from the West, there is little incentive for pharmaceutical companies to search for further innovations in their treatment. As a matter of fact, pharmaceutical companies direct most of their R&D efforts towards addressing the diseases of affluent nations. The justification that most pharmaceutical companies put forward is that they have a job to do –taking care of their bottom-line.

Hence, the role of public-private partnerships becomes crucial in directing R&D efforts and continuing the path of innovation whereby more effective and cheaper medicines and vaccines are developed over time. By continuing to drive both the effectiveness and cost reduction of these solutions at the same time, the opportunity may arise for eliminating these diseases from large populations of the world.

The second interesting issue that emerged during the panel discussion concerned the challenges associated with distribution. Linda Distlerath, VP at Merck, highlighted Merck’s ongoing efforts in Botswana to provide and distribute HIV drugs. She explained that, even though the HIV epidemic in Botswana has evolved into a major human tragedy, the distribution of the drugs remains a huge problem. Even worse, Merck has encountered the same problem in several Sub-Saharan countries and not just in Botswana. In some of the developing nations embroiled in wars, it is sometimes easier to distribute guns than life-saving drugs.

The third interesting issue was a debate surrounding intellectual property rights. Protection of intellectual property remains a major concern for pharmaceutical companies given the large streams of revenues they derive from a number of their patents. Several generic drug manufactures like the Indian company Cipla are manufacturing and selling identical drugs at a cheaper price. For example, Cipla sells a generic version of an HIV drug for $350 whereby Merck would sell the original drug for $10,000. However, pharmaceuticals companies are hoping that the implementation of TRIPs regime would enable them to shield their revenue streams from cannibalization by cheaper generics. Indeed, whether or not this actually happens, remains to be seen. Ultimately, while it is acceptable and humanly possible to live without computer software, without televisions and without cars, it becomes hard not to steal “intellectual property” when the choice is between life and death – as is the case with life-saving drugs.

All in all, the overriding theme that emerged from the panel was that there is a pressing need in addressing the issues concerning the spread of diseases in developing countries. A thorough and lively discussion of such hurdles ensued. However, the ultimate question of how to really tackle the goal of addressing the “neglected diseases” remains as elusive of a question after the panel discussion as it was before.