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Diseases of poverty and the 10/90 gap 127 Neglected diseases Many scholars and activists have suggested that because there is little market for treatments for tropical infectious diseases such as leishmaniasis, lymphatic filariasis, Chagas’ disease, leprosy, Guinea worm, onchocerciasis and schistosomiasis, there is a consequent lack of suitable drugs. These so-called ‘neglected’ diseases predominantly effect poor populations in low income countries (Murray et al., 2001), and pose particular social and economic problems for those affected. Patrick Trouiller, for example, has pointed out that of the 1,393 total new drugs approved between 1975 and 1999, only 1 per cent (13 drugs) were specifically indicated for a tropical disease (Trouiller et al., 2002). Research conducted by the DND Working Group and the Harvard School of Public Health in 2001 revealed that of the 20 global pharmaceutical companies surveyed, only two had research projects underway for the ‘neglected’ diseases of Chagas and leishmaniasis (Wirth, 2001) Neglected diseases are a tiny fraction of total mortality However, these bare statistics serve to mislead people into thinking that the poor are suffering at the expense of the rich. The reality is that ‘neglected’ diseases often do not represent the most pressing public health priorities in low income countries. They constitute a small fraction of their total disease burden (Figure 1). According to the 2002 World Health Organisation’s (WHO) World Health Report, tropical diseases accounted for only 0.5 per cent of deaths in highmortality poor countries, and only 0.3 per cent of deaths in lowmortality poor countries. Moreover, treatments already exist for many of these diseases. Schistostomiasis (bilharzia), which predominantly affects children in Africa, can be treated with praziquantel at a cost of just 8 cents per 600mg tablet (Fenwick, 2006). Onchocerciasis (river blindness) is controllable with ivermectin. A range of treatments exist for lymphatic filariasis (elephantiasis). In fact, the WHO acknowledges that there are
128 Fighting the Diseases of Poverty Figure 1 Number of daily deaths from diseases 7 10,814 Respiratory infections HIV/ AIDS Diarrhoeal diseases Tuberculosis Childhood diseases Malaria 5,482 4,504 3,611 3,079 7,852 Neglected diseases* 378 0 2,000 4,000 6,000 8,000 10,000 12,000 *Neglected diseases are defined as African trypanosomiasis, Chagas disease and leishmaniasis only three diseases that are genuinely ‘neglected’: African trypanosomiasis, leishmaniasis and Chagas disease (WHO/IFPMA, 2001). This notwithstanding, research and development into the diseases of poverty is far from moribund. Several public-private partnerships exist that specifically focus on diseases of poverty. In particular, the Medicines for Malaria Venture (MMV), the Global TB Vaccine Foundation (Aeras), 2 the <strong>International</strong> Aids Vaccine Initiative (IAVI), and the Infectious Disease Research Institute (IDRI) 3 coordinate publicly-funded R&D projects with private companies. Due in part to these arrangements, there are at least 63 drugs in the R&D pipeline targeting HIV/AIDS, including 15 vaccines (Moran et al., 2005). There are at least 30 more drugs in the R&D pipeline for malaria, and 22 for tuberculosis. 4
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About International Policy Network
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The authors Johan Biermann is a pla
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6 Cost effective means of fighting
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The value of vaccination 215 In the
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The value of vaccination 221 Figure
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Notes Introduction 1 The UN Human D
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Notes 267 18 The decline in their G
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Notes 269 4 The diseases of poverty
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Notes 273 to register new products,
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Notes 275 2 Snow, B et al., “The
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Sources 277 Karoly, L., Greenwood,
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Sources 279 ——— . 2004. The S
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Sources 281 University, March 13. A
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Sources 283 Alcazar, L and Andrade,
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Sources 285 Di Tella, R. and Savedo
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Sources 287 La Forgia, G. 2005. Hea
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Sources 289 Shishkin, Sergey. 2003.
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Sources 293 Wofford, D., & Shanahan
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The Campaign for Fighting Diseases
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Dr. Henry I. Miller joined the Food
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