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Research resources12010080604020Products currently in discovery and development for neglected diseases106 products in discovery, development or registered since 200085% of current projects driven by PPPsIOWH 3TDR 14GATB 17DNDi 22MMV 34industry alone 1601Figure 3: Products currently in discovery and developmentdiseases has shown that many of the long-held beliefs on theactivity of development of drugs for neglected diseases are nolonger valid or accurate and product development since 2000has increased substantially (Figure 3). However, despite thepublic-private label, 80% of the drug development is throughprivate philanthropy and the industry institutions are largelyself-funding. Moran et al point out that although the productdevelopment PPPs have proved to be a good conduit fordirecting public funding to industry and academia, they couldcollapse if there is not more public support.The access partnerships and drug donation programmeshave raised the profile of the diseases involved, kick-startednational disease control programmes and improved deliverysystems to those at “the end of the road”.However, there remain many gaps that the partnershipshave not been able to address which raise the concern ofsustainability – systemic problems in health systems andinfrastructure, capacity and human resources, long-termoperational funding. The clinical trial capacity is limited andunder-funded at present and mechanisms for “after researchand development” are not being addressed – i.e. how to getthe products to the people that need them.Overall, a better coordination between the partnershipsis needed, and integrated approaches to addressing theneglected diseases which would maximize efficient useof resources.The research needs in this area include: operationalresearch on sustainable delivery methods; implementationpractices/opportunities for collaboration across diseaseprogrammes; bringing new products to markets and targetcommunities and finally, how to “harmonize the partnershipswith health systems”.ConclusionPublic-private partnerships have changed the landscape ofdrug development for medicines for neglected diseases andthe delivery of medicines for some neglected diseases in thedeveloping world. Stemming from market and governmentfailures as well as ineffective legislative incentives, PPPs havebrought together participants from all sectors in an attempt tomaximize the skills and resources of those participants totackle complex issues of drug development and distribution.Whilst the product distribution and disease controlprogrammes are filling a gap and improving access totreatment for specific diseases, many issues concerning longtermsustainability remain.The product-development PPPs are relatively new entitiesand have not yet brought a product to market so it remains tobe seen if this innovative approach to drug development willreally succeed. They have introduced innovative and creativesystems and processes for drug development outside thetraditional for-profit pharmaceutical model. PPPs arechallenging governments, industry, academia, and non-profitorganizations to face urgent public health issues.Product-development PPPs face the challenges presentedby the risks inherent in the costly and time-consumingprocess of drug development especially for diseases wherebasic science and research has been dormant for decades.The cost of drug development is high and PPPs are optimisticthat sufficient funding will be available as drug candidatesmove through each stage of the development process. Itremains to be seen if the optimism is justified.As yet, most of those affected by the diseases that thesepartnerships were developed for are not yet benefiting. ❏Stefanie Meredith is currently Director of Public HealthPartnerships at the International Federation of PharmaceuticalManufacturers & Associations, having worked before in diseasecontrol partnerships, operational research, design andimplementation of health interventions in Africa.Elizabeth Ziemba is President of Scientists for Health andResearch for development (SHARED), a Massachussetts based notfor-profitfocused on improving access to medicines in developingcountries through strategic partnerships designed to fill gaps inhealth care delivery systems. She consults on issues related topublic-private partnerships as well as access issues.Global Forum Update on Research for Health Volume 4 ✜ 135
Research resourcesReferences1.Davey S (Ed.). The 10/90 Report on Health Research 2001–2002,Global Forum for Health Research, 2002, Geneva, Switzerland.2.Gwatkin DR, Guillot M. The Burden of Disease among the Global Poor:Current Situations, Future Trends, and Implications for Strategy, 2000.The World Bank, Washington DC.3.Wheeler C, Berkley S. Initial Lessons from public-private partnerships indrug and vaccine development, Bulletin of the World HealthOrganization, 2001: 79(8): 728-734. p.728.4.Kettler H, Marjanovic S, Engaging biotechnology companies in thedevelopment of innovative solutions for diseases of poverty. Nature,February 2004, Volume 3: 171-176.5.Orphan Drugs, Abstract, STOA Study – European Parliament,www.europarl.eu.int/stoa/publi/167780/default_en.htm, accessed7 January 2004.6.Milne C, Kaitin K, Ronchi, E. Orphan Drug Laws in Europe and the US:Incentives for the Research and Development of Medicines for Diseases ofPoverty, CMH Working Paper Series, Paper No. WG2:9, 2001.7.Biel PR. Why is There No AIDS Vaccine? World Economics, Oct.–Dec.2001: Vol. 2, No. 4, 1-16. p.6.8.Orbinski J. Market enticements are not enough. In Ridley R (ed.) A role forpublic-private partnerships in controlling neglected diseases? Bulletin ofthe World Health Organization, 2001, 79(8) 771-777, p.776.9.Milstein J, Widdus R. Facilitating Access to Vaccines: An Overview ofLegal and Political Issues. Pharmaceutical Development and Regulation,2003, 1(2):101-116, p.111.10.Shretta R et al. Sustainability, affordability, and equity of corporate drugdonations: the case of Malarone, The Lancet, May 13, 2000. Vol355:1718-1720.11.Kettler H, Towse A. Public-private partnerships, CHM Working PaperSeries, 2001, Paper No. WG2:21, p.21.12.Buse K, Walt G. Global public-private partnerships: part 1 – a newdevelopment in health? Bulletin of the World Health Organization, 2000,78(4):549-561, p.550.13.Reich M. Public-private partnerships for public health, Nature Medicine,June 2000, Vol. 6, Number 6: 617-620. p.618.14.Buse K, Waxman A. Public-private health partnerships: a strategy forWHO, Bulletin of the World Health Organization, 2001, 79(8) 748-754.p.754.15.Website for the Initiative on Public Private Partnerships for Health,(www.ippph.org, accessed 24 February 2004)16.Website for the organization Drugs for Neglected Diseases Initiative,(www.dndi.org, accessed 18 February 2004).17.Chirac, P, Torreele E. Global framework on essential health R&D. TheLancet, 2006, 12 May; 1560-1561 deficient market and public-healthpolicy failure.18.Buse K, Walt G. Global public-private partnerships: part II – what are thehealth issues for global governance? Bulletin of the World HealthOrganization, 2000:78 (5), p.700.19.The Initiative on Public-Private Partnerships for Health aims at increasingthe effectiveness of public-private collaboration, particularly by helpingthose seeking to develop health products, or to improve access to suchproducts needed to fight neglected diseases and other health problems indeveloping countries. (www.ippph.org, accessed 2 March 2004).136 ✜ Global Forum Update on Research for Health Volume 4
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Contents096 Child immunization: acc
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IntroductionResearch contributions
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