Outlook: Neglected diseases

One-sixth of the world’s population is affected by tropical diseases, yet the drug ‘pipeline’ for these diseases is almost dry. Why this urgent need for development of effective therapies is not being met.

Although the factors hindering drug development are well understood in the developed-world environment, the process becomes significantly more complicated when dealing with diseases that disproportionally afflict poor and marginalized populations. Peter Singer and colleagues investigate what additional problems exist in the developing world. Practical issues are paramount — many areas have no electricity, which means that drugs cannot be stored appropriately. And cultural considerations are vital to encourage uptake of a new treatment or technology — often scientists arrive with plans that do not suit the local populations. Singer presents a model for the future, the result of interviews with 70 key experts from academic, industrial, civil and governmental sectors, which takes into account ethical and practical factors.

Also in the supplement, Declan Butler investigates the role of academia in bridging the gap between basic research and effective therapies for neglected diseases. Benedicte Callan and Iain Gillespie write about the path to new medicines and the need for greater government involvement in this process. And Patricia Danzon argues that subsidies coupled with differential pricing could provide incentives for the development of drugs for diseases that have no market in the developed world.

CONTACT

Peter Singer (McLaughlin–Rotman Centre for Global Health, University of Toronto, Canada)
E-mail: peter.singer@utoronto.ca