Ending the R&D crisis in global health: a new report from Oxfam
Today, Oxfam launches ‘Ending the R&D Crisis in Global Health: promoting pro-poor medical intervention’, calling for a new Global Fund for research and development. This report is particularly pertinent as it is ahead of the Global Ministerial Forum on Research for Health in Bamako, Mali, which begins on the 16th November.The Oxfam report highlights a number of incredibly issues surrounding research and development many of which were discussed in a recent issue of The Lancet. The purpose of this News Item is to bring you the key issues surrounding R&D in global health and show you the potential solutions which have been suggested to tackle the problem.
Firstly, what is the problem? In 1990 by the Commission on Health Research for Development identified that less than 10% of global health research spending was channelled to addressing the health research needs of the poorest 90% of the world’s population. Oxfam highlights today that quite unbelievably this disparity still exists, with only 3 new drugs for neglected diseases emerging between 1990 and 2004.
So why is this the case? Again looking to Oxfam they suggest 3 key reasons: Lack of financing, lack of incentives and lack of coordination. Much of the investment in R&D comes from multinational corporations, looking to make a profit, it therefore follows that they are unlikely to prioritise R&D for less profitable areas of the world. It is therefore the job of the governments to step in to ensure that the health of the world rather than the health of the rich is promoted and protected.
In recent years there has been a move to attempt to increase the amount of R&D going into neglected areas of health with Public Private Partnerships set up to ensure that some attention is paid to these areas. The Drugs for Neglected Diseases Initiative and Global Alliance for Vaccines Initiative are just two of these.
Other schemes to try to diversify research within the bounds of the Intellectual Property regime imposed through the World Trade Organisation’s Trade Related Intellectual Property Rights rules, have been develop:
- Advanced market commitments bind donor governments to paying a set price for a drug once it is developed.
- Product Development Partnerships (PDP’s) bringing together the public and private sector have been promoted and have begun to produce results.
- Priority Review Vouchers which in the US entitle the holder to a fast track review (worth up to $321million) if they launch a new medicine to treat a neglected disease.
- Orphan drugs schemes extend patents and give tax credits if companies produce these drugs.
These schemes are however not without their flaws as Oxfam highlights today. There is still much room within this range of incentives for manipulation for profits and for drugs to be unaffordable, especially to middle income countries.
Oxfam has come up with a range of suggestions for ways to encourage the international R&D landscape to evolve to become a platform to improve global health rather than the illnesses of a select few. At its core is a need to support and encourage research both by multi-national companies and also by developing capacity in lower income countries. Below is a summary of the key recommendations:
- Establish a global fund for research and development
- The R&D agenda of everyone involved should be expanded to include development of formulations for developing countries and specific groups for example women and children.
- New well thought out and effective incentives should be created.
- Donor countries should scale up funding for research into diseases effecting developing countries.
- Donors should follow internationally agreed criteria for prioritising contributions
- Pharmaceutical companies and Universities should respond to the needs of developing countries and support PDP’s.
Oxfam provides an excellent platform for improving the R&D globally, with tangible solutions, which will hopefully be discussed in Bamako, we look forward to seeing the outcomes from this event.