Neglected diseases

Peter Singer is professor of medicine and the head of the McLaughlin-Rotman Centre for Global Health. He talked to Deutsche Welle about ways to combat dozens of neglected tropical diseases.

Deutsche Welle: Why do you think it is vital to step up the fight against neglected tropical diseases?

Peter Singer: Neglected tropical diseases are about 30 diseases that nobody can name - things most people haven't heard of. But they are the true diseases of the poor. They affect a billion people, they are chronic infections and they keep people in poverty.

Unfortunately, there are very few innovations, drugs, vaccines and diagnostics for these diseases. That's why it's an important problem and that's why any source of innovation really needs to be tapped and identified.

We have so many drugs for so many diseases like tuberculosis and malaria and there's so much money being spent on AIDS. Why is there so little money being spent on these neglected diseases?

Even though there is a lot of money being spent on tuberculosis and malaria and HIV, we still don't have a malaria vaccine, an effective tuberculosis vaccine, or an HIV vaccine on the market, but having said that, those three diseases were pretty neglected until five or 10 years ago.

The 30 diseases are really, really neglected because they affect the poor. We looked at 78 companies in India, China, Brazil and South Africa to identify the products they have on the market and the products they have in the pipeline and one of our key conclusions is that there is a pipeline of affordable innovations of vaccines, drugs and diagnostics for these neglected diseases in emerging economy companies. You can also think of it as a new vein of gold just sitting below the surface that hasn't been fully mined.

Do you think these drugs from companies in emerging nations could help more effectively than multinational pharmaceutical companies?

I wouldn't say more effectively, but I would say they are an alternative and an additional, rich source of drugs and vaccines and diagnostics. We found 62 products for neglected tropical diseases, 28 of which are on the market, with 44 others in development.

One key feature is that they were more affordable because these companies are closer to the problem and when they are innovating they are doing it with the price in mind. This is a source of affordable innovation. With the cost structures of multinationals, as important as their programs are, there will always be drug and technology donation programs.

For companies in emerging economies, diseases of poverty become market opportunities. Some of these innovations could be developed on a quasi-commercial or commercial basis, which is more sustainable and scalable.

If affordability is one of the main criteria, how can you ensure that the products are affordable for the poor?

Even if something is 10 times cheaper, you can buy 10 times as much or buy it in the first place if it was too expensive. There still is a market failure at the very bottom of the pyramid. What we've done is propose the Global Health Accelerator to help get these drugs, vaccines and diagnostics to the poor.

We found companies could serve their local and regional markets well but often had innovations that were useful for distant markets but never reached them. The Global Health Accelerator would provide business services, access to financing for research, and even an annual global health enterprise to recognize the most affordable and effective innovations for the poor. There is still some help needed to get drugs and diagnostics from emerging economies to the very distant poor markets, but if you have affordable innovation you're at a much better starting point.

Multinationals have been donating drugs to poor regions. Do you think these donations could be replaced by the new system?

I would say supplemented. These are different types of innovations. The multinationals have historically had different types of innovation.

I don't see any reason to replace it if you have a finished drug on the market that is excellent for river blindness, for example, and it happens to be owned by a multinational and that company has been donating that drug for 30 years and virtually eliminated the problem, and this is an example of an actual case with Merk - you wouldn't want to stop that. You'd want to continue it. But what about the other 29 neglected tropical diseases for which there aren't that many vaccines and drugs and diagnostics? That's where any additional source - like the very robust source of companies in emerging economies - should be welcome.

I think we need to put the pieces of the puzzle together to tackle the huge, technical, social, ethical problems like the problem of global health.

Click on the audio link below to find out how the Global Health Accelerator could help companies, government and non-government organizations improve the fight against neglected tropical diseases and the health of the poor around the world.

Interview: Anke Rasper (sms)

Editor: Kate Bowen