Health vs. Wealth: Does pharmaceutical innovation have to choose?

Public health researchers often bemoan the troubling lack of incentives for pharmaceutical innovation towards cures for some of the world's most devastating health conditions. Neglected disease such as malaria afflict millions in poor countries, but costly drug development is discouraged due to paltry ROIs. It would be the right thing to develop cures for the poor, but we often don't feel like its affordable, or economically sustainable. Developing drugs with the highest ROIs, meanwhile, doesn't necessarily address the worlds greatest health needs. Health as an outcome, it seems, is in competition with wealth.

Pharmaceutical innovators in the developing world have taken strides towards overcoming these business barriers. India's pharma sector, for example, has focused on drugs for conditions afflicting its own developing market with an eye towards appropriateness, uptake, and affordability. As the developing world begins to encounter more conditions typical of the developed world, conditions related to over-consumption and chronic disease, the concern is that pharmaceutical innovations for neglected diseases will suffer even more neglect.

Researchers from the McLaughlin-Rotman Center for Global Health at the Univeristy of Toronto are arguing that we do not need to choose between health and wealth. Writing in the September issue of Nature Biotechnology, Rahim Rezaie and Peter Singer lay out a series of workable, real world steps that could be taken to add a meaningful level of financial sustainability and investment incentives to developing cures for neglected conditions. These include robust partnerships between developing sectors and multinational pharmaceutical companies, public-private partnerships, priority review vouchers, and patent pools (such as GlaxoSmithKline's malaria pool), and supporting R&D investment with extended patent periods and accelerated approval. They also point to interesting projects such as the Global Health Accelerator, which provides assistance tackling complex areas such as market and regulatory assessments, partner identification, supply chain and distribution channels, and financing.

While they highlight a slew of global health funds as potential funding sources, the advice of Sproxil.com's Ashifi Gogo to seek government and grants only as a last resort may be worth heading. Instead, the real potential for innovation may be best exemplified by the numerous innovative partnerships that Rezaie and Singer describe in their paper. A good partnership, after all, creates synergy to produce far more than the sum of its parts.