Pharmaceuticals for Developing Countries Conference Proceedings (1979) / Chapter Skim
Currently Skimming:
CURRENT PROGRAMS FOR DEVELOPMENT OF PHARMACEUTICALS
CURRENT PROGRAMS FOR DEVELOPMENT OF PHARMACEUTICALS
Pages 121-167
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 122... ...
Development of improved tools needed to control tropical diseases The first objective is to develop new preventive, diagnostic, therapeutic and vector control methods specifically suited to prevent, treat and control selected tropical diseases in the countries most affected by them. The new methods must be susceptible to implementation: - at a cost that can be borne by developing countries; - requiring minimal skills or specialized supervision; and - in a manner that allows their integration into the health services, especially the primary health care systems of developing countries.
|
From page 123... ...
The problem The tropical parasitic and infective diseases remain a major cause of disease and death in many tropical countries, and often constitute a significant barrier to development. Furthermore, in some cases, the process of technological development, as for example the exploitation of water resources in the construction of man-made lakes and irrigation schemes, has aggravated the situation by intensifying transmission in endemic areas and by creating new foci of infection at man-made lakes.
|
From page 124... ...
- leishmaniasis - leprosy Research and Development The activities of the Special Program are directed towards development of any practical tool needed to solve the problems of the selected diseases, and focused on development of new drugs or modification of existing ones, search for vaccines, new methods of vector control, and improved diagnostic tests. The research activities are carried out by multidisciplinary groups of scientists formed on a world-wide basis.
|
From page 125... ...
For example, investigations showed that several pharmaceutical companies were actively engaged in development of new schistosomicidal drugs, but that one major constraint is the clinical evaluation of promising compounds. The Scientific Working Group on Schistosomiasis therefore accorded high priority to promotion of well-designed, multi-center clinical trials of schistosomicidal drugs.
|
From page 126... ...
"WHO has always had good relations with the pharmaceutical industry, especially at the technical level, where continuous communication exists between those sections of WHO concerned with the control of parasitic diseases and the representatives of industry concerned with the research and development of pharmaceuticals and pesticides." "There is no substitute for the facilities and expertise of industry in the search for new chemotherapeutic agents to control those parasitic diseases which concern the Special Programme. On the other hand, WHO can provide facilities for the clinicopharmacological evaluation of new drugs, thereby demonstrating to industry that an outlet exists for their products, and at the same time minimizing delay between pre-clinical experimentation and clinical use." In pursuance of this policy, collaboration with the industry has been sought in various components of the program, and the program is identifying useful modes of collaborating with industry.
|
From page 127... ...
, whose objectives are to: - strengthen research and training institutions in these countries, so that they can better respond to national and Special Program needs; support training of persons from the tropical countries to help meet national manpower needs; and - contribute to a rapid transfer to the affected countries from the industrialized world of the knowledge, technology, and skills relevant to their health objectives and within the sphere of the Special Program. The institution strengthening and training activities of the Special Program will in return ensure an increasing involvement of scientists from the tropical countries in the Program's research and development.
|
From page 128... ...
In addition to the six diseases of concern to the Special Program, WHO is developing, in close collaboration with UNICEF, a program on Diarrheal Diseases Control with an immediate objective to reduce diarrhea-related mortality and malnutrition by implementation of oral rehydration therapy. Research is an essential component of the program to to improve and develop new tools for better treatment, prevention, and control of these diseases.
|
From page 129... ...
Specific information on the gaps that the Program seeks to fill in the relevant research topics may be obtained on request to the Office of the Director, Special Program for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland.
|
From page 130... ...
What we are talking about today, as we all recognize, is research towards therapeutic agents for diseases that are uniquely tropical In their distribution ... or, at least, endemic in the poor world.
|
From page 131... ...
The organizational framework of current programs in the United States pharmaceutical industry that could have application to the Third World varies widely. Within it, you can find examples of almost every conceivable form of organizational accommodation.
|
From page 132... ...
No doubt a number of companies have reduced their investment in this type of research. Notwithstanding, the survey at least gives an indication of how the work is subdivided within the American component of the pharmaceutical industry.
|
From page 133... ...
Among the fecally-borne diseases, nine companies report work on typhoid and seven on cholera. Thirteen companies report work on infectious diarrheal diseases, and fifteen on intestinal parasitic diseases.
|
From page 134... ...
ALZA is collaborating with WHO in fertility-control work, and Wyeth is also active in this field. In summary, the programs of the American pharmaceutical industry directed to the health problems of the developing world are of long standing.
|
From page 135... ...
has been decreasing over the past decade. Projects have been dropped or cut back in most, if not all, of the laboratories whose directors provided me with information.
|
From page 136... ...
At an early stage of expansion, their commercial relations also extended to the so-called Third World, and they were confronted with the problems indigenous to these developing countries. This situation provided the impetus for certain specific activities of the European pharmaceutical industries of which the following is a short account, with examples drawn from research, therapy, pest control and eradication, health education and training, and finally technical assistance.
|
From page 137... ...
4 Filariasis 4 Trypanosomiasis 3 Leishmaniasis 2 Leprosy 2 Hookworm 2 Family Planning 2 Several European companies have established research organizations in Third World countries, particularly in India. The most representative one is probably the CIBA/GEIGY Research Center in Goregaon near Bombay with a total staff of 260, of which 35 are scientists.
|
From page 138... ...
Execution of the project was entrusted to the Swiss Tropical Institute, which in turn enlisted the assistance of Shell and CIBA as suppliers and technical consultants for the molluscicide, Frescon, and the chemotherapeutic agent, niridazole, respectively. The work included making an accurate epidemiological survey in an area of 25,000 acres, and the medical examination of the entire population of about 1l,000.
|
From page 139... ...
The extent of these training programs is not often realized, and a survey was therefore carried out among 15 European pharmaceutical companies._1,J/ It showed that l,976 nationals of Third World countries were trained by these 15 companies within the past two years. The average is 132 trainees per company, with a predicted increase of 15-20 percent in the years to come.
|
From page 140... ...
Such assistance agreements can only be successful if they are of mutual interest to both parties; namely, the pharmaceutical industry and the developing country. One such example has recently been published.
|
From page 141... ...
These few examples of specific activities of European pharmaceutical companies in developing countries show that efforts made by industry towards development of health care in the Third World are probably greater than usually assumed. Yet more could clearly be done.
|
From page 142... ...
WHO report TDK/WP/76.5 Special Programme for Research and Training in Tropical Diseases, Introduction to the Special Programme 4. Degremont AA: Mangoky Project -- Campaign against schistosomiasis in Lower Mangoky (Madagascar)
|
From page 143... ...
In the United States, support for biomedical research relating to the major infectious diseases of developing countries is funded by components of three cabinet-1evel departments: • Department of Health, Education, and Welfare National Institutes of Health Center for Disease Control Food and Drug Administration/Bureau of Biologics • Department of Defense Army Navy • Department of State Agency for International Development The missions and objectives of these federal agencies are quite different from each other; and the nature and extent of their commitment to studies on diagnosis, treatment, and prevention of infectious and parasitic diseases of tropical and subtropical countries vary accordingly. The National Institutes of Health (NIH)
|
From page 144... ...
Of particular interest was the amount of research support directed toward the six diseases targeted by the WHO Tropical Disease Research Program, and toward the enteric infections of WHO's new Diarrheal Diseases Program (Table 1)
|
From page 146... ...
. One other overseas United States supported tropical disease research laboratory that merits special mention is the Gorgas Memorial Laboratory (GML)
|
From page 147... ...
Of more than 13 million dollars only two million were devoted to chemoprophylaxis and treatment, and more than three quarters of this amount was used for development and testing of antiviral substances. The intramural laboratories of NIH, located on the Bethesda campus in Maryland and at the Rocky Mountain Laboratory in Hamilton, Montana, are very similar to those in academic medical centers or research institutes, in that the investigators, once recruited in a broad general area, are free to select their own research projects.
|
From page 148... ...
O O O o o 0 0 O 0 O O 0 O 0 O O o o O O 0 0 O O O O rH 0 o o o o 0 O 0 O o O 0 O Q CO ft vO 00 0v rH*
|
From page 149... ...
Overall, less than five percent of expenditures for parasitic diseases were related to pharmaceutical agents. While enteritis can be caused by a variety of agents (amebae, Giardia, strongyloides, enterobacteria, etc.)
|
From page 150... ...
O O O O O O O O O O O O O o O 0 O O O O O O 0 O O O O o i -- 1 o o o o o o o o o o o o o Q cd A A *
|
From page 152... ...
Although the Army's program is directed toward reducing or eliminating the deleterious effects of infectious diseases on military populations, the benefits derived also can be utilized by the civilian public health community, especially in developing countries. In addition to the work summarized in Table 8, studies of other diseases of special interest to developing countries were supported, including pseudomonas (burns)
|
From page 154... ...
Total Total l,934,000 424,000 2,358,000 Enteritis 87,000 87,000 Bacterial Meningitis 205,000 24,000 229,000 Gonorrhea 12,000 12,000 Pneumococcal Infections 93,000 59,000 152,000 Tuberculosis 114,000 21l,000 325,000 Mycoses 114,000 114,000 Arboviruses 207,000 207,000 Herpes viruses (all) 59,000 59,000 Rabies 84,000 84,000 Rickettsial Diseases 25,000 25,000 Respiratory viruses Influenza Other 354,000 206,000 24,000 65,000 378,000 27l,000 Viral Hepatitis 374,000 4l,000 415,000 154
|
From page 155... ...
H r~ m vO vO •o u cu u OOO O o o O O OOOO OOO 0 •H CO >, OOO O o o o O OOOO OOO o u CU 4-1 OOO O o o o O OOOO OOO 0 CO a -H f, ^ ft ft M M M * ft ft ft ft ft ft ft A w •H T3 C o o m m O O o o ommo ooo O 0 C 3 m o CM ro o 0 m or~r~in mmo m O i- H OO vO CO ~^ rH CM ON ~^- CNl r- H r -- 1 r^~.
|
From page 156... ...
Intramural laboratories are located at the Naval Medical Research Institute, Bethesda, Maryland, and at overseas Naval Medical Research Units in Egypt and Taiwan, the latter with a detachment in Indonesia. In addition to the data in Table 9, the Navy cited expenditures for pseudomonas ($250,000)
|
From page 157... ...
co O O O O o o o o o o o o 0 W 0 O O 0 o o o o o o o o o CO rH 0 O 0 0 0 0 0 0 O 0 O O o ^ 03 W 4-1 CM O O vO vO m t-~ o O CM o CM v43 CO O oo r-.
|
From page 158... ...
NIAID has been collaborating with the Army on development of an improved vaccine for this tick-borne typhus. Department of State Agency for International Development Under authority of the provisions of Section 104 of the Foreign Assistance Act of 196l, as amended, in relation to disease prevention, AID provides direct support for activities in the principal tropical diseases beyond those which the agency classified as research and development.
|
From page 159... ...
0 o O O o o o o O O o o r-i o o O o o o cd 4-i i-| o r^ *
|
From page 160... ...
CO u| H Z W < ocj CJ E-i |
From page 161... ...
It is noted with some surprise that, collectively, United States agencies spent nearly as much for the seven tropical diseases as for the eleven other selected major disease categories. Among the questions to be addressed are whether a disproportionate amount of national resources is being devoted to basic epidemiological and immunological studies and to vaccine development rather than to the development of new pharmaceuticals, or whether the total investment in tropical diseases research needs to be increased with a special emphasis on expanded drug research.
|
From page 162... ...
FOR DEVELOPMENT OF PHARMACEUTICALS, OTHER AGENTS AND TECHNIQUES FOR OTHER MAJOR DISEASES (FY 1978) Infectious Disease Grand Total All Research a/ Total 33,683 Bacterial Meningitis l,917 Gonorrhea 2,528 Pneumococcal Infections 874 Tuberculosis l,577 Mycoses 2,255 Arboviruses 9,155 Herpes viruses 730 Rabies 309 Rickettsial Diseases 3,349 Respiratory viruses Influenza 5,520 Other l,900 Viral Hepatitis 3,569 a/xlOOO that they are, it is desirable to consider how United States institutions can better utilize resources to expand existing research and training programs and to create new ones that will encourage United States-supported laboratories (l)
|
From page 163... ...
•O M i^3 vO >^ rH 00 rH CU O CO CM CO CO CU • H Z (4 1 Cd J rj O ^J CO H O a 04 H CU O ^ O CN in 0 CM w CO O - |
From page 164... ...
As a complementary initiative, NIAID has invited the scientific community to submit program-project grant applications to establish United States-based Tropical Disease Research Units that will bring together relevant biomedical knowledge in a multidisciplinary attack on the world's major tropical and parasitic diseases. In addition to the new knowledge to be gained, it is anticipated that this program will provide badly needed institutional support in the United States and a career ladder for scientists in this area, including those returning home from ICIDR projects.
|
From page 165... ...
, and State (AID) -- expended an estimated $31.5 million for research and development related to seven major tropical diseases plus an estimated $33.7 million for eleven other disease categories that are also important health problems in developing countries.
|
From page 166... ...
Sarett and Vischer amplify their comments regarding involvement of the academic community by the pharmaceutical industry in the development of new drugs for tropical countries.
|
From page 167... ...
amounted to perhaps three to four percent of the $1.3 billion industry annually spends for research.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.