Pharmaceuticals for Developing Countries Conference Proceedings (1979) / Chapter Skim
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STRENGTHENING INCENTIVES AND OVERCOMING DISINCENTIVES
STRENGTHENING INCENTIVES AND OVERCOMING DISINCENTIVES
Pages 399-433
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From page 400... ...
Such countries usually lack adequate health care delivery systems. There is also a serious time lag between the development of new pharmaceutical products and their readiness for application in 400
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From page 401... ...
DR. IVAN BENNETT addressed the need to coordinate international health policy, given the many similar activities pursued simultaneously by various branches of the United States government.
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From page 402... ...
Previous speakers at this Conference have reminded of the great complexity of the challenge of upgrading health in the tropics -- of the root causes of disease, such as the gross undernutrition brought about by grinding poverty; of the critical need for hygiene education to bring about behavioral change; of the vital need for improved water and waste sanitation; and of the need for vector control. Because the ultimate usefulness of pharmaceuticals in bringing endemic tropical diseases under control will be largely, if not entirely, determined by our ability to cope with these basic needs, those who propose and fund laboratory research need to be careful not to promise more from our research than can realistically be delivered as effective health care.
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From page 403... ...
Our drug laws unquestionably need to be rationalized, but it is imperative that in doing so we pay due heed to the importance of fostering innovation. The direct relevance of the issue to tropical diseases research is that unless innovation is encouraged, the research managers of the pharmaceutical industry will continue to be confronted by -- indeed preoccupied with -- the prospect of a continuing, steep decline in return on research investment.
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From page 404... ...
It has also been encouraging to hear the emphasis previous speakers in this symposium have placed upon the critical importance of developing the necessary field systems to deliver the useful technology we already have. As these efforts progress, and as other mass control programs are successfully mounted, the private sector will no doubt be stimulated to commit a larger portion of its resources to research on tropical diseases.
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From page 405... ...
The United States should encourage industry participation in carefully planned demonstration projects to assess the economic benefits to developing countries that can be achieved by expanded health investments. Finally, this immediate program should include efforts to improve appropriate utilization of pharmaceutical agents.
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From page 406... ...
$3.9 billion in health-related projects such as water supply and sanitation, nutrition, fertility reduction, and others. With WHO, the Bank has cosponsored a Special Program for Research and Training in Tropical Diseases, a global endeavor to find improved tools for controlling six tropical diseases.
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From page 407... ...
Thus, the existence of an adequate market and economic viability are the inescapable conditions, the essential prerequisites of a deepened industry participation in resolving Third World health needs. But if industry involvement is to do more than scratch the surface of this intractable problem, fundamental economic and political decisions must be made to improve the health care environments of the developing countries.
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From page 408... ...
Only with commitment of such additional financial resources can developing nations create and/or extend medical welfare schemes to provide basic care at little or no cost to the citizens who are simply too poor to pay for them. Only with such social security systems will markets for drugs -- specifically those to treat tropical diseases -- evolve.
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From page 409... ...
The WHO insists that the most valuable form of external support to the health needs of the world's poorest countries is to provide additional basic drugs, and that the situation requires extremely urgent international action. WHO has appealed to the pharmaceutical industry to cooperate by providing a limited number of basic medicaments to governments of the MSAC (Most Seriously Affected Countries)
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From page 410... ...
The question now is whether the drug industry can tailor its service functions more fully to specific needs of the public sector, especially to those of the Most Seriously Affected Countries. If the afore-mentioned conditions are fulfilled, private industry may have an incentive to cooperate with national governments in several areas.
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From page 411... ...
Drug companies taking additional initiatives in these directions could provide valuable complements to development programs. These are only a few examples of how industry could cooperate with international agencies to provide basic drugs and vaccines with concomitant services.
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From page 412... ...
The pharmaceutical industry does not view the developing world with eager expectancy. Indeed, the business conditions in large parts of the developing world have deteriorated so alarmingly that these countries have sunk to marginal importance in the world view of the multinational pharmaceutical industry.
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From page 413... ...
Because this is a Conference on "Pharmaceuticals for Developing Countries," DR. WARREN selected examples of these problems from one of the major tropical diseases, schistosomiasis.
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From page 414... ...
The ultimate clinical research is conducted by professors who act as consultants. He suggested continuing the dialogue between members of government, the academic and industrial communities, and the foundation world in order to develop an initiative for continued cooperation so that technical assistance and pharmaceutical products may be supplied to developing countries.
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From page 415... ...
• To define strategies to increase pharmaceutical industry involvement in developing countries. In conclusion, Dr.
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From page 416... ...
An opportunity for collaboration might be development of a contractual relationship between one or more pharmaceutical companies and WHO in a specific program area for public sector drug development. In this case, the major obstacles might be encountered at the transition from research to development.
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From page 417... ...
WHO could easily work out a contractual relationship with pharmaceutical companies for specific research and development programs. The size of the World Bank investment in health, and the commitment of WHO to supporting research in tropical diseases, are impressive.
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From page 419... ...
As President Kennedy said almost 18 years ago, "The health of a nation is the key to its future, to its economic vitality, to the morale and efficiency of its citizens, to its success in achieving its goals." By promoting and improving health in developing countries, we will be helping them to build stronger, more stable societies, which in the long-run can only be to the advantage of our nation and our national goals of world peace and stability. The international health problems we face are immense.
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From page 420... ...
More than 7 million of these childhood deaths are caused by diseases that are amenable to prevention -- pneumonia and diarrhea, which strike children who suffer from protein and calorie-deficient diets. Preventable infectious diseases also account for a great number of deaths, as evidenced by an Agency for International Development study of an African village which found that more than a quarter of all deaths were due to measles, tuberculosis, smallpox, and whooping cough.
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From page 421... ...
Many of the tools needed to control diseases affecting developing countries already exist, developed by our scientists and marketed by our private companies. What makes some of the tragic statistics I cited earlier so shocking is the fact that we know the problems are preventable.
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From page 422... ...
This international health service would then provide research, teaching, and health policy advice to aid developing nations in building the needed health infrastructure and in training their own health care providers. The United States government also must improve its efforts to provide assistance to developing nations who seek to improve health status and health care for their citizens.
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From page 423... ...
All of us would agree with the need for more research, but the facts require us to acknowledge that drug research and development alone will not solve the health problems of the developing world. Data presented at this Conference make it clear that there exist a number of excellent therapies appropriate for treatment and prevention of disease in developing countries.
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From page 424... ...
Infectious diseases are an important health problem in developing nations; but it is clear that malnutrition is a far more serious problem and leads in turn to susceptibility to disease. I suggest that a major effort of government and of concerned individuals and groups gathered here should be directed at finding ways to improve or develop health infrastructures in developing countries and more effectively address the problem of malnutrition.
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From page 425... ...
CLUFF described the Conference as a remarkable achievement, a landmark in the struggle to improve the health of developing nations. The Conference represents an unusual gathering with participation from foreign countries, foundations, international agencies, the United States government, and the pharmaceutical industry.
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From page 426... ...
• Constraints and disincentives act upon the pharmaceutical industry to slow the development of new products for developing countries, and there also are limitations on the academic community for conducting basic research. • The capabilities and interests of the World Health Organization are evolving in an exciting way.
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From page 427... ...
Distinguished Professor Department of Pharmacological Sciences School of Basic Health Sciences State University of New York, Stony Brook PEDRO CUATRECASAS, M.D. Vice President for Research and Development -- Medical Wellcome Research Laboratories Burroughs Wellcome Co.
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From page 428... ...
KOFI EKUE, M.D. Clinical Pharmacology WHO Tropical Diseases Research Center Ndola, Zambia VITTORIO FATTORUSSO, M.D.
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KRAUSE, M.D. Director National Institute of Allergy and Infectious Diseases National Institutes of Health Bethesda, Maryland SANJAYA LALL, Ph.D.
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From page 430... ...
LUCAS, M.D. Director Special Program for Research and Training in Tropical Diseases World Health Organization Geneva, Switzerland TAG MANSOUR, Ph.D.
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From page 431... ...
Director, Department of Chemotherapy Janssen Pharmaceutica Beerse, Belgium MAX P
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From page 432... ...
WARDELL, M.D., Ph.D. Associate Professor Department of Pharmacology and Toxicology, and Medicine University of Rochester School of Medicine and Dentistry Rochester, New York KENNETH WARREN, M.D.
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