Topic: Development
It's all the Guardian's fault for publishing articles that make me go all thinky. In 'Not just for profit, or not just?', Salil Tripathi comments on the difficulties inherent in getting pharmaceutical companies to do research into health issues that are critical for poorer countries, since trying to profit from such drugs is a public relations nightmare for the companies. Tripathi is highly complimentary of Bill Gates's substantial donations to research on anti-malarial drugs, since he and Gates apparently agree that 'what we have to do is create the right incentives for the pharmaceutical companies'. The responsibility for providing these incentives, according to Gates and Tripathi, lies with philanthropists and governments, which can help absorb the risk of research into low-profit areas by providing research funding and/or committing to purchasing profitable quantities of drugs from pharmaceutical companies, and then supplying the drugs to poorer countries.
It's an interesting article, and put me in mind of discussions I had with former co-workers about the difficulties of providing anti-retroviral drugs to poor HIV-affected communities in Africa. The cost of getting the drugs is only part of the problem, and may actually be the most easily solved, using incentive mechanisms such as those described by Tripathi. At least, the cost issue might be solved initially by, say the US government purchasing a large quantity of anti-viral drugs and donating them to a poorer country. But then other challenges start to surface, for example, appropriate provision of the drugs, which have to be taken on a precise schedule because if they're taken incorrectly they lose effectiveness and may encourage drug-resistant forms of HIV to develop. Another difficulty is working out ways to provide sustainable long-term access to anti-viral medications, since grant funding usually has a term of about 5 years, and hopefully, the life of someone who is successfully taking anti-retrovirals will last many years beyond that. So its not just as simple as 'getting the drugs out there'.
I did find it frustrating, though, that the article was more about working around the current system than thinking about ways to change it. There's a sentence that hints at an issue that I think needs further exploration: 'Making a vaccine also takes time, but in general, there is more money to be made in curing diseases rather than in preventing them.' It seems to me that there's a fundamental flaw in a system that disincentives research into vaccines because there's more money to be made in treating diseases than in preventing them.