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 The worst-ever Ebola outbreak, which has already killed at least
2,296 people in West Africa, has triggered a scramble to develop the
first drug or vaccine for a deadly disease that was discovered
nearly 40 years ago in the forests of central Africa.
But Ebola is not the only tropical disease without a cure, and many
other infections for which effective treatments are lacking or not
widely available afflict far larger populations.
The absence of economic incentives for drugmakers to develop and
supply medicines for neglected tropical diseases (NTDs) has long
been highlighted by health campaigners, but it rarely gets on to the
political radar in the West.
Out of 336 brand-new drugs approved for all diseases between 2000
and 2011, only four, or 1 percent, were for such conditions - three
for malaria and one for diarrhoeal disease, according to a study
published in The Lancet journal last year.
The pipeline is also thin, with just 1 percent of clinical trials
under way around the world focused on NTDs such as rabies, sleeping
sickness, leishmaniasis, elephantiasis, trachoma and other parasites
that maim, blind and kill millions.
The Ebola outbreak now ravaging West African communities could
change those statistics as biotech firms and pharmaceutical
companies, spurred on by government funding, fast-track drug
development programs.
“This will draw more attention to Ebola and (neglected) diseases
like it, because this is the first time we’ve seen an outbreak of
this magnitude,” said Chris Elias, head of global development for
the Bill & Melinda Gates Foundation, which has just pledged $50
million to fight the epidemic.
It is not that scientists don't have ideas for new drugs and
vaccines but, until now, they have lacked the industry buy-in needed
to take experimental products through the costly late stages of
clinical development.
BIOWEAPON FEARS IN WEST
Significantly, much of the funding for Ebola has been driven not by
concerns about sporadic outbreaks in Africa but by a biodefence
strategy in the United States and other countries fearful of the
potential to weaponize the virus.
There are signs that the threat from neglected diseases is now
moving up the agenda but efforts remain woefully inadequate,
according to Jean-Herve Bradol, a former president of Medecins Sans
Frontieres who leads research at the group's CRASH Foundation
research center and who co-wrote the Lancet paper.
"Unfortunately, we need a major frightening epidemic in a highly
developed country to make world leaders understand that they cannot
keep on neglecting these infectious diseases,” he told Reuters.
“The neglect has been so long-lasting that if we want to catch up we
need much more than a slight improvement.”
Bradol said clinical tests on Ebola vaccines - now under way for a
shot from GlaxoSmithKline and planned for others from NewLink
Genetics and Johnson & Johnson - could have been conducted on
healthy volunteers far earlier.
But Ebola has simply not been a priority.
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Past outbreaks, while frightening, have killed relatively few people
and there have been no recorded Ebola deaths in 22 out of the last
38 years. The disease does not even figure on list of 17 priority
NTDs drawn up by the World Health Organization (WHO) in 2012 that
together threaten more than 1 billion people worldwide.
WHO Assistant Director-General Marie-Paule Kieny, a leader in
today's Ebola battle, says there has simply not been enough
investment in the development of drugs against multiple diseases
affecting poor people in poor countries.
DENGUE, MALARIA VACCINES
In a bid to break the logjam, 13 pharmaceutical companies joined the
WHO and the Bill & Melinda Gates Foundation at the start of 2012 in
a pledge to eradicate or control 10 NTDs by 2020, in part by
increased donations of medicines.
There has also been a modest increase in NTD research funding, up 3
percent in 2012 to $3.2 billion after several years of decline,
according to the latest annual survey from the group Global Funding
of Innovation for Neglected Diseases.
Contributions from governments and charities dominate, with
drugmakers chipping in just $527 million - a tiny part of the
industry's overall $70 billion research spend - and most of that
industry money is targeted at diseases like dengue, malaria and
tuberculosis with some commercial upside in the West.
Among individual firms, GSK and Sanofi lead the pack, each investing
more than $100 million a year on tropical disease research,
according to a Deutsche Bank analysis.
Both companies are developing vaccines for mosquito-borne diseases -
malaria and dengue, respectively - that could be launched late next
year.
GSK's malaria shot will be sold on a not-for-profit basis but
Sanofi's dengue vaccine is potentially a commercial blockbuster,
with the company predicting that annual sales could exceed 1 billion
euros ($1.3 billion).
It is a sign that some companies at least are taking a long view
when it comes to assessing the customers of the future.
"The tropics are home to 40 percent - and rising - of the world's
population," Deutsche Bank said. "Economic growth in the decades
ahead will inevitably see many of these nations becoming
increasingly important commercially to the pharma industry."
(1 US dollar = 0.7744 euro)
(Additional reporting by Kate Kelland; editing by Anna Willard)
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