Tropical Medicine and International Health volume 6 no 11 pp 945±951 november 2001

Drugs for neglected diseases: a failure of the market and a public health failure?
Patrice Trouiller1, Els Torreele2, Piero Olliaro3, Nick White4, Susan Foster5, Â Dyann Wirth6 and Bernard Pecoul7
1 2 3 4 5 6 7 Centre Hospitalier Universitaire de Grenoble, Grenoble, France Department of Immunology, Parasitology and Ultrastructure, VIB-Free University Brussels, St-Genesius Rode, Belgium TDR, World Health Organization, Geneva, Switzerland Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand Boston University School of Public Health, Boston, MA, USA Harvard School of Public Health, Boston, MA, USA Medecins Sans Frontieres, Access to Essential Medicines, Geneva, Switzerland  Á

Summary

Infectious diseases cause the suffering of hundreds of millions of people, especially in tropical and subtropical areas. Effective, affordable and easy-to-use medicines to ®ght these diseases are nearly absent. Although science and technology are suf®ciently advanced to provide the necessary medicines, very few new drugs are being developed. However, drug discovery is not the major bottleneck. Today's R&Dbased pharmaceutical industry is reluctant to invest in the development of drugs to treat the major diseases of the poor, because return on investment cannot be guaranteed. With national and international politics supporting a free market-based world order, ®nancial opportunities rather than global health needs guide the direction of new drug development. Can we accept that the dearth of effective drugs for diseases that mainly affect the poor is simply the sad but inevitable consequence of a global market economy? Or is it a massive public health failure, and a failure to direct economic development for the bene®t of society? An urgent reorientation of priorities in drug development and health policy is needed. The pharmaceutical industry must contribute to this effort, but