Monique F. Mrazek

Stimulating pharmaceutical research and development for neglected diseases

New vaccines and drug treatments are needed for tackling the neglected diseases (NDs) of poor countries. These diseases are associated with high levels of mortality and/or morbidity, but lack appropriate vaccines and drug treatments because of bacterial resistance, toxicity, long-treatment protocols, problems with administration or because none are available. Current initiatives directed at research and development (R&D) of NDs are being led predominantly by the governmental, inter-governmental and private not-for-profit sectors implemented by way of public-private partnerships. Push and pull mechanisms targeted at the pharmaceutical industry have also been proposed as another way to stimulate R&D of NDs; however, these should be viewed with some caution. Stimulating R&D for NDs is important as part of a wider long-term public health strategy and must be addressed simultaneously with resolving more immediate problems of access to medicines and health system sustainability in less developed countries.

Pharmaceutical pricing in the developing world: issues of access to medicines

Events during 2001 raised greater awareness in the global community to the problems facing less developed countries in gaining access to essential medicines because they are not affordable. The difference between the price of medicines and income in many developing countries is significant and consequently, price stands as an important barrier to access. Steps taken this year to clarify the flexibility clauses of the Trade-Related Aspects of Intellectual Property Rights Agreement – international discussions on the feasibility of applying a differential pricing mechanism and the Global Fund to Fight AIDS, Tuberculosis and Malaria – have been important advances in the process that seeks to ensure access to affordably priced medicines. This paper reviews recent developments and proposals concerning issues of drug pricing in developing countries and discusses what still needs to be done in order to improve access.