WHO Considers Patent Pooling, Prizes

Knowledge Ecology International, the U.S.-based non-profit, has pushed a proposal for pooling patents and awarding prizes for developing drugs for neglected diseases onto the World Health Organization agenda. A WHO committee is meeting in Geneva this week to consider that proposal along with other approaches to this thorny problem, according to yesterday's Financial Times (registration required).

The WHO mainstream is leaning towards "cheaper distribution of medicines through measures including more support for generic companies, compulsory licences under World Trade Organisation rules, and transparent, consistent and lower prices for drugs," the FT reports.

A few thoughts: It's important in this debate to disentangle the issues of access to existing drugs and development of new drugs. HIV/AIDS medicine, for instance, has a well-developed market in the advanced industrial nations, and results in billions of dollars of sales. This is adequate to incentivize continued drug company investment in newer medicines, to tackle drug resistant strains of the disease, for instance. Therefore, companies can afford to sell the drugs to the poor countries at the marginal cost of production. It will have no impact on their willingness to invest in research and development.

But the search for a new drug for a disease for which there is no cure, or for which there is no first world market is very different. Here, there are two choices: either you incentivize the private sector to throw significant resources at the problem. Or, you can rely on the non-profit model.

The American Society of Tropical Medicine and Hygiene annual meeting now underway in Philadelphia is filled with sessions about non-profits developing new and better drugs and vaccines for malaria, African sleeping sickness, and river blindness. Many private firms are collaborating with the non-profits like Medicines for Malaria Venture, One World Health and the DNDi (Drugs for Neglected Diseases Initiative, a project of Doctors Without Borders). But, in a new wrinkle, many of these for profit firms are small start-ups like Scynesix of Research Triangle Park, NC, which was started by idealistic refugees from large pharmaceutical firms who devote substantial resources to the neglected disease arena while simultaneously serving as a contract house for Big Pharma's R&D department. In taking money to do research from groups like DNDi (which gets most of its own money from the Bill and Melinda Gates Foundation), these firms agree to turn over the intellectual property they develop at no or extremely low cost to generic manufacturers for eventual production, should the research efforts prove successful.

Prizes and patent pooling are great ideas. But, as things stand now, they are of greater relevance to creating a model for developing affordable medicine in the advanced industrial world than they are to incentivizing drug development for neglected diseases. To the extent that drugs for the diseases of the global poor already exist and are patent protected, strong laws protecting country rights to compulsory licensing ought to be sufficient to ensure that those drugs are offered at affordable prices in the developing world.

On the neglected disease R&D side, the deep pockets of Bill Gates and Warren Buffett have changed the equation. A large amount of money is flowing into neglected disease R&D. Could there be more? Of course. But as I listened to the arguments between sessions (I could only attend for one day, alas), I was pleasantly surprised to hear that the strongest disagreements among scientists came over what targets to pursue, not where to deploy scarce resources.