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OUT OF ORDER: Taking a global view
January 2014
by Randall C. Willis  |  Email the author
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As DDNews enters its tenth year of publication, another organization has just celebrated its decadal anniversary: the Drugs for Neglected Diseases initiative (DNDi).
 
For the uninitiated and those who have not read the countless pages in DDNews articles past, the vision of DNDi is “to improve the quality of life and the health of people suffering from neglected diseases by using an alternative model to develop drugs for these diseases, and by ensuring equitable access to new and field-relevant health tools.”
 
In short, the organization has targeted a number of infectious conditions (e.g., malaria, HIV, Chagas, leishmaniasis) that significantly impact the developing world and yet have largely gone un- or under-treated. Now, some of you may look at that list and think I’m crazy for listing malaria and HIV as untreated after the decades of research and drug development that have gone into these two conditions in particular. That’s where the latter part of the vision comes into it.
 
As I and several others have harped over several years, the needs and practical realities of patients in the developing world are significantly different from those in the developed world. While that statement may sound patently obvious and therefore ridiculous, it has significant implications when it comes to delivering useful and sustainable healthcare.
 
For us, disease diagnosis is about making an appointment with your physician. For people living in remote villages, it can be about having the good fortune of a healthcare organization moving through your region at the right time.
 
For us, ensuring our medications are kept in ambient conditions means NOT using your bathroom medicine cabinet. For those in the developing world, it is about therapeutics that become compromised by heat and humidity too quickly to be of long-term use.
 
For us, access to healthcare is about medical insurance and a decent income. For many people of the world, the costs of healthcare are weighed against the costs of not starving.
 
DNDi and organizations like it recognized this and said, “Let’s put the patient and their practical living conditions at the center of what we do.”
 
To accomplish their goals, DNDi established itself as a partnership hub—it has no research facilities of its own—to leverage old and new learnings in the repurposing of existing drugs and the development of new ones to meet specific needs.
 
According to a report it released in November, the past decade has resulted in more than 350 collaborations spanning 43 countries, with representation from both academia and corporate pharma and biotech. The organization has also raised approximately €277 million from various government and support agencies, about half of which has gone into R&D.
 
The result to date has been six improved treatments and 12 new chemical entities in its pipeline. The poster child for the former category is a fixed-dose combination therapy (ASAQ) for malaria that started development in 2003 and was delivered in 2007. With an R&D cost of just €12 million (millions, not billions), more than 250 million treatments have been distributed throughout Africa by Sanofi since 2007. The other, more recent programs have similar budgets and tens of thousands of treatments have been distributed to date.
 
So aside from being a nice humanitarian effort, what does this have to do with the developed world?
 
Well, would you like to increase the size of your global markets tenfold or more?
 
I appreciate that I am writing for a select audience who work in and around the pharmaceutical industry, so to some extent I am preaching to the converted, but these types of efforts are as much about global economics as they are about human health and well-being.
 
As those of us in the developed world invest our knowledge and resources in the developing world, finding ways to improve the lives and health of billions of people, we raise the economic status of these regions. And one of the first things that happens when people live in better economic conditions is they become consumers. I give you the explosive buying power of countries like Brazil and India that were once considered commercial backwaters, resources to be tapped rather than invested in, and yet are now behemoths on the international economic stage.
 
Now imagine a consumer market throughout Southeast Asia that can focus on telecommunications and transportation rather than tainted drinking water and fears of Dengue fever. Or vast tracts of Sub-Saharan Africa where grandparents won’t have to be the sole caregivers of HIV-orphaned children.
 
Maybe this is just the holidays talking (I am writing this a week before Christmas), but I think efforts like that by DNDi show us how making a humanitarian effort can go a long way to feeding not just our souls but also our bellies (with something other than turkey).
 
All the best to each of you in 2014 and to the world at large.
 

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