Designing Strategies for Neglected Disease Research

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Designing Strategies for Neglected Disease
Research

• Lecture 1A
• Amy Kapczynski
• UC Berkeley Law

From MSF Campaign for Access to Essential
Medicines, AccessNews (No. 18, Jan 2009)
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Female Life Expectancy at Birth (2006)
Japan - 86
Sierra Leone - 42
From http//www.globalhealthfacts.org/ and WHO,
World Health Statistics 2008
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From The Lancet Infectious Diseases Vol 2 July
2002
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Health System Building Blocks
From WHO, Everybodys Business Strengthening
Health Systems to Improve Health Outcomes, WHOs
Framework for Action (2007)
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New Chemical Entities Approved,1975-1999
Troullier et al, Drug Development for Neglected
Diseases, 359 Lancet 2188 (2002)
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From Nwaka Hudson, Innovative Lead Discovery
Strategies for Tropical Diseases, Nature Reviews
Drug Discovery 5, 941-955 (November 2006)
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Worldwide Pharmaceutical Market by Region, 2005
CIPIH Report, data provided by IMS Health
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Overseas Development Assistance for Health,
2001-2006
From Global Forum for Health Research, Monitoring
Financial Flows (2008)
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WHO Neglected Tropical Diseases
Buruli Ulcer Chagas disease (American
trypanosomiasis) Dengue/dengue haemorrhagic
fever Dracunculiasis (guinea-worm disease)
Fascioliasis Human African trypanosomiasis
Leishmaniasis Leprosy Lymphatic
filariasis Neglected zoonotic diseases
Onchocerciasis Schistosomiasis Soil
transmitted helminthiasis Trachoma Yaws
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Adult mortality rates by major cause group and
region, 2004
Slide taken from http//www.who.int/entity/healthi
nfo/global_burden_disease/GBD2004ReportFigures.ppt
, data from WHO Global Burden of Disease Report
2004
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Type I, II and III Diseases

• Type I large burdens of disease in rich and poor
  countries
• Hepatitis B, measles
• Cardiovascular diseases, tobacco-related
  illnesses
• Type II majority of disease burden in poor
  countries
• HIV/AIDS, TB
• Type III overwhelmingly / exclusively in poor
  countries
• Sleeping sickness, river blindness, buruli ulcer,
  Chagas, leprosy, dengue, leishmaniasis, guinea
  worm

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From Yach et al., The Global Burden of Chronic
Diseases, 291 JAMA 2616 (2004).
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Projected deaths by cause and income, 2004 to
2030
Intentional injuries
Other unintentional
Road traffic accidents
Other NCD
Cancers
Cardiovascular disease
Maternal/perinatal/nutritional
Other infectious
HIV, TB, malaria
Slide taken from http//www.who.int/entity/healthi
nfo/global_burden_disease/GBD2004ReportFigures.ppt
, data from WHO Global Burden of Disease Report
2004
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Why act against neglected diseases? (GFHR, MCH)
Health is a key determinant of welfare -- ill
health negatively affects income, education --
each year 100 million families impoverished b/c
of health spending -- health second biggest
expenditure after food - has implications for
other basic needs (nutrition, housing)
Development -- huge economic returns to
investment in health - estimated returns of 3 to
10 for every 1 invested (compared to 1.2-1.5
in other sectors of economy)
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Why act against neglected diseases? (Fisher
Syed)
National self-interest (externalities, national
security, immigration, trade)
Historical equity (colonialism, wealth / labor
extraction, client regimes / institutions, terms
of trade - including contemporary)
Social utility (RD directed to do greatest good
for greatest number, DALYs)
Distributive justice (equal concern and respect
for persons, human capabilities, right to health)
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