'Big pharma' urged to develop treatments for global health

More drug companies are being urged to prioritise treatments for people in the developing world after a new report has shown that just a handful of the world's major firms are making the majority of global health products.

A review of pharmaceutical companies’ effortsto improve access to medicines among people in low and middle income countries has found that just five firms  – GSK, Johnson & Johnson (J&J), Sanofi, Merck and Novartis – are conducting two thirds of the research and development into these diseases.

UK pharmaceutical giant GSK has by far the most products in the pipeline, with 58, followed by J&J with 41 and Sanofi with 33. But the report warned that if any of them withdrew from the market the world's most vulnerable communities could be left without access to vital drugs. 

Danny Edwards, research lead at the Access to Medicine Foundation, said: “It’s great that companies are focusing their efforts on global health but there’s a danger that if any of them decided to pull away from this it would have a big impact. We would like to see more companies come to the table.”

Katy Athersuch, policy adviser for the charity Médecins Sans Frontières' access campaign, said it was a "precarious situation" to have just five companies investing in the majority of research and development. 

But she added that while it may appear that companies were doing well, they were often aided by large amounts of public money. 

J&J, which was ranked third overall on the index, has recently launched bedaquiline, a new class of antibiotic set to revolutionise the treatment of multi-drug resistant tuberculosis. 

"If you look at the story of bedaquiline a huge amount of public funds has subsidised its development. There are 18 high burden countries where the drug is still not licensed and many national TB programmes are not switching to using it because the costs are so high," she said

“We call on J&J to cut the price, and to license this medicine to the Medicines Patent Pool so generic producers can start to supply at a lower cost.”

The report also found that few major drug companies were investing in emerging infectious diseases – many of which the World Health Organization has warned could spark the next major global epidemic. Instead they are investing in the major killers such as malaria, HIV/Aids and TB.

WHO's list of blueprint priority diseases – first published in 2015 – was updated earlier this year and Middle East respiratory syndrome (MERS), which has killed 800 people since 2012 and for which none of the major firms are developing medicines, vaccines or diagnostics in development.

And there is nothing in the pharmaceutical pipeline for Nipah virus, which killed nearly 20 people in India earlier this year or Lassa, an outbreak of which killed more than 100 people in Nigeria in the spring.

Mr Edwards said: “What we find is a strong association between companies being active in an area and well defined global health priorities and funders. HIV and TB are diseases that get a lot of focus because there’s a strong focus from the global health community."

Jayasree Iyer, executive director of the foundation, called for more donor funding into these ignored diseases to “derisk” them for pharmaceutical companies.

“All these diseases have significant market failure and they disproportionately affect the poor. We need donor funding to create a mechanism so there is a concentration of resources into these areas,” she said.

Other diseases which are largely being ignored by the major pharmaceutical firms include cholera, for which there is just one vaccine in development, despite the fact that the world’s largest ever cholera outbreak is taking place in Yemen, with more than a million suspected cases since April 2017.

Ms Iyer called for more initiatives such as the Coalition for Epidemic Preparedness Innovations, a public-private partnership led by the UK's Wellcome Trust, which is at the very early stages of funding the development of vaccines for Nipah and MERS.

GSK topped the overall list of pharmaceutical companies in terms of providing access, followed by Novartis, Johnson & Johnson and Merck. Bottom of the list of 20 global companies was the US firm Eli Lilly. 

Phil Thomson, president of global affairs at GSK, said he was pleased the company had improved its score on the index and come top once again.  

He said: "Improving the health of people in developing countries is a shared responsibility and we also welcome the achievements of other companies highlighted by the index. We need a much stronger focus on collaboration both within our industry and across sectors."

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