Bitter Pills:Medicines & The Third World Poor | Page 59

that only a minority of new products licensed offer any major therapeutic advance.
Out of a total of 484 new drug applications approved over a five year period,
112 were new chemical entities, 106 new formulations and combinations and 253
replicas of existing formulations. According to the FDA, of these 31 represented
an important therapeutic gain, 62 a modest gain and 391 a minimal or non-existent
gain.1401
The majority of these new drugs may therefore do little more than add to the cost
of treatment, which can only be harmful to the poor. The British licensing
authorities concluded from their study of new drugs that innovation is "directed
towards commercial returns rather than therapeutic need". Most new drugs are
not directly relevant to the needs of the Third World poor, but are for' 'conditions
which are common, largely chronic and occur principally in the affluent western
society".' 4 "
Of course the poor could potentially benefit from research into heart disease,
cancers and other chronic and viral diseases common to both developed and
developing countries. Because of this industry commentators argue that "it is
misleading to split off pharmaceutical research oriented towards the health
problems of countries like Britain from that for poor nations". (42) A second
argument advanced is that all research is relevant to the poor because a
breakthrough, for example on immunology techniques for rheumatoid arthritis,
may turn out to be helpful in preventing parasitic diseases. (43)
But there is a wide gap between theoretical benefits and concrete advantages to
the poor. The Third World poor are still not benefiting from essential drug
technology developed in the 1950s and 60s. Since they are expected to contribute
to the cost of this research (in paying higher prices for brand-name drugs) it is
essential to question how far the research actually sets out to benefit people in
developing countries.
In 1976 WHO estimated that total world expenditure on research and development
forxtropical diseases amounted to about £17 million a year - a sum equivalent to
2% of the money spent each year on cancer research alone. |44 '
An article that appeared in the Roche staff journal in 1978 stated: "It has
unfortunately become apparent that in recent years a number of university
institutes and pharmaceutical companies have reduced or even ceased their research
activities in the difficult field of chemotherapy of tropical diseases." (45)
The explanation given is that research costs have increased because of stricter
clinical trials now needed before a drug can be marketed. This makes it unlikely
that profits from sales of tropical medicines will be sufficient to cover the initial
research outlay, given the lack of purchasing power of people in the Third World.
Roche also suggests that with the severing of colonial ties the British and French
now give less priority to tropical medicine.(461
According to Roche: "It is today mainly pharmaceutical companies in Switzerland
(Roche, Ciba-Geigy), Germany (Hoechst, Bayer), France (Rhone-Poulenc) and,
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