Nonprofits Work With Drug Firms to Treat Diseases in Third World

February 7, 2004

Victoria Hale is chief executive of the ultimate oxymoron: a nonprofit drug company.

From her office in San Francisco's financial district, she hopes to wipe out diseases that plague developing nations but are ignored by Western drug companies for lack of profit potential.

Hale's prescription is to gain marketing rights to promising drug candidates that are owned by drug companies but sit undeveloped in labs.

The drug industry spent $32 billion on research and development in 2002, which yielded millions of possible drug compounds, many of which could fight diseases endemic to the developing world.

But with profit pressures, the companies largely focus on lucrative therapies for widespread diseases such as cancer and diabetes and distinctly Western worries such as penile dysfunction and baldness.

There's simply no money in fighting the "black fever" in India or the exotic Chagas' disease in Latin America.

"Every company discovers many, many more candidates than they can pursue," Hale said. "These are clear opportunities that just sit and collect dust."

So the former government drug regulator and Genentech Inc. scientist launched the Institute for OneWorld Health three years ago, when she turned 40.

"Looking in the mirror, I asked, 'Let's be honest, what have you really done?' " she said.

OneWorld is gobbling up rights to drug candidates sitting on companies' shelves that could treat illnesses caused by parasites, such as kala azar — Hindi for "black fever" — and infant diarrhea, a leading cause of infant mortality around the world.

"When she first told me of her plans, I didn't believe it would work," said Alan Taylor, an executive with biotech firm Gilead Sciences Inc. and a OneWorld advisor. "But OneWorld has created a buzz throughout the industry."

Several similar private-public partnerships have emerged in recent years, including Swiss giant Novartis' nonprofit Institute for Tropical Diseases and the New York-based Global Alliance for Tuberculosis Drug Development.

That's a significant departure from the historically antagonistic stance nonprofit groups and corporate America have taken toward each other in addressing global health issues.

"We are in the midst of a huge change in how these groups can work together," said Dr. Regina Rabinovich, infectious diseases director of the Bill and Melinda Gates Foundation, which funds many partnerships. "It's a global experiment, and there will be some blind alleys. But there are some credible groups that are now pushing products forward."

The drug and biotechnology industries, notoriously secretive about their patent portfolios, are starting to realize the altruistic and public relations benefits such arrangements can have. Companies also can get tax write-offs if they donate patents.

Recently, Chiron Corp. donated most commercial rights to the drug compound PA-824 to the tuberculosis alliance. The drug was being developed to treat cancer but was found to be effective against tuberculosis in preliminary experiments.

"Chiron doesn't have any reason to move this forward, and our goal is to get that drug developed," Alliance spokeswoman Gwynne Oosterbaan said. "Chiron has every incentive to hand it over to us."

Oosterbaan said the Alliance hoped to start human experiments sometime next year.

Two years ago, gene-mapping pioneer Celera Genomics Group donated the rights to a compound to treat Chagas' disease, a Latin American affliction transmitted by an insect dubbed the "assassin bug" that causes heart failure. Some 18 million people, mostly low-income rural residents, are infected with the disease and 45,000 die annually.

"It made sense for us to donate it," Celera spokesman Rob Bennett said of the compound, known as K-777. "They were well-positioned to move it forward and we weren't."

More recently, armed with $10 million from the Gates Foundation, OneWorld started a large and pivotal human experiment in Bihar, India, that is testing a drug to treat kala azar.

Known medically as leishmaniasis, kala azar is carried by the sand fly and kills an estimated 200,000 people annually. About 12 million people are thought to be infected, mostly in India.

The milder form of the disease is characterized by skin sores and has been dubbed "Baghdad boil" by U.S. soldiers in Iraq. About 150 U.S. soldiers have been infected there, according to newspaper reports.

Symptoms of more severe forms of the disease include fever, weight loss, anemia and swelling of the spleen and liver.

The compound being tested, paromomycin, was developed by a company owned by Pfizer Inc., which donated it to the World Health Organization. The drug showed promise in earlier experiments, but WHO shelved it because of budget constraints. Now OneWorld has taken over.

"If this experiment works and this trial becomes successful, I think it will attract the attention of many more companies and trust funds," said Dr. Shyam Sundar, director of the Kala-Azar Free and Charitable Medical Clinic in Bihar.

"Everyone is watching to see if this can actually work," Sundar said.