Research of neglected diseases gets shot in arm

April 27, 2005

At a laboratory near Madrid, where the air pressure is reduced to prevent air leaks, corporate scientists in protective suits are reviving interest in some of the world's most widespread and lethal diseases.

The staff handling dangerous microbes at GlaxoSmithKline's Drugs for the Developing World centre, in Tres Cantos are participants in pioneering public-private partnerships created since the turn of the millennium by an unusual combination of pharmaceutical companies, philanthropists and governments.

While neglected diseases such as malaria and tuberculosis infect millions of people every year and kill hundreds of thousands, their concentration in low-income countries that have little ability to pay means the drugs industry has long turned its research efforts to more lucrative ailments in the developed world.

That is starting to change. "In 1999, only 1 per cent of new drugs developed were for neglected diseases," says Simon Croft, research director for the Drugs for Neglected Diseases Initiative (DNDi), an organisation working to find treatments for malaria and the tropical diseases trypanosomiasis (sleeping sickness) and leishmaniasis. "Today, the problem is still big but the omens are good. There is new hope."

The most recent drugs for tuberculosis were developed in the 1960s. Researchers are still struggling to fill gaps in their understanding of the disease, let alone bring better medicines to market.

But since its creation in 2000, the TB Alliance, a non-profit group in New York, has helped mobilise more than a dozen projects for new treatments. It is working with GSK, has signed a letter of intent with Novartis, and is in discussions with AstraZeneca.

The companies have expertise and often under-studied chemical compounds that could form the basis of new drugs. The TB Alliance has offered a new impetus.

Mel Spigelman, director of research, says: "It's a win-win situation, with us providing critical mass, expertise and a holistic approach." A similar model has worked for the Medicines for Malaria Venture (MMV), which, since 1999, has co-operated with companies such as GSK, Novartis, Roche and Ranbaxy, of India, forging links between them and academic institutions.

Sanofi-Aventis this month agreed to produce an affordable new combination malaria therapy with DNDi.

This year, the Institute for OneWorld Health in San Francisco, a self-styled non-profit drug company, hopes to launch a treatment for leishmaniasis in India.

One reason for such recent activity is a change of heart towards corporate social responsibility by the drug companies.

"It has a lot to do with our Swedish shareholders, who have a strong sense of social commitment and ask questions at the annual general meeting," says Aileen Allsop, from the Discovery division of AstraZeneca, formed by the merger of Astra, of Sweden, and Zeneca, of the UK, in 1999.

By re-focusing its Bangalore Discovery centre entirely on non-profit tuberculosis research, Astra-Zeneca found a new use for an operation previously judged unproductive - and which might not otherwise have survived the merger.

The same applies to GSK's Tres Cantos centre. Its future had been questioned after its anti-bacterial and anti-infective research programmes were closed down because of successive mergers in creating GSK. While both companies, and Novartis, with its newly opened Singapore tropical disease institute, are doing more than many of their rivals, one researcher estimates that their neglected disease centres cost only a few million dollars a year each to run.

"That's a rounding error for a big pharmaceuticals group," he says.

Philanthropy, above all from the Bill and Melinda Gates Foundation, has made a big difference, allowing beneficiaries to approach pharmaceutical groups with money and ideas instead of simply pleas for funding. Two such recipients, MMV and the TB Alliance, jointly fund half of Tres Cantos's 100 scientists, with GSK paying the rest.

Tax and legal issues aside, such money could arguably be offered directly to the big companies. But Jon Pender, from GSK, says that the partnerships "provide integrity, transparency, a portfolio approach and focus" that augment a corporate approach.

Nevertheless, the new interest in neglected diseases is in its infancy.

Paul Herrling, head of corporate research at Novartis, warns that even if new drugs emerge from the laboratory, "the crunch will come" in the cost and regulatory issues surrounding clinical trials and in the distribution of drugs. Much more money, patience, political commitment and luck will be required.