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Science, Technology, and Global Health

Chapter 17

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Chapter 17: Science, Technology, and Global Health

The Need for New Products

Characteristics of new technologies must reflect the following:

Most important target groups are poor people.

Quality of care and injection safety is often low.

Many low- and middle-income countries have poorly organized health systems.

Science and technology have the potential to make major contributions to the development of diagnostics, vaccines, drugs, and medical devices that can help address the highest burdens of disease in low- and middle-income countries.

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The Need for New Products

Diagnostics : specific, sensitive, inexpensive, easy to use, and noninvasive

Drugs : safe, effective, inexpensive, and able to be used for many years without becoming susceptible to resistance

Vaccines : safe, effective, inexpensive, include several antigens, and require only one dose to confer lifelong immunity

Ideally these products would also be easy to transport, heat stable, and not require refrigeration

Needed technological advances are unlikely to come about on their own. Historically, the for-profit sector has been a major developer of diagnostics, vaccines, and drugs but does not believe that the market for these products in the developing world is sufficient to give it an adequate return on its investment. Only a small number of drugs have been developed over the last 20 years to address the main burdens of disease among the poor in low- and middle-income countries.

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Goals of the Grand Challenges in Global Health

Improve vaccines

Create new vaccines

Control insect vectors

Improve nutrition

Limit drug resistance

Cure infection

Measure health status

The Grand Challenges in Glob;a Health Goals include:

Improve vaccines

Create new vaccines

Control insect vectors

Improve nutrition

Limit drug resistance

Cure infection

Measure health status

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The Need for New Products

Gaps in current technology:

Effectiveness of TB vaccine is “limited.”

Drugs for TB, malaria and HIV are susceptible to resistance.

There are no vaccines for HIV, malaria, or any of the NTDs.

HIV drugs can control, but not cure the infection.

Current technology has not yet address the issues of the limited effectiveness of current TB vaccine. Drugs for TB, malaria, and HIV have already developed resistance to the medicines used for these diseases. There is a huge need for vaccines for malaria, HIV and any of the NTDs.

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The Potential of Science and Technology

Sequencing the genome of pathogens could help improve the development of vaccines and drugs and reduce resistance.

Improvements in technology will facilitate the development of new drugs.

New technologies can assist in the design and manufacture of new vaccines.

Genetic modification of plants could lead to more nutritious and disease resistant crops (but is not always welcome).

Scientific progress has led to significant control for so many diseases. Sequencing the genome of pathogens could help improve the development of vaccines and drugs and reduce resistance. So far sequencing has been done for 100 microbial species. Improvements in technology will facilitate the development of new drugs; can assist in the design and manufacture of new vaccines.

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Constraints to Applying Science and Technology to Global Health Problems

For-profit sector does not believe it could make a sufficient profit from products for low- and middle-income countries.

Costs of research and development on new products are very high.

Number of firms engaged in vaccine production is small .

There are some several constrains to the development of desired products. First, most of the research and development on new drugs, vaccines and diagnostics is carried out in the for profit sector and For-profit sector does not believe it could make a sufficient profit from products for low- and middle-income countries. Second, Costs of research and development on new products are very high. Given these costs, profit making firms are more willingly to produce “ Blockbuster” drug against diseases like high cholesterol that could be sold in high income countries. In addition to all these vaccine markets carry some particular constrains. The cost is considerably high in addition to the governmental regulations that further reduce the market. The number of firms engage in vaccine production worldwide are also very few and their production capacity is limited.

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Enhancing New Product Development

Means of reducing the risk of developing new products enough that the for-profit sector might be interested:

Push Mechanisms : reduce risk and cost of investments

Pull Mechanisms : assure a future return in the event that a product is produced

Overcoming market failures and encouraging the development of desired products will probably require a series of measures. Some of these can be “push mechanisms,” which lower the cost of research and development for the private sector.

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Push/Pull Mechanism for Product Development

Adapted from Glass S. N., Batson, A., Levine, R. Issues Paper: Accelerating New Vaccines. Geneva: Global Alliance for Vaccines and Immunizations; 2008.

Other efforts can be “pull mechanisms,” which are intended to help assure a satisfactory return to investors in the event that a product is produced.

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Some Ideal Characteristics of Diagnostics, Vaccines, Drugs and Delivery Devices

Some of the ideal characteristics that are desirable in diagnosis, vaccines, drugs, and delivery devices are described in this table.

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Product Development Partnerships

Public-private partnerships created to overcome limitations of the private sector.

Many of these public-private partnerships are product development partnerships (PDPs).

Examples of PDPs include Aeras, Malaria Vaccine Initiative, International Partnership for Microbicides and the International AIDS Vaccine Initiative.

Considerable hope for new product development is being placed in public-private product development partnerships, such as the International AIDS Vaccine Initiative, the Global Alliance for TB Drug Development, and the Medicines for Malaria Venture

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