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Medications are used to diagnose, prevent, and treat many diseases. However, some diseases are specific to poor patients in the developing world and may not be researched as a result. These are called neglected diseases. This is because most research is market driven and is pursued if there is a high market value for that product. Governments often rely on the pharmaceutical companies to conduct this research. Relying on this model has resulted in very limited research done to benefit developing countries and their poor populations. What causes this lack of research?

Type 1

Type I diseases represent less than 3.0/100,000 persons, i.e., the disease burden is approximately the same and no more than 3 times higher in low/middle income countries than high income countries…with large numbers of vulnerable populations in both rich and poor countries (WHO, 2012, pp. 1-2). Diseases occur in both rich and poor countries, such as diabetes, hypertension, and pneumonia. Given the potential for pharmaceutical companies to make large profits from sales in the more affluent countries, there is substantial market-driven research and development related to type one diseases.

Type 2

Type II diseases represent between 3.0 & 35.0/100,000 persons. The disease burden is at a rate that is between 3.0–35.0 times higher in low/middle income countries than in a high-income country...incident in both rich and poor countries, but with a substantial proportion of the cases in poor countries (WHO, 2012, pp. 1-2). Diseases that occur predominantly but not exclusively in Africa, South America, and Southeast Asia, such as tuberculosis and malaria, with some market-driven research and development but not enough or not suitable in these low/middle income countries.

Type 3

Type III represent > 35.0/100,000 persons. The disease burden is at a rate that is at least 35.0 times and up to more than a thousand times higher than is recorded in high income countries… are those that are overwhelmingly or exclusively incident in developing countries (WHO, 2012, pp. 1-2). Diseases that are virtually all in Africa, South America, and Southeast Asia, such as the classic “tropical diseases of poverty” (Hotez, 2011), including sleeping sickness, leprosy, and worm infestations, with no market-driven research and development.

The pharmaceutical companies make the research and development choices as to what research will be funded since they will be doing the work and taking the risks to develop the medications. This risk is compensated by charging sufficiently high prices to both governments and patients to recover or make a return on their investment and maximize their profits. This innovation model for the creation of new medications is motivated by the profits that will return the cost of the investment as well as additional profits that will be realized from the results of the research. The research is then patented so the owner has the exclusive right to produce the medication. The interest in creating policy to incentivize pharmaceutical research is still struggling to accomplish that goal.

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2. Market-Based Solutions

arket-based solutions that are used to create new medications for neglected diseases depend on procurement funds, innovation prizes, and commitments in advance of the market (Brown, Yamey, & Wamala, 2014). Profits either push or pull the pharmaceutical industry in these innovations and the solutions are trade secrets under patent until it expires. The medications produced under a market-based solution are based on the principle of making a profit on the products sold. It is believed that this system is the most efficient, since the supply of product is based on the demand for it. If there is no demand, the product is not produced.

The pull and push incentives have two different sources of funding. Pull incentives are consumer-funded and push incentives are government-funded. Legislation provides a 10-year guarantee to the pharmaceutical company that they alone may benefit from the sale of the drug treating a neglected or orphan disease. This is not a big motivation though since the drugs would not be sold in high-volume markets located in the United States or Europe, as the market is usually in poorer countries. The pull incentive operates on research and development grant programs. Some governments can provide tax credits up to 50% for research and development expenses. There is another market-based solution and that is to create a public market by using public and philanthropic funds to create a pull incentive to gain industry research and development.

The pharmaceutical industry in the Kingdom is one of the fastest growing areas in the economy. However, counterfeit medicines are sold in pharmacies according to Dr. Al-Tubaiqi (Saudi Gazette, 2015). Several solutions have been suggested to protect the population of Saudi Arabia from the risk of counterfeits when they need medications. Radio frequency identification (RFID) allows the tracking of a medication through the supply chain ensuring its authenticity beginning at the manufacturer to the point where the medication is dispensed.

Microtagging is another identification technology that are non-visible edible bar codes that allows the tracking of the medicine and the batch that it came from. This barcode is read using a spectrometer-based device once they reach their destination. Nanoscale encryption is a way to emboss encrypted information codes to identify and authenticate the medication at 200 nanometers. These codes are read with an electron microscope and decryption software (Agaj, 2017).

Ending Neglected Diseases - The Story of the END Fund

https://youtu.be/pbscuLm29RI

3. Non-Market Solutions

Non-market-based solutions understand that neglected diseases are not a market that would encourage investment and research since there are no real profits to be realized. This market is not linked to profit so there is no financial incentive for pharmaceutical companies to participate. The funding must come from philanthropic organizations and public funding.

This means that research and development is funded by the public, but the positive side of this strategy is that the drugs are sold nearly at cost. Since the intellectual property is virtually valueless, this also allows generic companies to manufacture the drugs at lower prices. The non-market approach has generated 80% of new neglected disease drugs and vaccines registered sin 2000 (Policy Cures, 2012).