Filling the Gaps

The market-driven system, which relies on patents and protected pricing to finance medical innovation, leaves treatment gaps in Europe and the developing world. So says a report commissioned by the Dutch government on behalf of the World Health Organization. The report, "Priority Medicines for Europe and the World," identifies 17 conditions for which treatment is inadequate or nonexistent, and it maps out strategies for filling the gaps, using government-funded research, public-private partnerships, and adjustments to the incentives offered to industry. (The full report is available online at mednet3.who.int.prioritymeds/.)

Heading the list are antibiotic-resistant bacterial infections and pandemic influenza—which WHO believes have the potential to kill millions around the world. The authors identify conditions for which better formulations are needed (diabetes, for example, and depression in the elderly and adolescents) and two for which biomarkers are absent (Alzheimer's disease and osteoarthritis). It calls for more basic and applied research on treatments for cancer and acute stroke, and lists several areas that disproportionately affect the developing world and receive insufficient research because they are unlikely to generate large profits. These include malaria, tuberculosis, and sleeping sickness, as well as a vaccine for HIV. Finally, the report identifies diseases for which prevention is particularly effective, such as chronic obstructive pulmonary disease (COPD) and diseases caused by alcohol abuse.

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