The irony of the surname of 19th century Scottish author and reformer Samuel Smiles resonates within the pharmaceutical industry in its efforts to bring disease education and prevention to a huge and diverse population. Smiles stated, “Hope is the companion of power, and mother of success, for who so hopes strongly has within him the gift of miracles” – which begets smiles. Pharma has hope for humanity through drug development/dissemination, strategy interventions and funding for both ancient diseases of poverty in developing nations and non-communicable illnesses in developed nations.
Ancient Diseases of Poverty in Developing Nations
Background. Unclean water systems, degenerative housing and unsuitable waste disposal in poverty-stricken developing countries are contributing factors to longstanding tropical diseases. The aim of the World Health Organization (WHO) is to eradicate the following nine tropical diseases within the next four years: Chagas disease, Dengue, Dracunculiasis (guinea-worm disease), Leprosy, Leishmaniasis, Lymphatic filariasis, Malaria, Onchocerciasis and Schistosomiasis. The great disparity between 90% of diseases being dependent on only 10% of global medical research mandates a call to action to produce better medicines and vaccines. The 90/10 gap is even more disconcerting when considering that over 1 million people succumb to Malaria each year because new drugs to combat the disease lose their effectiveness in a relatively short period of time due to the parasite quickly adapting itself to the newly created drug.
Strategy interventions. Vaccinations, preventive chemotherapy and concentrated disease management will control and eliminate these targeted diseases. One-time dosages of high quality and safe medications are on tap to be administered as treatment for these nine diseases. On the other hand, single applications are not yet available to handle protozoan and bacterial diseases. Improved case detection and decentralized clinical management are two ways that the WHO intends to prevent mortality for such complex illnesses.
Funding. The Global Alliance for Vaccines and Immunization (GAVI), Medicines for Malaria Venture (MMV), Global Alliance for TB Drug Development (TB Alliance) and Drugs for Neglected Diseases Initiative (DNDi) are only a few of the public-private partnerships (PPIs) formed by governments, health agencies and private industry to overcome tropical diseases. Under the TB Alliance, the Bill and Melinda Gates Foundation and Rockefeller Foundations pledged $40 million to develop new Tuberculosis drugs. The MMV raised $107 million to create anti-malarial drugs while the GAVI raised $2.3 billion to provide access to valuable but insufficiently used vaccines. Along with PPIs, several pharmaceutical companies are donating an unlimited supply of drugs as long as needed to treat tropical diseases. At the same time that GlaxoSmithKline is providing Alberndazole for handling Lymphatifilariasis worldwide, Novartis is contributing an indefinite supply of multidrug therapy blister packs of rifampicin, clofaziminie and dapsone to deal with Leprosy.
Non-communicable Diseases (NCDs) in Developed Nations
Background. Non-communicable diseases (NCDs) are aptly defined as “non-infectious and non-transmissible diseases that may be caused by genetic or behavioral factors and generally have a slow progression and long duration which include cardiovascular diseases, cancer, chronic respiratory ailments and diabetes.” They are impacted by genes, stressful lifestyles in the age of technology and early life environmental factors which are connected to the amount and timing of toxicants and nutrients that infiltrate the placenta. Deaths caused by NCDs are on the rise; mortality is projected to increase by more than half in a little more than a decade.
Strategy interventions. As part of the WHO Global Action Plan, 80% of the basic technologies and high-priority medicines will be made easily available. Lowering deaths from NCDs by 25% by the year 2025 (known as the 25 by 25 goal), lessening current tobacco use by 30% and minimizing the detrimental use of alcohol and lack of physical activity each by 10% are key components of the program. The daunting task of persuading a population to update its life regimen appreciably based on scientific findings may seem unattainable. However, fundamental interventions that are both inexpensive and highly impactful have been identified to assist in the process. Specifically, the WHO initiative addresses a multitude of risk factors that promote healthy living by providing guidance on how to: 1) educate the public on preventing and reducing tobacco use and overconsumption of alcohol; 2) engage in substituting more fruit and vegetables for less fatty foods while reducing amounts of salt; and 3) expand physical activity. Bringing the fight against NCDs and the promotion of healthy living forward at the national level can be brought to fruition if merged into governmental policies that support legislative action.
Funding. Disease prevention and education programs established under the Department of Health and Human Services (HHS) are supported by the formidable endeavors of the National Institutes of Health Research (NIH) and the Center for Disease Control (CDC). For over 20 years, the CDC has provided grants to state and major city health departments to identify risk factors and organize systems to monitor epidemiology and track vaccine-preventable diseases. In 2012, the CDC funded a Field Epidemiology Training Program with over $12 million to prepare trained public health workers to respond to NCDs. In the same year, NIH awarded $14.4 million to scientific institutions for NCD research and surveillance.
In summary, health care in developing nations is designed to treat infectious diseases with ancient diseases of poverty; non-communicable diseases are the priority of developed nations. Pharma is committed to bringing disease education and prevention to both worlds with specific strategies and funding. Its goals are based on the strong desire to reach the masses with pharmaceutical treatments that provide overall wellness and longevity by eradicating ancient tropical diseases and controlling NCDs. The positive attitude of pharma is making a difference in many lives and bringing hope, miracles – and smiles.
“Accelerating Work to Overcome the Global Impact of Neglected Tropical Diseases: A Roadmap for Implementation.” World Health Organization. (2015)
“Fighting Diseases of Developing Countries.” Parliamentary Office of Science and Technology. (2013)
“Preventing Emerging Infectious Diseases: A Strategy for the 21st Century Overview of the Updated CDC Plan.” Center for Disease Control. (2014)
“Primary Prevention: Avoiding Non-Communicable Diseases by Reducing Early Life Exposure.” National Institute of Environmental Health Sciences. (2015)
“The U.S. Government and Global Non-Communicable Diseases.” The Henry J. Kaiser Family Foundation. (2014)