Industry steps up interest in developing world, fueling doubling of R&D pipeline

World Health Organization (WHO)
The World Health Organization has been influential in getting neglected tropical diseases back on the R&D agenda, the report finds. (WHO)

The pipeline of drugs and vaccines aimed at diseases prevalent in low- and middle-income countries has more than doubled since 2014, according to the Access to Medicine Foundation (AMF). However, the trend was driven by surging activity in noncommunicable diseases, leaving many conditions underserved by the current pipeline.

AMF has tracked the extent to which biopharma companies are developing products for low- and middle-income countries and ensuring they are available in these markets since 2008, giving it a wealth of information on how the industry’s approach to tackling certain diseases has changed. In a new report, AMF broke out the data gathered since 2014 to analyze the level of industry interest in the treatment of 47 diseases and conditions that it tracked consistently over the period.

The analysis shows the number of developmental candidates against the 47 diseases increased from 327 in 2014 to 673 last year, an increase of more than 100%. Preclinical programs account for most of the growth. In 2014, there were 118 preclinical programs. Last year, the figure hit 388.

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That boom in preclinical activity could precipitate a surge in clinical programs in the year to come, adding to the 37% increase in the size of the pipeline AMF tracked from 2014 to 2018.

AMF praised the changes, with executive director Jayasree Iyer stating that compared to 10 years ago companies are “taking seriously the problems people face in low- and middle-income countries when accessing healthcare.” Yet, Iyer is conscious that the trends could reverse quickly, and other parts of the report show the benefits of changes are unevenly distributed.

Notably, the fast growth in the R&D pipeline was driven by increased activity in noncommunicable diseases. These diseases, which include diabetes, heart disease and stroke, are big problems in low- and middle-income countries but industry interest in treating them likely stems from the potential to sell the resulting products in Western markets. AMF wants companies to make the products available in developing countries, too. 

The question mark over whether that will happen means the significance of the doubling of the size of the pipeline to patients in low- and middle-income countries remains uncertain. But there are other facets of the data that are more unambiguously positive, such as the rise in programs against neglected tropical diseases. From 2014 to 2018, the number of neglected tropical diseases pipeline programs roughly doubled, hitting 90 by the end of the period. AMF attributed the trend to the efforts of the World Health Organization. 

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