A New Model for R&D
Delali Attipoe at the DNDi explains why we need an R&D model attuned to the needs of forgotten patients.
| 3 min read | Opinion
What we asked: “Looking ahead to the next 5–10 years, what will be the key disruptors and/or what can be improved upon in the pharma industry?”
Response from: Delali Attipoe, North America Director of the Drugs for Neglected Diseases initiative
Over the next ten years, I would like to see a revolution in research where the biopharma sector works in closer proximity and greater participatory fashion with communities that are still largely excluded from the latest advances in science.
The past ten years have seen some progress in how we equitably share the fruits of medical innovation, but considerable gaps remain – especially for low-income communities around the world. Millions of people do not have access to the therapeutics, vaccines, and diagnostics they sorely need, including for neglected diseases such as leishmaniasis, Chagas, or onchocerciasis.
Women are disproportionately neglected in medical research. Children, too; of the 47 medicines for neglected diseases recommended by WHO, only seven are available in pediatric formulations. Climate-sensitive diseases, such as dengue, are spreading fast, predominantly impacting communities that are already being left behind. A 2022 comment in The Lancet highlighted that the African continent carries 25 percent of the global disease burden, but accounts for less than 3 percent of all clinical trials.
We therefore need an R&D ecosystem that can answer these challenges. We need R&D that is more attuned to the needs of these forgotten populations.
There are reasons to be optimistic. Alternative drug development models exist that are driven by patient needs rather than by immediate profit-seeking and have demonstrated they can deliver new and better, safer medicines.
My own organization works hand in hand with communities, doctors, and researchers in places where neglected diseases are endemic. This compels us to embed equitable access at every stage of our drug R&D process – from lab bench to patient bedside. If we realize a drug candidate or a new project won’t fit patients’ specific needs, we tweak it until it does – or we stop developing it.
Patients benefit from this model. Manufacturing and research organizations in endemic countries also benefit. This virtuous cycle connecting all stakeholders, particularly the underrepresented, can provide the pharmaceutical industry with new and innovative ways to deliver promising and accessible products. I hope the next ten years will see an accelerated shift in that direction.
After all, this is the fundamental reason we all chose to be medicine makers: to improve lives – everyone’s lives.
Eun Lee at work at LAB-IQ. She is a Ph.D. candidate in Pharmaceutical Chemistry. This is herfirst time making drugs for neglected diseases and parasitic illnesses. “I’m happy to be discovery new chemicals and I’m also learning a lot about pharmacokinetics,” she said.
Lab focal person for Fexi Study, Fredrick Jumah demonstrates the preparation of a sample for examination by use of mini Anion Exchange Centrifugation Technique (mAECT) at the Rumphi District Hospital's laboratory in Malawi.
Dr Willy Kuziena, Investigator for the fexi trials at Masi Manimba, with staff of the lab at the Masi Manimba Hospital, examining cerebrospinal fluid.
There are two seasons in DRC – rainy and dry. According to Dr Willy, “the dry season is difficult. Patients (who are largely subsistence farmers) are in the fields cultivating their crops, so they are getting bitten by tsetse flies and potentially infected. But many don’t want to go to the hospital because they are scared of leaving their fields for too long.”
“Fexinidazole would be a huge improvement because we could treat patients in their health zones and nurses don’t need specialized training.”
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