Big drugs and TB: The love/hate story
Big drugs and TB: The love/hate story
Two events, two takes on big pharma
Should TB controllers harness the pharmaceutical industry or hijack it? TB experts on opposite sides of the globe seemed to be having a hard time deciding. For proof of the TB world’s ambivalent attitude toward the pharmaceutical industry, take another look at two events from last month.
The first event, of course, was the long-awaited launch of the Global Alliance for TB Drug Development, held in Bangkok. The launch was tacked onto the agenda of a suitably press-heavy event called The First International Conference on Health Research for Development.
The second event was a conference sponsored by the World Health Organization and UNAIDS, titled "Massive Effort Against Diseases of the Poor" and held in Winterthur, Switzerland.
The launch seemed almost redundant because the Global Alliance has been in orbit for several months now, minus only its official incorporation papers. Still, the Bangkok festivities, which were rumored to have cost the alliance $150,000 to organize, generated lots of press notices and gave alliance leaders the chance to announce the news that two more scions of global capitalism — Chiron, a biotech heavy-hitter, and Aventis, the pharmaceutical megafirm — have hopped onto the alliance bandwagon alongside the Gates Foundation.
There was also the good news of the appointment of Giorgio Roscigno to the post of interim director of the new alliance. Formerly with Aventis, Roscigno brings impeccable private-sector credentials to the job, plus a reputation for being willing to fight hard for TB research.
The Winterthur conference, by comparison, was notable for its emphasis on making do and for a spat between Doctors Without Borders (aka Medecins Sans Frontieres, or MSF) and WHO operatives.
As Winterthur participants fiddled with the bits of insecticide-impregnated mosquito netting and condoms tucked into workshop displays, MSF head Jim Orbinsky fired off a press release denouncing the conference for failing to address the "structural" issues that needed fixing.
More plainly put, Orbinsky and company wanted to remind Winterthur sponsors how tired they were of trying to treat multidrug-resistant TB in Russia without access to costly second-line drugs and handing out condoms instead of protease inhibitors in AIDS-stricken sub-Saharan Africa.
Conference organizers say they don’t blame MSF for being impatient; still, they say, government programs and nonprofits would do well to work harder with what they’ve got. "What MSF may be overlooking is the fact that these technologies do exist — and that where they are made available, people benefit from them enormously," says Ian Smith, a member of the STOP-TB team at WHO. "By rights, people who need them ought to have better access to them."
In any case, the spat kept things interesting, Smith adds. "It certainly livened things up, and it got people thinking hard," he says.
Back in Bangkok, no one was in the mood to bite the hand they hope someday may feed them. "The genius [of the global alliance] is to realize that the elements for funding new drugs may well be out there, but that there’s never been a coordinating body to bring them all together," says Jim Yung Kim, MD, director of Cambridge-based nonprofit Partner in Health. "The idea is that with a little money, you can get past these roadblocks and essentially force all these elements to work together."
Even if the alliance turns up nothing but a bunch of dead ends, adds Kim, that will be helpful, too. "Then we’ll know we have to dramatically restructure the pharmaceutical industry to get our goals accomplished," he says.
A scruffy town reinvents itself
Lofty talk was in shorter supply back in Winterthur, where even the setting perfectly reflected themes of hard work and anti-glamour. Winterthur is a former center of heavy industry about 15 minutes outside Zurich, says Smith. As town fathers watched the city’s fortunes decline, they conceived the notion of reinventing the place as a convention center for health forums. The fact that Winterthur lacks convention facilities hasn’t stopped them, Smith adds.
Thus, meetings were held in the town hall, a converted factory building. The 200 or so participants were housed creatively, using student hostels and the like, and townspeople turned out in numbers to help with cooking and transportation, Smith says. Winterthur organizers say they’re looking forward to a repeat of the conference next year.
For the immediate future, Smith says he’s looking forward to Okinawa, where G-8 members will reconvene in December to revisit promises they made in the first summit earlier this year. "It’ll be a chance for them to put their money where their mouths are," says Smith.
At the upcoming World Economic Forum in Davos, Switzerland, in December, it’s rumored that diseases of the poor also will get a spot on the agenda.
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