Stronger incentives to smaller biomedical companies rather than to large pharmaceutical groups could help boost the development of treatments for "neglected" diseases of the developing world such as malaria and tuberculosis, according to a report commissioned by the Wellcome Trust, the London-based medical charity.
Fresh finance and help for small companies in winning approval from the regulatory authorities of developing countries could create profitable markets to provide medicines for poorer countries that are more sustainable than the existing philanthropic system.
“Neglected diseases”, which tend to occur in poor countries where companies would have little chance of making a big profit, kill 3m people a year.
The report, by the London School of Economics, says non-profit public-private partnerships, such as the Medicines for Malaria Venture – charities established involving large and small companies – account for three-quarters of all identified neglected disease projects.
The findings, published this week, contradict the accepted wisdom of policy documents such as the recent UK government-led Commission for Africa, which calls for fresh incentives to persuade pharmaceutical multinationals to do more for diseases in Africa.
While the multinationals are largely involved for altruistic reasons, the Wellcome Trust report argues there can be more of a commercial motivation for smaller drugs companies, with lower overheads and no need for large revenues.
However, smaller companies are often frustrated by a lack of experience in developing countries and their regulatory and purchasing regimes.
The study identifies 60 neglected disease drug development projects under way by the end of last year, while stressing that nearly half involve collaboration with smaller drug companies. Just four of the top 12 multinationals, all European-based, account for the rest.
Thirteen projects have reached the stage of human testing. Two – rectal artesunate for malaria and paromomycin for the skin disease leishmaniasis – await regulatory approval.
But the analysis warns that if funding dries up the projects would quickly be placed in jeopardy.
The report calls for the creation of a public research and development fund worth up to $2bn (€1.6bn, £1.1bn) over 10 years, to provide a more predictable source of funding for PPPs. It also proposes helping small companies to navigate regulatory systems in developing countries and recommends the lowering of fees charged by patent offices to protect new medicines.