The Global Alliance for TB Drug Development has no medical labs, which might seem a odd for a group that wants to develop a new treatment for tuberculosis.
Global Alliance is among a new breed of nonprofit organizations that, instead of doing their own research, are partnering with pharmaceutical companies, biotech firms and universities to try to find affordable medicines for diseases that plague the world's poor.
The organizations, like Medicines for Malaria Venture, the International AIDS Vaccine Initiative and the Malaria Vaccine Initiative, often act somewhat like venture capitalists, providing money for drug and vaccines development.
However, instead of getting a portion of the profits from a discovery, they secure the rights to sell the product in the developing world at an affordable price. In turn, they give companies that participate the product rights for the developed world, where some money can be made even if the market is small.
Few firms bother to research malaria and tuberculosis because most of the need is in the developing world where people can't afford medicine. While several companies may be working on an AIDS vaccine, the high cost of current AIDS treatments and their limited availability to the Third World, even though special programs and arrangments approved by drug makers, demonstrates the need for new approaches.
"We are trying to balance having a market for companies to be able to sell their drugs with our social mission," said Maria Freire, chief executive of Global Alliance. "Our job is to make key investments and drive development as far as we can."
The year-old venture signed its first deal in early February, licensing a chemical compound from Chiron Corp. for an undisclosed sum. It is seeking partners to develop the compound, which has shown promise in treating tuberculosis.
Chiron gave up any royalties from sales in poor countries, but retains an option to make and sell the medicine in wealthier countries. It would receive a royalty for sales in rich countries regardless.
"This was the best deal for us," said Craig Wheeler president of Chiron's BioPharmaceuticals division. "We may have gotten less money for the compound than we otherwise would have, but we have an opportunity to take it back later without worrying about the development risk."
Over the last 25 years, fewer than 1 percent of the more than 1,300 drugs approved for sale were developed to treat tropical diseases.
Malaria kills one child every 30 seconds around the world, yet new drugs are too expensive for most of the world's poor and in many cases the disease is resistant to older medicines. Tuberculosis kills more that 2 million people a year yet the last innovative treatment was developed 30 years ago.
"Drug development occurs for western diseases. These public private partnerships make the situation a lot less hopeless," said Nathan Ford, who advises a campaign by Doctors without Borders' to create greater access to medicines.
So far, none of the new partnerships has successfully developed a product. The oldest one, the Global AIDS Vaccine Initiative, was founded seven years ago. It says it may have a vaccine ready by 2007.
Drug research and development costs can be astronomical, and activists fear that the partnerships may never reach their full potential because of a dependency on foundations and governments for funding. Those donations could be reduced, or simply ended, at any time.
The Global Alliance has raised $40 million, but says it needs between $200 million and $300 million so it can invest in several projects because most compounds fail in clinical trails. Its goal is to discover a new tuberculosis drug by the end of the decade.
The pharmaceutical industry says it costs an average $802 million to develop a new drug. Frier maintains it won't cost his group that much because some of the early research is already done when the partnerships begin their projects, and because universities and companies will make in-kind contributions. The Alliance estimates the cost for developing a new TB drug to be between $115 million and $240 million.
"We (these partnerships) won't be viable if the drugs still prove too expensive to produce. And that is something we just don't know yet," said Christopher Henteschel, the chief executive of the Medicines for Malaria Venture.
There are risk for companies agreeing to join forces with the nonprofits. AlphaVax Inc. agreed to partner with the Global AIDS Vaccine Initiative in 1998 and the biotech companies chief executive Peter Young says there is "inherent tension in relationship."
Young said there are always lingering concerns over whose expertise should be paramount in the project and he fears that the company's proprietary technology may be inadvertently revealed through the Initiative's talks with its other partners.
And while the affiliation with the prestigious organization has raised AlphaVax's profile, the company is now forced to carry out development in a kind of goldfish bowl of additional publicity. Young fears this could inflate either positive or negative news.
But the $8.5 million AlphaVax has received so far from the Initiative has helped spur the technology's progress. And AlphaVax can use what it is learning to develop vaccines for other diseases without being beholden to the Initiative.
"In the end it has been a reasonable trade-off for us," Young said.