Every day, Médecins Sans Frontières teams throughout the world witness first-hand the human impact of the lack of good medical tools – drugs, diagnostics and vaccines - for many diseases.   Far too often our doctors simply cannot give good medical care to patients, because the tests or drugs at their disposal are either antiquated, ill-adapted or ineffective – that is when they exist at all.

Tuberculosis kills more than two million people a year - but there have been no new drugs developed to treat the disease in over forty years, and the most commonly used diagnostic tool was first used in the 1880s! Today more and more patients are coming to our projects with more virulent drug-resistant forms of tuberculosis – but the tests that tell doctors which drugs work for a patient are too high tech to be used in remote places.  Even if we can get a good diagnosis, treating a patient with resistant strains of TB means giving them weak drugs that have to be taken for up to two years, and that have terrible side effects.

TB is just one example of medical tools being not good enough – there are many others. There is no tool to diagnose infants that have HIV/AIDS; there is no simple test that can detect Chagas disease in patients; some essential antiretroviral drugs used to treat HIV/AIDS require refrigeration and thus can’t be dispensed to patients that don’t have electricity (let alone fridges) at home; many patients treated for sleeping sickness have to undergo painful treatment with an arsenic-based medicine as more effective treatments remain unavailable; and so on.

Failure of the current research and development model
Adapted, effective and affordable medical tools are lacking because of one simple reason: the current way the development of health products are financed. Today, the medical research and development (R&D) system relies - with huge detrimental consequences - on companies recouping their R&D investments through charging high prices, and protecting that price through patent monopolies.  Not only does this mean that some drugs remain completely out of reach for many patients, it also means that diseases like TB or paediatric HIV/AIDS that mostly affect the poor don’t get anywhere near the attention and investment into research as diseases that have bigger, more lucrative markets.

The fact is that ninety per cent of the world’s spending on health research is still spent on the health problems affecting less than ten percent of the world’s population. Between 1975 and 2004, 1,556 new chemical entities were marketed globally. Only 20 of these – a mere 1.3 per cent – were for tropical diseases and tuberculosis, which account for 12 per cent of the total disease burden.