A maternal health "drug drought" is contributing to the likely failure to meet Millennium Development Goal targets on reducing maternal and under-five mortality, says an article in PLoS Medicine.
Nicholas M. Fisk and Rifat Atun say that investment in drugs for post-partum haemorrhage and pre-eclampsia would help cut the annual toll of 536,000 maternal deaths — 99 per cent of which occur in the developing world — and 13.5 million under-five deaths.
But with only 17 drugs for maternal health indications in the pipeline (compared with 66 for cardiovascular health), and only one new drug class licensed in the last 20 years, the market has failed pregnant women.
The reasons for this creation of a virtual "pharma-free zone" range from the danger — and cost — of causing defects in a foetus, the small market size in industrialised countries and the cost of toxicology studies.
The business model of the pharmaceutical industry, the authors say, is increasingly geared to blockbuster drugs for life-long conditions — not the relatively short-lived illnesses arising from pregnancy.
They also accuse international donor agencies of neglecting pregnant women, and call for replication of investment-incentive models such as the Medicines for Malaria Venture and the Drugs for Neglected Diseases Initiative.