The world's 20 biggest drug companies have stepped up their efforts to improve drug access in the developing world, but there is still much room for improvement, a report reveals.
Increasing research and development (R&D) spending on neglected diseases, knowledge sharing and innovative collaboration all reflect the pharmaceutical industry's attempts to address the needs of the developing world, according to 'The Access to Medicine Index 2012' published this week (28 November).
But the report, produced by the Access to Medicine Foundation, also raises serious questions over the firms' commitments to conducting safe and ethical clinical trials in developing nations and to building R&D capacity in those countries.
David Sampson, one of the report's authors and the foundation's management information expert, says it is "pretty remarkable" that every company has improved drug access over the past two years despite the tough economic conditions.
"There is still an enormous way to go, but their feet are on the road and pointing in the right direction," Sampson says.
The third edition of the biennial report ranks the companies by measuring their attempts to improve the availability of treatments for 33 neglected diseases in 103 low- and middle-income countries.
Although some companies score lower than they did in 2010, this is due to more stringent criteria, as opposed to an actual reduction in access-enhancing activities, Sampson says.
The report reveals an increased commitment to R&D for diseases covered by the index, both in terms of financial resources and the number of potential drugs under investigation, with five firms dedicating more than 20 per cent of their drug pipeline to this area.
There are also attempts to improve access by using innovative approaches to knowledge sharing and collaboration, the report says.
For example, it highlights a GlaxoSmithKline-funded laboratory where visiting researchers can collaborate on neglected disease research, and Eli Lilly's sharing of an online molecule database, saying that both are steps in the right direction.
While the bulk of resources measured by the index account for high-impact diseases such as HIV and malaria, some neglected tropical diseases, including leishmaniasis and Chagas disease, receive significant attention, it reveals.
This overall increase in investment in neglected diseases is an encouraging trend, says Sampson.
He tells SciDev.Net that improving access has "moved away from philanthropy and has started to make sound business sense".
But the development of drugs for many neglected tropical diseases, such as African trypanosomiasis and Buruli ulcer, will always be financially unattractive and so will need non-commercial support, says Javier Guzman, director of research at Policy Cures, a think-tank specialising in neglected disease.
"The activity is positive, but it is not spread evenly to address all diseases," he says.
How companies enforce high ethical standards for drug trials conducted by external contractors, or contract research organisations (CROs), is another area of concern raised by the report.
A lack of procedures for disciplining CROs that breach ethical guidelines, and a general lack of transparency about how these contractors operate, could put drug trial participants at risk, it says.
Also, the report says that R&D capacity building activities through funding, training provision and knowledge and technology sharing, are sparse and that most projects are simply continuations of projects started before the 2010 index.
Guzman, however, did not see this as a major problem. "Companies should support R&D capacity building initiatives, but public and philanthropic funders should step up to the plate and take the lead," he says.