#GiveUsTheSerum, Adam Smith, Cure, Development, DNDi, Drugs, Ebola, Economics, GVFI, IVI, Misery, Neglected Tropical Diseases, NTDs, NVGH, Outbreak, Peter Hotez, Pharmaceuticals, POTUS, Self Examination, Self Pride, Vaccine, West Africa, WHO
I’m sorry it’s been a while since I blogged. Too many balls in the air at the moment. But I left all that alone to make a not too brief commentary about the ongoing #Ebola outbreak and my opinion on comments and sentiments coming out of my beloved continent Africa about treatment options.
One of my earliest motivations to get in to biomedical research was actually fueled by the so called ‘neglected diseases’ (abbreviated NTDs for Neglected Tropical Diseases) a.k.a, ‘diseases of poverty’. Dr. Peter Hotez who is particularly passionate about changing the game in NTDs defines them thus: “Neglected tropical diseases (NTDs) are a group of chronic, disabling, and disfiguring conditions that occur most commonly in the setting of extreme poverty, especially among the rural poor and some disadvantaged urban populations.”However, I think the definition needs to be broader.
And though there has been a simmering debate over how many diseases truly qualify as neglected, the World Health Organization (WHO) currently lists the following 17 diseases with their “causative agents” here: WHO | The 17 neglected tropical diseases.
Virus: Dengue/Severe dengueRabies
Protozoa: Chagas disease, Human African trypanosomiasis (sleeping sickness), Leishmaniases
Helminth: Cysticercosis/Taeniasis, Dracunculiasis (guinea-worm disease), Echinococcosis, Foodborne trematodiases, Lymphatic filariasis, Onchocerciasis (river blindness), Schistosomiasis, Soil-transmitted helminthiases
Bacteria: Buruli ulcer, Leprosy (Hansen disease), Trachoma, Yaws
Other neglected conditions: Chronic suppurative otitis media (CSOM), Mycetoma, Nodding Syndrome (NS), Podoconiosis, Scabies, Snakebite, Strongyloidiasis
Neglected how you might ask: Well, neglected in terms of research and resource allocation. The claim is that, though these conditions represent 90% of the disease burden globally, they only receive 10% of the global health research resources. This imbalance by research institutions but largely by pharmaceutical companies is what is termed as ‘neglect.’
The recent Ebola outbreak in West Africa has been the most severe with at least 1000 people reported dead. In the course of the outbreak however, two Americans who were involved in the outbreak response were flown to the US for treatment prior to which they had received the now wildly famous “secret serum” that reportedly improved their response. This sparked outcries on social media especially directed at pharmaceuticals, POTUS (President of the United States) and the WHO to
It seems rational at face value that a lot of Africans would feel like a cure was being intentionally withheld in the face a killer disease and some even viewed it as cruelty. The Onion satirically ran this article:Experts: Ebola Vaccine At Least 50 White People Away | The Onion – America’s Finest News Source.
My question though is #Africa, why are we always so eager to push our frustrations outward? Where the hell is our self examination? Have we even bothered to ask ourselves, “why is it that countries that are typically not affected by Ebola have a ‘secret serum’ and possible medications? The answer is simple. Developed countries are proactive. Africa and most other developing countries still remain reactive. Consequence???? The epic fail we are currently witnessing.
Africa, what is your strategy for dealing with diseases that disproportionately affect your population? Currently it seems to be, “we will make a public appeal to the West for vaccines/cures.” But on top of that approach which is not only unsustainable but also lacking in innovation, foresight and self pride, African ministers of health and citizens alike start a chorus lambasting western pharmaceuticals for, “the immoral cost of drugs”!
Seriously?! Here’s an old age lesson from ‘The Father of Economics’ himself Adam Smith: “It is not from the benevolence of the butcher, the brewer, or the baker that we expect our dinner, but from their regard to their self-love.” This means that the interest of the larger population is mainly perpetuated by individual self-interest!
It takes at least 13 to 15 years and at least $1 Billion to develop a drug/vaccine. Most drugs actually fail during the clinical trial process. So for every single successful drug, the drug developer might have spent millions of dollars on drugs that eventually failed. So the final cost of the drug must factor in not only the cost of the specific drug but also the costs of the failed drugs because if the drug makers cannot recoup all those costs guess what? There would be no drugs at all being manufactured.
But sadly we Africans fail to see the initial investments in the drug making process and by the way further upstream, how much does a country like the United States invest in training their scientists? Do not forget to factor that in. Meanwhile as Africa rises, we continue to be nonchalant about science and about investing in health. But when outbreaks like Ebola happen, we expect the US, Canada etc to
We MUST DO BETTER! We just have to do better! First by acknowledging that developing countries have a different disease profile from developed countries. That being the case, there is really no better situation than the current outbreak to open up our eyes to the fact that the pharmaceutical industry in the West has no incentive at all to make drugs for an African market that cannot afford said drugs anyways. These diseases long disappeared from their wealthy populace who could afford them.
So while we laud initiatives like DNDi – Drugs for Neglected Diseases initiative, and other initiatives that aim to develop vaccines that cost below a dollar for developing countries for example the International Vaccine Institute. and the Novartis Vaccines Institute for Global Health (NVGH), we need to do more. Disease is the biggest source of human misery and its effect on curtailing development cannot be overemphasized. As the saying goes, “healthy nations are wealthy nations.”
However, I will be the first to admit I’m not sure how. I’m no economist but I imagine few if any African countries have the kind of money it takes to invest in drug discovery. So then what is the solution? What diseases take priority? Who decides? At the same time however, whom are we allowing in to Africa in the name of health research and what exactly are they doing on our continent? Are they there just to perpetuate their own self interests?
Case in point and especially as pertains to the current Ebola outbreak is the defeanening silence from the Global Viral Forecasting Initiative (GVFI) in the face of the current outbreak. GVFI primarily operate in West Africa last I checked and they aim to ‘hunt deadly viruses before they hunt us,’ please see: Virus Hunter Tracks New and Deadly Pathogens Around the Globe | PBS NewsHour. I am deeply disappointed that despite their huge presence in the region this was the characterization of the Ebola outbreak response by other organizations on the ground: Ebola outbreak: Initial response called a ‘failure’ – CNN.com.
I have no idea or blueprint on how Africa might turn the tide for now save for, the response to every outbreak/epidemic/pandemic in #Africa simply cannot be: