Pharma Ill-Equipped To Handle 10 Most Infectious Diseases And Future Pandemics, Report Warns
A new report has found that current R&D is primarily geared towards COVID-19, with next to no efforts to address other pathogens with the potential pandemic risks like Zika and Sars.

With ten of the world’s most infectious diseases not catered by drug firms, pharmaceutical giants remain unprepared to tackle future pandemics, a new report has said.

The report, published on Tuesday, found that though current medicine and vaccine research and development is primarily geared towards the COVID-19 pandemic, there are next to no efforts to address other pathogens with the potential pandemic risks: namely Nipah, Zika, and Sars.

The Access to Medicine Index evaluates 20 global pharmaceutical companies – including AstraZeneca and Pfizer – and compares how far each goes in fulfilling the role of developing urgently needed health products and improving equitable access to them. The companies’ performance is ranked every two years.

Pfizer joins top 5, while GSK retains its number one position, yet only slightly ahead of Novartis. Pfizer moves into the top five. Johnson & Johnson complete the top five companies. Eight of the top ten companies, including the leaders, are setting a new best practice of systematic access planning during R&D.

“The state of infectious disease research today is, if I can put it mildly, on thin ice,” said Dr Jayasree Iyer, executive director of The Netherlands-based Access to Medicine Foundation, in an interview with DW.

COVID-19 has emphasized the need for both the private and public sectors to actively engage in emerging infectious disease research well before the next pandemic breaks out.

It has also shown that ending a pandemic requires suitable products to be developed and equitably distributed: much of the responsibility for which lies with pharmaceutical companies.

Without their sustained commitment to pandemic preparedness, the report suggests, the world world will remain vulnerable to pandemics.

Increased R&D for COVID-19, but Other Pandemic Risks Unaddressed
Pharmaceutical companies are not targeting priority pathogens with epidemic potential through R&D. Excluding coronavirus, pathogens with pandemic potential where pharma companies are active in R&D show very small pipelines in 2020. Out of 16 pathogens, 10 have empty pipelines.

Even for pathogens under scrutiny, research activity remains low. With most research focused on coronavirus, there are just 13 R&D projects across five non-COVID-19 diseases (Ebola, Zika, Chukungunya, Marburg, and non-polio enterovirus) and zero for the remaining ten of 16 infectious diseases.

Emerging infectious disease (EID) research is concentrated among a few companies. In 2020, 17 companies targeted coronavirus, while nine companies are targeting other EIDs: Bayer, Eisai, Gilead, Johnson & Johnson, MSD, Merck, Roche, and Takeda.

This figure shows the number of R&D projects and companies identified by WHO and Policy Cures as emerging infectious diseases, and how this has changed since 2018.

What 2020 has highlighted is that large pharmaceutical companies have a critical role to play in preparing for the next pandemic, but that these companies have so far delivered a range of responses: some of them apparently shortsighted.

Small biotech companies and academic groups may be able to pioneer new ideas, but it is the big players that are responsible for rapid development and access to vaccines, therapeutics and diagnostics, with the capacity to scale-up both manufacturing and distribution capabilities.

Poorer Countries Lacking Access to More Than Half Key Products Covered By Pharma Companies

However, the pharmaceutical industry only mobilized against COVID-19 once it became clear that the outbreak affected rich as well as poor countries.

“Even in light of COVID-19, there were very few commitments from the pharmaceutical industry last year,” said Iyer.

Other than projects developed within the Access to COVID-19 Tools (ACT) Accelerator, there was little evidence in the first months of the pandemic response that there structures in place to ensure access and distribution to COVID-19 vaccines in poorer countries.

This has once more shown that the Global South still does not benefit significantly from access strategies implemented by big pharma. Less than half of key products controlled by 20 large companies are being offered in countries classified as either lower-middle income countries (LMICs) or low-income countries (LICs).

Low-income countries are most consistently over-looked by access strategies, particularly for products that need to be administered by healthcare practitioners.

The response is even more profound in LICs, which are consistently overlooked despite being home to almost 700 million people. Currently, only eight of the 60 – or 13% – critical products that need to be administered by healthcare professionals, like injectable treatments for cancer, are covered by access strategies in at least one LICs. Self-administered medicines such as pills have 26%.

The numbers jump slightly in LMICs, and even more so in upper-middle income countries (UMICs), with approximately half of critical products covered by access strategies in UMICs. The greatest number of people also benefited from both healthcare professionals administered medicine and self-administered medicine in UMICs.

Many industry access arrangements do not go far enough, with many of the world’s most vulnerable and marginalized not receiving the life-changing medicines they need.

Solving the access to medicine problem requires the pharmaceutical industry to take large-scale action, reaching more people with more products across a wider range of the world’s poorest countries.

“I believe the past year has demonstrated the pivotal importance of supplying affordable medicines for the many, rather than premium-priced products for the few,” said Iyer.

“By investing in fair access to medicine for the poorest and most vulnerable among us, we are also investing in a fair, peaceful and prosperous global community.”

Eight Pharma Companies Paving Way Towards Equitable Access
Top 6 companies with access planning, with percentage of R&D projects with access plans

There are positives: eight companies have taken the lead to integrating systemic access planning into their development processes. Novartis was noted as the first to begin mainstreaming access in the previous Index, and joining them in 2021 are AstraZeneca, GSK, Johnson & Johnson, Merck, Pfizer, Sanofi, and Takeda.

Though the 20 companies in the Index have 394 projects in late-stage development that target either global health priorities (114) such as coronavirus, malaria, tuberculosis or HIV, or offer benefits to low- and middle-income countries (280), the majority of these are not supported by an access plan.

An access plan can include a wide range of activities – prioritising countries with the highest disease burden to strengthening supply chains to ensure all populations have fair access.

To have maximum impact, the Index advises that access plans have a broad geographic focus, explicitly aiming to reach a majority of people affected by a disease or in need of a vaccine or diagnostic tool.

The 20 companies in scope have 394 R&D projects in late-stage development that either target established global health priorities or offer clear public health benefits for low- and middle-income countries. The majority of these are not yet supported by an access plan.

If this happens, people living in low- and middle-income countries, especially those in resource-limited or remote settings, will no longer be left behind for pharmaceutical innovations.

Concluded Iyer: “The power of science to help humanity – whether through new vaccines for common pathogens or novel drugs for rare diseases – is remarkable. But these breakthroughs will only truly deliver for the world if they reach all those who need them.”

Image Credits: Access to Medicine Foundation , Access to Medicine Foundation .

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