terça-feira, fevereiro 14, 2006
G8 querem financiar vacinas
G-8 Nations Shape Plan to Fight Diseases - Goal Is Getting Drug Makersto Generate Vaccines Against Illnesses in Developing World
By MICHAEL M. PHILLIPS
February 13, 2006; Page A8
Wall Street Journal
MOSCOW -- The U.S. and its wealthy allies are moving to approve a first-of-its-kind plan to encourage pharmaceuticals companies to develop vaccines for diseases that afflict countries too poor to afford them.
Finance ministers from the Group of Eight major industrialized powers, who met here this weekend, expect to approve a pilot project when they next get together, in Washington in April.
Under an advance market commitment plan, the G-8 nations would promise to subsidize the purchase of new vaccines -- for between $800 million and $6 billion -- if pharmaceuticals companies develop ones that meet standards of efficacy and safety. Once the G-8 spends the pledged amount, the drug companies would sell the vaccine at a set discount in the developing world.
The idea is to ensure that companies get a substantial, upfront, government-backed financial incentive to develop the drugs, even if they ultimately have to sell them at a low price. "By restoring appropriate incentives," advance market commitments "can stimulate private research and investment, accelerate the discovery of new vaccines, save lives and contribute to economic development in a cost-effective way," Italian Finance Minister Giulio Tremonti wrote in a report to his G-8 colleagues in December.
Advised by the World Bank and other outside experts, G-8 negotiators are working through details, including which of six Third World killers should be the test case: HIV/AIDS; malaria; tuberculosis; pneumococcus, a source of pneumonia and meningitis; rotavirus, which causes fatal diarrhea in children; or human papillomavirus, a cause of cervical cancer."It is a promising approach," Treasury Secretary John Snow said after two days of meetings by the G-8, which includes the U.S., Britain, Russia, Germany, France, Italy, Japan and Canada.
It is unclear whether the initiative will draw support from big drug companies. "We are aware of the discussions around advanced marketcommitments and are tracking them, but are not involved," a spokesman for the pharmaceuticals company Wyeth, Christopher Garland, said. The company is one of several with new pneumococcus vaccines in the pipeline.
Wyeth already makes a pneumococcus vaccine, Prevnar, that is effective in the U.S. and Europe. But the vaccine doesn't prevent infection by strains of the bacteria that are common in the developing world, according to a Treasury official. What is required, the official said, is accelerated development of a second-generation vaccine made in sufficient quantities to protect children in the developing world.
Mr. Tremonti and Britain's Chancellor of the Exchequer, Gordon Brown, led the effort over the past year to persuade the G-8 to back an advance market pilot. What was just a notion when President Bush and G-8 leaders mentioned it at their summit in Scotland in July looks likely to become a reality in a few months.
The plan aims to address a paradox in the pharmaceutical world: The countries that most need certain drugs are the ones that can least afford them. The result is that drug companies often focus research in areas that are more profitable while poor nations are ravaged by infectious diseases that otherwise might be successfully fought, Mr.Tremonti wrote.
In some cases pharmaceuticals companies are reluctant to invest in Third World diseases because they fear that governments and activists wielding moral suasion will embarrass them into providing new drugs to the poor at unprofitably low prices or free, according to a U.S. official involved in the proposal.
While charities such as the Rockefeller Foundation and the Bill &Melinda Gates Foundation fund vaccine development aimed at poor countries, the amount of money available is too small to generate more than a handful of new drugs, according to research by the Center for Global Development, a Washington think tank that has studied the issue,with Gates Foundation funding. A large promised market would spur more drug-company investment and a wider selection of more-effective vaccines, the center concluded.
The G-8 plan has a few detractors, among them Donald W. Light, professor of comparative health systems at the University of Medicine and Dentistry of New Jersey. Prof. Light doubts the pharmaceuticals companies will respond enthusiastically to the G-8's lure, and so wonders whether the money would be better spent elsewhere. "Why not use this wonderful gift of billions of dollars to purchase effective vaccines that can save millions of lives right now?" he said in an interview last week. He suggested that wider distribution of the hepatitis B vaccine, for example, would have a more certain impact.
The G-8 plan, however, boasts powerful advocates who believe it will increase the overall amount that donors provide for vaccines. With enough political will, donors won't have to decide between providing vaccines now or funding new vaccine development for the future, said Susan McAdams, a World Bank expert who has been advising the G-8 on the vaccine issue.
The Bush administration is enthusiastic about the G-8 idea because it combines philanthropy with market mechanisms. Unlike some other vaccine proposals, in which donors agree to buy a single company's product once developed, the G-8 plan would create a market that would be split among all companies that develop vaccines that are sufficiently safe and effective. Presumably a company whose drug was better than its competitors' products would secure a greater share of the market -- a strong incentive for continued improvements and competition.
The size of the G-8 investment -- and the price of each dose of the vaccine -- would be negotiated in advance. The donors would aim for a price that guarantees a return just generous enough to get the drug companies involved, but not as lucrative as a blockbuster drug. G-8 officials are working to clear obstacles to the project, including how much each nation would contribute to the purchase fund.
The debate over which disease the pilot project should target reflects a philosophical decision the G-8 must face. Some countries might prefer to pick a disease for which a promising vaccine already is well into development, but which, without the advance commitment, might not be manufactured widely enough to help poor countries. Such a choice might lead to faster, more-certain success.
Others may want to aim at the tougher scientific challenges, such as HIV/AIDS or malaria, for which a promising vaccine might be over the horizon, some 10 or 15 years away."I didn't get the impression there were any kinds of division on this issue," a spokesman for U.K. Chancellor Brown said after the G-8 meetings. "It's just a matter of making sure the momentum is kept up," The Treasury Department, which is leading the U.S. negotiations, would prefer to put the G-8's weight behind a vaccine for pneumococcus, a bacteria that killed 1.6 million people in 2002, according to the latest World Health Organization figures.
Such a project would require a G-8 investment of between $1 billion and $1.5 billion and could generate a vaccine in about four years, according to the Italian Ministry of Economy and Finance report. By contrast, the report projects an HIV/AIDS vaccine might need as much as a $6 billion commitment and 15 years to develop. A malaria vaccine might take $5 billion and 11 years; a vaccine for rotavirus just $1 billion and two years.