Bucking the trend
Drugs for some of the world’s most neglected diseases have not been developed by the big Western pharmaceutical companies because there is no viable market for them. The DNDi (see also NI 354) is determined to make available a handful of drugs for diseases like sleeping sickness, Chagas’ disease and leishmaniasis. What’s more, it aims to provide them equitably and quickly – within the next decade. Part of the DNDi strategy includes working with Big Pharma; Champey himself is a former vice-president of R&D at the French drug company Rhône-Poulenc Rorer (since merged with Hoechst to form Aventis).
NI What kind of collaboration is DNDi seeking with Big Pharma and what do you hope to gain?
YVES CHAMPEY We are looking for two things: one is access to expertise from R&D people in the industry because this is where the most experienced people are working. Second, we are seeking co-operation on particular projects – we may need access to libraries of pharmaceutical compounds or assistance with industrial development when we have identified promising new drugs.
NI The drug business is completely controlled by the market. What incentive can DNDi give to get the big pharmaceutical companies involved in your project?
YC To be frank, little economic incentive. But, as you know, many people in the R&D departments of these companies are very keen on working on projects relating to poor people, to try to bring some of their energy and knowledge to those who need it. The other thing we are bringing to the companies is the possibility to say that they are strongly contributing to an important project at a relatively small cost. It is important that they bring their knowledge and expertise in favour of the patients – if their image benefits as a result, OK fine.
NI Suppose the DNDi develops a drug which tackles one of the major tropical diseases – how can it ensure equitable access? Who would hold the patents for this drug?
YC It is improbable that DNDi will be the sole owner of the patent because we are not going into actual medicinal chemistry research. But one thing we will have to ensure when signing patents is to have the best possible agreement in favour of patients. The use of the drug will be restricted to specific areas in poorer countries so profits will be minimal or non-existent. There isn’t a single case of leishmaniasis in New York’s Bellevue Hospital, for example.
NI James Orbinsky, the former president of Médecins Sans Frontières, says life-saving drugs ‘must be considered public goods and not simply consumer products’. What is the DNDi view?
YC The vision we have developed with James Orbinsky is of drugs and health as public goods. But we have to be realistic. The compounds we want to access in the next few years are going to belong to someone and we will have to agree with them on the conditions under which we can develop these drugs. In the future, if we succeed, we could think of building an international public library of drugs. And that could eventually lead to a bank of compounds that are considered ‘public goods’. But we are far from that.
NI Considering your industry background, what drew you towards a project like the DNDi?
YC As a young physician I worked in Algeria under extremely difficult circumstances, which at the beginning of your professional life you don’t forget. When I was in the industry I always tried to fight for particular diseases and take attitudes which were not always considered ‘classic’. I was lucky to be able to develop a career without thinking too much about marketing, profit, market shares, etc.
NI Critics argue that many of the diseases you are targeting really need a huge public health response with governments and international bodies taking action. In this context, is the DNDi just going to be a drop in the ocean?
YC It might be a drop, but then what is an ocean but a collection of drops? We won't have much political power, but hopefully we will have good advocacy power through our partner organizations. The issue is complicated and full of potential problems. We certainly do not have the perfect conditions. But if we wait for all aspects to be solved, nothing will happen. What choice do we have but to go ahead? www.dndi.org