Experts discuss disease-fight dollars for developing world

The debate over how to spend the hundreds of millions of  dollars earmarked to fight AIDS and other killer diseases in developing countries will come under the spotlight at a meeting of international experts.

The two-day meeting at the Open University in Milton Keynes aims to assess ways of successfully integrating foreign investment into the healthcare and drug production capacity of some of the world's poorest countries.

Current thinking is split between those- including UK Prime Minister Gordon Brown and Microsoft founder Bill Gates- who back investment into drug production technologies and those, such as the World Health Organisation, who think frontline healthcare services should be better supported.

Professor Joanna Chataway, co-director of the Economic and Social Research Council's (ESRC) Innogen Centre who are organising the meeting, says that current funding models have not yet got the balance of investment right.

"Recent announcements that drug companies are going to invest in provision of drugs for developing countries are a welcome call. 

"However, in developing new drugs there is a need to resolve capacity within developing countries so that they not only have access to these medicines, but they are capable of contributing to the production and distribution of them through improved healthcare systems." 

Western governments and pharmaceutical companies need to urgently reassess the financing of these schemes, she added, which often focus all their efforts on one particular disease at the expense of other important healthcare issues.

Professor Chataway will deliver her message to the gathering of key players from industry, donors, and governments.

Since the mid 1990s, drugs, vaccines and diagnostics for diseases such as AIDS, malaria and tuberculosis, have been produced as a result of funding 'product development partnerships' (PDPs).

PDPs involve not-for-profit organisations coordinating drug and vaccine innovation in collaboration with private sector partners, such as major pharmaceutical companies. 

Professor Chataway and her colleagues have found that while these partnerships can build capacity in the science sector of developing countries, they could improve their co-ordination with local scientific and health facilities.

"PDPs build capacity but reinforce power structures so that local health researchers cannot make their own decisions and do not have access to the resources that are needed to solve the broad health problems their country suffers," she said.

In order to engage policy makers and others with these issues, the ESRC Innogen Centre has recently been running an online 'e-discussion' around what they term 'Technologies for Healthy Systems Strengthening'. 

This international forum has sought views on how production of drugs, vaccines and diagnostics can take place in such a way as to complement health services and scientific research in developing countries. 

"This discussion is important because there is huge disagreement within the policy and donor communities about the correct balance between investment in health systems and investment in technology," says Professor Chataway.

"One way forward, and a topic of discussion at our meeting today, is the question of how to evaluate the effectiveness of these partnerships and product development activities. 

"Often this is based on the impact of a new medicine on disease reduction, or on the number of vaccines or drug trials conducted. However, these measures do not adequately measure the complex relationship between product innovation and health service provision or health systems strengthening requirements."