Getting drugs into wide control use
Relatively few drugs for tropical diseases reach the market, and even if they do, there are huge inequities in access to drugs between rich and poor countries. Drugs are often inaccessible and unaffordable to the very people who need them.
TDR has helped bring a number of drugs into disease control use. Some examples include:
In 1999, the use of artemether as an intramuscular injection for the treatment of severe malaria was expanded to more than 30 endemic countries. It was also included (for restricted use) in the WHO Model List of Essential Drugs.
DEC+albendazole or ivermectin+albendazole
These combinations form the basis of the strategy to eliminate lymphatic filariasis by 2020. From 2000-2001, SmithKline Beecham provided 34 million tablets of albendazole through WHO. WHO/TDR facilitated the procurement of 115 million tablets of DEC (diethylcarbamazine), and Merck and Co. Inc. provided ivermectin for the Ghanaian, Nigerian and Tanzanian lymphatic filariasis programmes.
In May 2001, Aventis (was Hoechst Marion Roussel), donated US$25 million to support WHO’s activities in the field of African trypanosomiasis over a five-year period. This included the donation of eflornithine drugs.
Reich, M.R. (2000) The global drug gap. Science, 287: 1979-1981.
WHAT WAS TDR ROLE?
With its base within the UN system, its long history of partnership with industry, donors, research and control communities, TDR was in a strong position to act as a broker between the different stakeholders.
Artemether: TDR negotiated a preferential price with Rhône- Poulenc Rorer DOMA (now Aventis Intercontinental)
Ivermectin: TDR negotiated with Merck & Co. Inc. for the free supply of ivermectin, and with the OCP (Onchocerciasis Control Programme) for provision of advice on how to distribute and monitor the drug in Africa
Albendazole: TDR helped to negotiate with SmithKline Beecham (now GlaxoSmithKline), who pledged to donate albendazole to WHO for 'use by governments and other collaborating organizations until lymphatic filariasis is eliminated from the world as a public health problem.'
Eflornithine: TDR played a key negotiating role with the private and non-governmental sectors.