1. Altruism vs Profitability: How do we get our drugs to where they are needed?

2. Why did I choose this topic? Leprosy Elephantiasis (form of Lymphatic Filiariasis) Universities Allied for Essential Medicines http://www.medicalook.com/diseases_images/leprosy.jpg www.healthcaremagic.com/articles/Elephantitis-Lymphatic-Filariasis-elephantiasis/2516 http://essentialmedicine.org/

3. Perspectives I will explore Altruism? vs Profitability?

4. Inequitable access to essential medicines (2000-2003) Access to essential drugs has grown but inadequate financing and poor health care delivery are still constraining factors Ref: http://apps.who.int/medicinedocs/en/d/Jwhozip16e/8.2.html

6. selected with relevance to public health

7. selected with evidence to efficacy, safety and cost effectiveness

8. intended to be available at all times

10. “90% of global expenditure on medical research is on diseases causing 10% of the global burden of disease” Ref: Solomon, R., Benatar, Abdallah, S. Daar & Peter A. Singer (2003) Global Health ethics: the rationale for mutual caring. International affairs 79, I 107-138

12. Transnational flows

13. Globalisation

14. Interdependence

15. Social Justice

16. Equity

17. Equality

18. Health

20. Why has it been so difficult for these big companies with so much power and so many resources at their disposal to be more altruistic? The answer: profit is incentive, altruism not so much. “Chasing profits does not deliver most people the goods they need at a price they can afford, and so the market is much smaller than it could be: a CEO who doesn’t deliver won’t last long.” * “Several former pharmacutical CEOs have criticised the research climate after stepping down, while other leading researchers have moved to academia, where they can explore innovative science free from the constraints of profitability.” * Ref:*Philip Ball (2010): Making a better world. Prospects magazine – issue 175

21. ‘Our drugs. Our labs. Our responsibility.’ UAEM Ref: http://essentialmedicine.org/about-us Ref: http://uaemedinburgh.files.wordpress.com/2009/01/uaem_efisher01.jpg?w=667&h=450

22. What have the students done so far? 2001 2006 2010 Kishore S P, Maciag K. (2010) Generic drugs for developing nations. Nature Reviews. Microbiology http://essentialmedicine.org/our-work/successes The Ticker: 5 universities to use licensing to provide cheaper drugs to poor and developing world. The Chronicle of Higher Education 2009

24. Has promised $8million to provide researchers to investigate these compounds

27. Over $280million to the Global TB Vaccine Foundation (2)

28. Over $5million to visceral leishmaniasis research (3)"Gates gives $287m to HIV research". BBC News. 2006-07-20.http://news.bbc.co.uk/1/hi/world/americas/5197082.stm Nightingale, Katherine (2007-09-19)"Gates foundation gives US$280 million to fight TB”http://www.scidev.net/en/news/gates-foundation-gives-us280-million-to-fight-tb.html (3) ($5m for disease control in Ethiopia in Israel 21c Innovation News Service. http://www.israel21c.org/briefs/5-m-for-disease-control-in-ethiopia

30. I have more understanding of the reasons behind incentive for research

31. It may be so that recent pressure has forced pharmaceutical companies to take some kind of action. However we must not become apathetic as there is still an important access gap and neglected disease research drought.

32. I am reassured by the action of organizations including the Gates Foundation and the universities, and I urge other medical students to have a look at the UAEM

33. I now aim to take my global health learning and engagement further.