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Thursday, August 21, 2008

A Drug Exec And a Congressman Spend $10 Billion

Three weeks ago The Wall Street Journal kicked off a debate on how best to allocate scarce resources to solve the world's problems. Bjorn Lomborg offered a summary of the latest findings from his Copenhagen Consensus project, where he has enlisted some of the world's top economists to address the issue. Now we're offering views on the subject from top political and business leaders. How would you spend $10 billion of American resources (either directly or through regulation) over the next four years to help improve the state of the world?

*Here we will feature the drug exec's article:

Teach Them How to Fish

In contemplating ways to spend $10 billion to realize the greatest gain for humanity, the key questions obviously are "Where?" and "How?" But allow me to suggest that our goal should be to create programs that are sustainable and to leverage the investment of billions of dollars into billions more -- regardless of the issue addressed.

Here's where I believe we can accomplish the greatest good: fighting infectious diseases that ravage the developing countries and increasingly threaten the developed ones.

Infectious diseases are the world's second-leading cause of death. Just three diseases -- malaria, tuberculosis and HIV/AIDS -- together kill nearly six million people a year, mostly in developing countries. This is roughly equivalent to the population of metropolitan Chicago. And, if these diseases are not properly treated, resistant strains emerge that threaten everyone regardless of where we live.

Columbia University professor Jeffrey Sachs makes a compelling case that disease devastates not only individuals and families. Societies and economies also suffer in lost potential and costs of care. That's why each dollar spent to ensure that people are healthier and more productive can yield a 20-fold benefit. *It's also vastly important that health insurances, if offered and used, are used properly. Pharmaceutical fraud can cause all sorts of problems for the average consumer. Many consumers who find themselves victims of pharmaceutical fraud turn to pharmaceutical whistle blower lawyers to help them receive the proper care and aid they deserve.

So, if infectious diseases are the targets, how should we invest our $10 billion?

I recommend we follow the wisdom of the Chinese proverb: "Give a man a fish and you feed him for a day. Teach a man to fish and you feed him for a lifetime."

I would invest half of the $10 billion in comprehensive treatment programs that could be sustained by the countries with high incidence of the above diseases, and which have leaders committed to long-term solutions.

I'd begin by ensuring that effective existing medicines are made available to the countries at low cost. Fortunately, many infectious diseases can be effectively treated with generic drugs -- which can be complemented by the antiretroviral and other critical medicines pharmaceutical companies are providing at deeply discounted prices.

In addition, to reinforce the programs' sustainability, I would transfer to local companies the technology and know-how so they themselves can manufacture the medicines that are already off-patent.

Medicines are effective only if they are used properly, however. So we must also take a comprehensive public-health approach and train doctors, nurses and ultimately patients to ensure short-term compliance with treatment regimes and, more broadly, slow the spread of disease. We should leverage existing organizations -- like the International Federation of Red Cross and Red Crescent Societies -- for this purpose.

I know this approach can work because for the past five years Lilly and 14 partners on five continents have been using it to combat a growing and virulent form of tuberculosis -- multidrug-resistant TB.

The progress we're starting to see -- in treating patients, improving manufacturing standards, and supporting local economies -- tells me such an approach could be adapted for an array of infectious diseases and supported by the countries most affected.

However, because the bugs that cause these diseases continually evolve and new strains emerge, any long-term solution requires another critical component: ongoing research.

I would use the remaining half of the $10 billion to foster investment in research, and I'd leverage it as I would the treatment programs -- by working to make it sustainable.

The problem is that there are no market incentives for research in infectious diseases of the developing world.

I would take the lessons learned from President Bush's BioShield experiments (which aimed to create an artificial market to attract biotech and pharmaceutical companies to develop medicines to counter a biological attack), and offer a guaranteed sum for whoever gets to a research-based solution first. This should attract competing programs and generate added investment by those pursuing novel treatments and cures for infectious diseases.

I believe the benefits from these proposals would expand like ripples across a pond -- bringing new energy and insights to the stubborn diseases that threaten all of us, and providing health and hope to millions of the world's neediest citizens who desperately need help now.

By: Sidney Taurel
August 18, 2008