Given how NTDs are primarily diseases of poverty, Hotez acknowledged that to an extent, getting pharmaceutical companies to directly invest in them may be akin to “getting a square peg in a round hole.” Even so, there are opportunities for the pharmaceutical industry to get more directly involved.
In this regard, Hotez cited the existence of new “pull mechanisms” intended to create incentives for private sector involvement in diseases of poverty. Unfortunately, for a variety of reasons, they have not yet worked in the NTD world. Priority review vouchers, which entitle companies that invest in neglected diseases to FDA priority review for another product, have not yet encouraged pharmaceutical companies to more deeply invest in NTDs. Similarly, advance market commitments, or binding contracts that guarantee viable markets for drugs, have not yet been used for NTDs.
Donor-funded PDPs will continue conducting vital research to end the disease burden of several common NTDs, with donations from pharmaceutical companies. In the meantime, said Chin, “The expectations for pharmaceutical companies seem to be broadening. People today are demanding more from companies.” Hopefully these raised expectations, together with the above-mentioned pull mechanisms, can soon compel pharmaceutical companies to directly develop drugs and vaccines for the world’s poorest billion.
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