"The World's Most Neglected Diseases"

"Infectious diseases can be considered 'neglected' when there is a lack of effective, affordable, or easy to use drug treatments" (BMJ 29 July 02). " As most patients with such diseases live in developing countries are too poor to pay for drugs, the pharmaceutical industry has traditionally ignored these diseases."

Médicins sans Frontières recently organised a meeting in New York to explore the question of why the publicprivate partnerships which have tackled malaria, HIV and tuberculosis, have ignored kala-azar, Chagas' disease and sleeping sickness. The answer is that the first three can claim sufferers in developed countries.

The company that developed Eflornithine for sleeping sickness stopped its production in 1995; African patients could not afford to buy the drug. "Eflornithine became available five years later in the United States, when it was found to reduce facial hair in women."

Médicins sans Frontières, backed by the Pasteur Institute, the Indian Council for Medical Research and the Brazilian Government pharmaceutical organisation Fiocruz, has launched an initiative to test the idea that a drug research and development network could be established in the developed world, with a central management. This would define its needs, and then rely on public investment, not market forces, to meet them.