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What is Medical Innovation?

Every day, Médecins Sans Frontières teams throughout the world witness first-hand the human impact of the lack of good medical tools – drugs, diagnostics and vaccines - for many diseases.   Far too often our doctors simply aren’t able to give the best medical care they could wish, because the tests or drugs at their disposal are either antiquated, ill-adapted or ineffective – that is when they exist at all.
Tuberculosis (TB) kills 1.7 million people every year and another nine million are suffering from the disease - but there have been no new drugs developed to treat the disease in almost 50 years, and the most commonly used diagnostic tool was first used in the 1880s. Today more and more patients are coming to our projects with more virulent drug-resistant forms of tuberculosis – but the tests that can show which drugs will work for a patient are too high tech to be used in remote places.  Even if we can get a correct diagnosis, treating a patient with resistant strains of TB currently means giving them weak drugs that have to be taken for a period of up to two years, and that have severe side effects.
TB is just one example of medical tools that are not good enough – there are many others. There is no tool to diagnose infants that have HIV/AIDS; there is no simple test that can detect Chagas disease in patients; some essential antiretroviral drugs used to treat HIV/AIDS require refrigeration and thus can’t be dispensed to patients that don’t have electricity (let alone fridges) at home; there are patients treated for sleeping sickness who may still have to undergo painful treatment with an arsenic-based medicine that can kill them as more effective treatments remain unavailable; and so on.
Failure of the current research and development model
Adapted, effective and affordable medical tools are lacking because of one simple reason: the current way the development of health products are financed. Today, the medical research and development (R&D) system relies - with huge detrimental consequences - on companies recouping their R&D investments through charging high prices, and protecting that price through patent monopolies.  Not only does this mean that some drugs remain completely out of reach for many patients, it also means that diseases like TB or paediatric HIV/AIDS that mostly affect the poor don’t get anywhere near the attention and investment into research as diseases that have bigger, more lucrative markets.
The disparity between the huge amount of funds spent on research to address the health problems of the comparatively small populations of rich countries was encapsulated in what has become a catch phrase; the ‘10/90 gap’. This was initially based on the calculation that ninety per cent of the world’s spending went towards research to sort out the health problems of only ten percent of the world’s population. While this phrase no longer represents a current quantitative measure, it has become the symbol of the continuing mismatch between medical needs and R&D funding priorities.
Last updated: July 2011
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