The Lancet calls for health R&D G8

Existing R&D efforts to fight diseases are not enough to ensure improvements to health care in developing countries, according to an editorial in The Lancet. Often this is because there are gaps in measuring the effectiveness of major campaigns, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, which has not been the subject of a rigorous, scientific assessment of its operations since 2002, the authors claim. Another problem is the lack of implementation science: the effectiveness of an intervention may be known, but how to deliver it is unclear.

The International Policy Network, a UK-headquartered think-tank specializing in development issues, recently published a report on the shortcomings of public sector attempts to deliver medicines in poorer countries. The IPN's health program director, Philip Stevens, argues that, money would be used more efficiently if it were given to the private sector via outcome-based competitive contracts, "rather than used to subsidize dysfunctional public sector delivery as is currently the case," he told the Marketletter.

In contrast to the Global Fund's headline-grabbing claims of 1.1 million people on antiretroviral drug programs and 30 million receiving insecticide-treated mosquito nets in 2006, there are less dramatic, but well-managed campaigns such as that of Germany's Merck KGaA, which is delivering 200 million Cesol (praziquantel) tablets worth about $80.0 million over 10 years to combat the worm disease schistosomiasis in four African countries (Marketletter October 20).