Neglected Diseases: Lost in translation

The culture of academia needs to change if scientists are to bridge the gap between research and the development of drugs and vaccines for neglected diseases in the developing world, says Declan Butler.

Read any scientific paper or grant proposal on basic research into neglected diseases and you inevitably find a claim that the work could lead to new therapies for diseases that affect millions of people in the developing world. Few, in fact, ever do, and scientists, universities and research funders are waking up to the fact that part of the blame lies with them and their perpetuation of a reward culture that focuses excessively on papers and patents, and not on whether the research actually benefits society.

In disease research, academia has traditionally restricted its role to basic research. Subsequent development is then left to the pharmaceutical industry. But when it comes to neglected diseases — those that disproportionally affect poor and marginalized populations — the drugs and vaccines have low returns, so commercial firms cannot fork out for the expensive development. As a result, there is a 'translational gap' in which promising research leads sit on the shelf, and potential drugs and vaccines go undeveloped.

The academic reward culture means that researchers have little incentive to do the 'grunt work' needed to close this gap because it does not generate papers in top journals, says Mel Spigelman, director of research and development at the Global Alliance for TB Drug Development in New York. The competitive nature of academic research and of the publication reward system can also lead to unnecessary duplication of work, and hinders the sharing of data, he adds.

The time has never been riper for greater engagement of academics in the development of new drugs. Over the past decade, the translational gap has started to close for neglected diseases, thanks to the emergence of a series of public–private partnerships between charities, large pharmaceutical companies and small biotech firms. These partnerships are run like businesses, but not for profit, and include the Malaria Vaccine Initiative in Bethesda, Maryland; the Medicines for Malaria Venture in Geneva, Switzerland; the Global Alliance for TB Drug Development; and the Drugs for Neglected Diseases Initiative (DNDi) in Geneva, Switzerland, which is seeking cures for the 'most neglected' diseases, such as sleeping sickness (African trypanosomiasis), Chagas' disease and leishmaniasis.

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