Health. CARE. First. AID.

words.

"This system does a reasonable job of getting Westerners the drugs they want (albeit often at high prices). But it also leads to enormous underinvestment in certain kinds of diseases and certain categories of drugs. Diseases that mostly affect poor people in poor countries aren’t a research priority, because it’s unlikely that those markets will ever provide a decent return. So diseases like malaria and tuberculosis, which together kill two million people a year, have received less attention from pharmaceutical companies than high cholesterol. Then, there’s what the World Health Organization calls “neglected tropical diseases,” such as Chagas disease and dengue; they affect more than a billion people and kill as many as half a million a year. One study found that of the more than fifteen hundred drugs that came to market between 1975 and 2004 just ten were targeted at these maladies. And when a disease’s victims are both poor and not very numerous that’s a double whammy. On both scores, a drug for Ebola looks like a bad investment: so far, the disease has appeared only in poor countries and has affected a relatively small number of people.

It’s not just developing nations that the system disserves, however. In recent years, the rise of drug-resistant microbes has made the antibiotics we use less effective and has increased the risk that an infectious disease could get out of control. What people in the West need, health officials agree, is new drugs that we can keep in reserve against an outbreak that regular antibiotics can’t contain. Yet, over the past thirty years, the supply of new antibiotics has slowed to a trickle. “Antibiotic resistance really has the potential to make everything about the way we live different,” Kevin Outterson, a co-director of the Health Law program at Boston University and a founding member of the C.D.C.’s working group on antimicrobial resistance, told me. “So we need to stoke the pipeline.”

...The up-front costs of a prize system would be substantial—a recent report commissioned by the F.D.A. estimated that it would cost a billion dollars to get a great new antibiotic, factoring in tax credits. But we’d save lives by developing the drugs we need and taking measures against future disaster. The alternative is pretty grim: a system that, when it comes to some fierce mortal perils, is leaving a lot of blood on the floor."

THE NEW YORKER: Ebolanomics