by Owen Barder
Sir, Policymakers are rightly turning their attention to finding ways to use scientific knowledge to address the health needs of the developing world. As Andrew Jack reports ("Rich world divided over the health of the poor", June 17 - subscription required), no single solution will ensure that new medicines and vaccines are developed and affordable. But it is not true that policymakers are "sharply divided" about which approach to adopt: on the contrary, there is a clear consensus among experts that we need a mixture of publicly funded research, public-private partnerships, and commercial investment to accelerate development of new medicines. It is not surprising that this combination has such wide support: it is the mixture of funding and incentives that has led to the development of medicines for the health needs of the rich world.
Private sector investment is constrained by the absence of a valuable market for medicines for poor countries. The Group of Eight finance ministers' communiqué endorsed advance purchase commitments as an additional policy that would create a market incentive for more private sector investment, to complement public and charitable funding of research. As your other report, "Drug companies appeal for G8 backing to fight diseases", explains, public and charitable funding alone are not sufficient for new medicines to be developed and brought to market.
There is no competition between these approaches. A benefit of advance purchase commitments is that payments are only needed if and when a new vaccine has been developed; so in the meantime the donors can and should increase public funding of research. Without an advance purchase commitment, many medicines will remain stuck in the pipeline, and there is no guarantee that poor countries will be able to afford them if and when they are developed.
Owen Barder, Center for Global Development, Washington, DC 20036, US