title: [Research and pharmaceutical development on the subject of communicable diseases in the intertropical region].
abstract: The development of the antimalarial drugs mefloquine and halofantrine in 1988 by American military research teams marked a start in the decline in investment in tropical disease research and drug development. The globalization of the market, increased clinical costs, and constraints on public health spending caused the pharmaceutical industry to concentrate on more profitable market segments (cardiovascular drugs, antineoplastics, anti-infection drugs, etc.). The market in developing countries represents a large volume, but a very low return because the added value is small, generic drugs are used and the state of the populations is impoverished. The ten or so drugs that have been developed recently result from chance (eflornithine), veterinary research (ivermectin), fortuitous analysis of traditional pharmacopoeia (artemether) or reevaluations of former drugs (amopyroquine). The deficiency of research and drug development for diseases of the intertropical zone has a direct negative effect on public health and also reveals health policy inconsistencies, particularly the incompatibility of the pharmaceutical industry's interests and international health priorities. The problem is also aggravated by the closed approach of external health assistance (official development aid) which aims to minimize costs by favoring primary health care.
authors.affiliation: Centre hospitalier universitaire de Grenoble, Service pharmacie, France.
authors.forename: P
authors.initials: P
authors.lastname: Trouiller
mesh_terms: D000634:Aminoquinolines; D000871:Anthelmintics; D000890:Anti-Infective Agents; D000962:Antimalarials; D000970:Antineoplastic Agents; D000077549:Artemether; D037621:Artemisinins; D002317:Cardiovascular Agents; D003140:Communicable Disease Control; D003906:Developing Countries; D016527:Drug Costs; D004345:Drug Industry; D004358:Drug Therapy / Q000191:economics; D016568:Drugs, Generic; D000518:Eflornithine; D005102:Health Expenditures; D006291:Health Policy; D006292:Health Priorities; D006801:Humans; D007559:Ivermectin; D015767:Mefloquine; D010616:Phenanthrenes; D011203:Poverty; D011634:Public Health; D012106:Research; D012717:Sesquiterpenes; D014329:Tropical Climate; D014344:Trypanocidal Agents
chemical_list: D000634:Aminoquinolines; D000871:Anthelmintics; D000890:Anti-Infective Agents; D000962:Antimalarials; D000970:Antineoplastic Agents; D037621:Artemisinins; D002317:Cardiovascular Agents; D016568:Drugs, Generic; D010616:Phenanthrenes; D012717:Sesquiterpenes; D014344:Trypanocidal Agents; D007559:Ivermectin; D000077549:Artemether; C023768:halofantrine; C009846:amopyroquine; D015767:Mefloquine; D000518:Eflornithine