Fighting the 10/90 Gap

While wealthy nations pursue drugs to treat baldness and obesity, depression in dogs, and erectile dysfunction, elsewhere millions are sick or dying from preventable or treatable infectious and parasitic diseases.1 It's called the 10/90 gap. "Less than 10% of the worldwide expenditure on health research and development is devoted to the major health problems of 90% of the population," explains Els Torreele, co-chair of a working group that provided background recently for an initiative announced

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MSF's Drugs for Neglected Diseases initiative (DNDi) will address what MSF-USA executive director Nicolas De Torrente called "a fundamental mismatch, expressed as millions of lives lost each year, between human needs and scientific innovation." Planning began in 1999, when MSF gathered international experts to identify contributing social, political, economic, and technical factors, and to suggest solutions. The March unveiling, in a packed auditorium at the Graduate Center of the City University of New York, attracted almost 400 people—an eclectic mix including government scientists from the United States and European Union, representatives of MSF and the World Health Organization (WHO), activists and health care workers, a brave few from the pharmaceutical industry, and interested others.

The challenge is clear. "Old drugs are becoming less effective, existing drugs aren't being made, and no new drugs are on the horizon," summed up James Orbinski, working group co-chair and a researcher at the Munk ...

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