No More Pneumonia

A new initiative to get needed drugs to poor countries

IN ROME LAST week, a group of leading industrialized nations backed one of those rare ideas that is popular, cost-effective and highly consequential for the world's poor. The United States was not among them -- a mistake we hope U.S. policymakers will correct as the initiative proceeds.

Currently, drug companies do not have a strong incentive to develop new medications or to increase production capacity to serve low-income countries. There's demand in developing nations for everything from better anti-retrovirals to new malaria medication, but the money isn't there, especially given the fickleness of foreign aid. So manufacturers face the unappealing prospect of investing hundreds of millions into drug development and production plants only to see the money available to buy their product disappear.

The solution Italy, Britain, Russia and a few other countries endorsed is in essence a promise to buy medication from any company willing to develop it according to World Health Organization standards and sell it at a certain price. Purchases would continue for at least 10 years, a commitment that would make the market more predictable, and the product would be delivered to poor countries.

Ultimately, donor nations hope to spur development of new drugs against malaria, HIV-AIDS and tuberculosis. But they selected pneumococcus, which causes pneumonia, meningitis and other deadly illnesses, as a test case for the scheme, and committed to buy about $1.5

billion worth of new vaccine for use in poorer countries.

Backers of the plan say that pneumococcus is a natural place to start. It is an unheralded killer, responsible for the deaths of 2 million children a year -- much larger than the annual AIDS toll. Yet the amount of money devoted to developing and producing new drugs to treat pneumococcus infections is tiny compared with that for other high-profile diseases. And, because there are drugs on the market in rich countries that effectively protect humans from the bacterium, the $1.5 billion carrot could have an effect quickly. Drug companies will rapidly decide whether or not to invest in new production capacity.

Notably absent from the agreement so far is America's contribution, even though the plan is a relatively cheap, market-based approach that could eliminate a major killer in the developing world. If the pneumococcus test case produces results, the United States should join similar ventures.