Western society's decision to leave drug development in the hands of the private sector has led to a crisis for the world's poor, because the private sector has failed to develop or distribute drugs to treat infectious diseases in the poorest regions of the world.

A new public sector initiative is urgently needed to combat such diseases. These were the conclusions of an international meeting, "The crisis of neglected diseases," held by the humanitarian organisation Médecins Sans Frontiàres in New York last week.

The organisation presented its recent study of neglected diseases, which it defines as those for which there is a lack of affordable, effective, easy to use medicines. These diseases, which include sleeping sickness, kala azar, and Chagas' disease, account for 10% of the global disease burden.

The study found that of the 1393 new drugs marketed between 1975 and 1999, only 16 were for neglected diseases. Of these 16, five had originally been developed through veterinary research and two through US military research.

Els Torreele, co-chairwoman of the Médecins Sans Frontiàres working group on neglected diseases, told the meeting that the pharmaceutical industry can never be expected to develop drugs for these diseases, since its research and development agenda is driven purely by a profit motive.

"Pharma [the pharmaceutical company] operates in a global market economy, and market forces skew the direction of research and development towards diseases that ensure the highest financial returns," she said.

The failure of industry to develop drugs for neglected diseases, she added, represented a "public policy failure," in that public policies in the West are geared towards private investment in drug development.