Geneva - Virtually no new drugs are being developed for diseases that predominantly affect the poor, according to "Fatal Imbalance", a report issued today by the international medical aid agency Médecins Sans Frontières (MSF).

The report details survey responses of drug R&D activities from some of the largest pharmaceutical companies in the world, representing combined sales of nearly $117 billion. From these 11 companies, only one new tuberculosis drug was brought to market in the last five years. Eight of the 11 reported no research activities in the last year for fatal diseases that almost exclusively affect the poor: sleeping sickness, Chagas disease and leishmaniasis .

"Millions of people in developing countries are dying every year because the only drugs available to treat many infectious diseases are old, toxic or ineffective" says Dr Bernard Pécoul, Director of MSF's Campaign for Access to Essential Medicines. "Tropical diseases alone account for almost 10% of the global disease burden but virtually no new medicines are being developed, and drug resistance is wiping out the drugs we have."

This dire lack of drug R&D into unprofitable diseases is also demonstrated in new data showing that, of the 1393 new drugs approved between 1975 and 1999, just 13 (1%) were for tropical diseases. "Fatal Imbalance" explains that the current global system works well when it comes to developing drugs for diseases like cancer and heart disease or even conditions such as baldness or impotence. But it also explains why diseases that affect people with low purchasing power will not attract investment from private industry.

Responsibility for correcting the Fatal Imbalance lies with governments, who must become directly and proactively involved in searching for solutions at a global level. The report also recommends that capacity building and technology transfer projects to increase R&D expertise in developing countries be actively pursued.

"Drugs are not developed according to public health need, but according to profitability." said Dr Pécoul. "A new paradigm is urgently needed to address this fatal imbalance. Together with partners from wealthy and developing countries, MSF is actively exploring the creation of a Drugs for Neglected Diseases Initiative (DNDi), which will focus exclusively on drug development for neglected diseases. This initiative will need strong public leadership and financing, as well as private sector support."

The Drugs for Neglected Diseases Initiative will harness funding and new science and technology, foster public-private co-operation and strengthen pharmaceutical R&D capacity in developing countries. The ultimate aim is to develop new drugs which are affordable to those who need them.

As part of this exploration, MSF is funding three pilot drug development projects on drugs for malaria, leishmaniasis, and sleeping sickness. Partners include experts from Brazil, Thailand, Malaysia and Burkina Faso.

"Fatal Imbalance: The Crisis in Research and Development for Drugs for Neglected Diseases", is the product of the DND Working Group, a collaboration between scientists, health professionals, drug development experts, international organisations and NGOs.