No Incentive for a Cure?: What Really Scares Me About AIDS

We SciBloggers were posed with this question:

To what extent do you worry about AIDS, either with respect to yourself, your children, or the world at large?

Here's what really worries me about AIDS (from the old Retrospectacle):

The Federal Chief of AIDS research recently said that he believed that drug companies don't have an incentive to create a vaccine for HIV and are likely going to wait for the government to develop the vaccine and then profit from it.

"They're dropping out like flies because there's no real incentive for them to do it. We have to do it."

The UN also recently acknowledged that it was not realistic that the AIDS pandemic would be stopped by 2015, and it would likely take 20 years before an HIV vaccine is created. In the US total annual spending on a vaccine is $682 million, which represents 1% of total spending on health product development. Private sector efforts for vaccine research only amount to (total for ALL drug companies) $100 million annually. In comparison, the private sector annually spends untold billions on advertising, and the CEO of Pfizer (in 2000) made over $40 million.

(More under the fold.....)

Now, I wasn't necessarily saying that private drug companies have an obligation to develop an AIDS vaccine. Rather, I think its interesting that the Fed Chief of AIDS research was frank enough to make a statement that (hopefully) might increase federal funding to academic labs researching a vaccine.

That said, to me it is interesting that drug companies try to portray this fluffy cure-all humanitarian image (just look at Pfizer's homepage) while ignoring the more pressing diseases out there. Pharms are businesses, yes, and their main obligation is to their stockholders. Creating salient drugs are a byproduct. What's wrong with that? Nothing so long as the pharms message is clear.

The Orphan Drug Act was designed with this problem in mind (helps pharms recoup R&D costs by tax deductions, monopoly, etc). Also, private companies can apply for government grants to research high-profile diseases. There is actually a huge well-funded panel of the NIH just for AIDS research, and they're practically begging people to take the money. So it puzzles me that, even if ALL their R&D costs are freely given, still no pharms want to tackle the vaccine. The reason, I might wager to guess, lies in where the majority of the affected live and their inability to pay much for the drug. Not to mention the huge anticipated world outcry to give it away for next to nothing.

As for advertising, I have no problem with ads directed to the informed party, namely doctors. Direct to consumer advertising undermines the role of the doctors and creates brand-oriented patient awareness rather than merit-based. Non-drug industry sponsored survey research, such as that done last year by the Kaiser Family Foundation, found that almost three out of four people who had just seen an ad said they learned little or nothing about the specific health condition mentioned. Almost 60% reported they had learned little or nothing about the specific drug being advertised. In addition, "about half or more of the respondents could not correctly identify the potential side effects after just having viewed an ad."