In recent years, Brazil has made tremendous advances in the field of biotechnology despite its status as a developing country. It has taken advantage of its public-sector infrastructure and low-cost production to tackle the issue of poor health care, which is one source of poverty, by investing heavily and soundly in health research and development to create and patent new vaccines, technologies, and health services to combat diseases that primarily affect the poor.
Due in part to global product development partnerships, Brazil is successfully pioneering the development of vaccines for tropical infectious diseases that are largely ignored by the international public health community because of relatively small capital returns on investment. It is then exporting these vaccines to the rest of the developing world. This seminar focused on biotechnological accomplishments and obstacles to overcome in the field of neglected tropical diseases.
Heloisa Sabin invoked the memory of her late husband, Albert B. Sabin, the developer of the oral vaccine for polio. She stressed the vital importance of biotechnology and medical research in working to eradicate diseases and improve the lot of the world's poor. Ciro de Quadros described how the Sabin Institute commemorates Sabin's legacy through the promotion of vaccine research by identifying viable research opportunities and supporting their development. The Institute is currently developing a vaccine for the production of the human papilova virus vaccine, as well as working on its flagship Human Hookworm Vaccine Initiative. According to Quadros, the main challenge to biotechnology lies in the transfer of technology, so that those in poorer countries can utilize and benefit from medical inventions that, more often than not, are developed in rich countries. He sees ongoing vaccine developments, in both the developed and developing world, as heralding in a new era: while "the twentieth century was the century of antibiotics, the twenty-first will be the century of vaccines."
Peter Hotez highlighted collaboratory measures taken by Brazilian public health organizations such as Fiocruz and the Butantan Institute, with global partner development partners, such as the Sabin Vaccine Institute, to target tropical diseases neglected by most researchers in the developed world. Malaria, HIV, and tuberculosis, or the "big three," receive all the attention from the international community, he argued, while 13 parasitic and bacterial diseases are often overlooked and understudied. These 13 diseases have been burdening humanity for centuries, and many of them are associated with intense stigmas, as is the case with leprosy. These diseases mainly afflict the rural poor of low-income countries, as such diseases are often both causes and consequences of poverty. Many of these diseases cause physical growth suppression and cognition underdevelopment, decreasing victims' chances of making a better livelihood. A paradigm shift is needed in the way we think about diseases in developing countries, Hotez insisted, with the big three replaced by the "gang of four," to account for neglected tropical diseases in the aggregate.
While there are numerous drugs on the market that fight some of these neglected diseases, new vaccines are needed to prevent resurgence and ensure eradication. Hotez has been the brains behind the vaccine for hookworm, an intestinal parasite that usually just causes mild diarrhea or cramps but can cause serious health problems for newborns, children, pregnant women, and malnourished people. After passing initial human tests in the United States, it is going to be tested in villages in Minas Gerais State, Brazil, where around 70 percent of the population is infected.
Obstacles to research and development of other vaccines lie in the lack of sizeable commercial markets to incentivize the pharmaceutical sector to finance them. While the market for such vaccines is huge, the likely commercial payoffs are comparatively small. Indeed, the medication used for Sleeping Sickness was developed more than seventy years ago. There is little incentive to stimulate innovation, so this obsolete medication, which is basically constituted of arsenic, continues to be used even though it kills 5 to 10 percent of patients treated with it. The only way to make the commercialization of vaccines for neglected diseases viable, concluded Hotez, is through increased public-private partnerships between developing world initiatives and developed world resources.
Isaias Raw reiterated the problem of lack of commercial incentive, explaining that medicine should be "for people," not for profit. He highlighted the need to invest in research and development in the developing countries themselves so that medicines are made available to the poor at affordable prices. It is rare for developed countries to be willing to transfer technology to developing ones. There are companies in Brazil willing to pay the intellectual property rights, but a full technology transfer is needed, not one in which further technology is required every two or three years. The developing world wants to be able to develop its own medications to better protect its citizens, Raw argued. According to the Brazilian Constitution, citizens are entitled to receive health care free of charge. For this to be feasible, the government must have access to affordable medicines.
Akira Homma provided an overview of the development and evolution of Brazilian biotechnology. He outlined the country's increasing vaccine production capacity by showing that in 2004, 96% of polio vaccinations used in Brazil were produced domestically. This year, Brazil became the first developing country to introduce the Rotovirus vaccine in the public sector. However, despite significant achievements, there still remains a gap in technology development, with not enough private companies taking the high risk of investing in tropical disease research.
In regards to intellectual property rights, Homma stressed the need for the developed world free up technology and share it with the developing world at negotiated prices. For Brazil, he recommended addressing four basic issues to continue the pursuit of knowledge and development of biotechnology to combat tropical diseases: creation of a more favorable political, social and cultural context; supporting the strong demand for vaccines; fostering scientific and technological progress; and more effective policies and financing.
Drafted by Daniel Budny.
- Professor and Chairman, Department of Microbiology and Tropical Medicine, George Washington University
- Acting President & CEO, Albert B. Sabin Vaccine Institute; Associate Adjunct Professor, Johns Hopkins School of Hygiene and Public Health
- President, Fundação Butantan; Researcher, Center of Biotechnology, Instituto Butantan, Brazil
- Director, Bio-Manguinhos / Fiocruz (Brazil)
- Founding Member, Sabin Vaccine Institute