Delta Scan: The Future of Science and Technology, 2005-2055: Improved Health Care for Underdeveloped Regions

Key Pages

Category:
Science and Technology

Domain:
Biology and Biotechnology

Keywords:
Developing World - health care, economics, intellectual property, medicine, poverty

Outlook:
Advances in technology and medicine, as well as the expiration of patents on medicine, will open up wider opportunities in health care in developing regions.

Summary Analysis:
The convergence of widespread health care research (and the ensuing knowledge) with the expiration of patents on medicines and medical devices, could make quality health care much more widely available in underdeveloped regions.

The developed world has been providing structured funding for 50+ years to address the unique health care challenges faced in poor regions (such as sanitation and nutrition). While these have contributed to significant progress in life expectancy within these regions, economic disincentives have prevented investment in research to address developing world diseases. Now many medical discoveries from the mid-20th century onward are coming into the public domain as patents expire and developing nations with drug industries (South Korea, Israel, India, and China) are waiting in the wings to manufacture generic versions of biologics (that is, follow-on biologics).

Furthermore, as information technology is likely to play a growing role in health care in developing nations, these nations are likely to benefit from the enormous number of health care applications now becoming freely available as 'open source'.

While these developments alone are unlikely to be sufficient, these, coupled with growing economies, improving educational systems and political priorities, could bring significant benefits to healthcare and life-expectancy in some of the poorest parts of the world.

Implications:

Increased pressure on First World drug and device prices from black and grey markets
Reordering and growth of developing economies thanks to increased life span and quality of life for citizens
Potential for widespread health problems stemming from misapplication or misuse of powerful drugs and devices because of improper training (for example, overuse of antibiotics)
Potential jumpstarting of experimentation and drug research by development of basic manufacturing competency in previously underdeveloped regions

Early Indicators:

Dr. Peter Lansbury's testing of more than 1,000 drugs on which the patent has expired for their treatment effects on Parkinson's Disease (Harvard Medical School)
India's increasing production of pharmaceuticals, making it the fourth largest producer worldwide, according to the World Health Organization

What to Watch:

Foundation grants, together with the support of the UN and Western donor nations, enable development of inexpensive medicines for widespread illnesses.
Developing nations collaborate to create a complete drug development industry, from basic research through preclinical and clinical development to generic and new drug production.

Parallels/Precedents:

Enablers/drivers:

Upcoming expiration of the patents of some early biotech discoveries
Development of creative approaches to intellectual property that help to create domestic industries for generic drugs (such as India's policy of allowing process patents for drugs that are product patented elsewhere)

Leaders:
Institutions:

Ranbaxy, Cipla, Dr. Reddy's, and Sun Pharmaceutical Industries (India's first, second, third, and fourth largest drug producers, respectively)
Teva Pharmaceutical Industries Ltd. (Israel), Mylan Laboratories Inc. (U.S.) (production of generic drugs)
AIDS Law Project, Centre for Applied Legal Studies, University of the Witwatersrand, South Africa [link]
Canadian Program on Genomics and Global Health, University of Toronto, Canada [link]
Indian Council of Medical Research [link]
Department for International Development Health Resource Centre, UK [link]
Nuffield Centre for International Health and Development, Leeds University, UK [link]
Science Commons
Open Source Health Care Alliance
OneWorld Health

Figures:

Sources:

"Nature Biotechnology: Health Biotechnology Innovation in Developing Countries." Nature 22 (Dec. 2004) [link]
Maurer, SM, A. Rai, A. Sali. 2004. "Finding cures for tropical diseases: Is open source an answer?" Public Library of Science Medicine 1(3): e56. [link]
Rai, AK. 2005. "Open and collaborative research: A new model for biomedicine" in: Hahn R, editor. Innovation in Frontier Industries. Biotech and Software. Washington, (D.C.): AEI-Brookings Press. In press.
Thorsteinsdóttir, Halla. "The Different Strands of International Collaboration in Health Biotechnology in Developing Countries."
"Drugs: Round One to Africa." Observer. April 22 2001 [link]
Shadlen, K. "Patents and Pills, Power and Procedure: the North-South Politics of Public Health in the WTO." Studies in Comparative International Development. Fall 2004 [link]
"Genomics and World Health." World Health Organisation. 2002 [link]
United Nations Millennium Project Task Force on Science, Technology and Innovation. 2004 [link]
"Fatal Imbalance: The Crisis in Research and Development for Drugs for Neglected Diseases." Médecins Sans Frontières. Brussels. Sept 2001 [link]

At A Glance:
When:
11–20 years

Where:
Global

How Fast:
Months–Years

Likelihood:
Medium-High

Impact:
Medium

Controversy:
Medium

Related Outlooks:

About this outlook: An outlook is an internally consistent, plausible view of the future based on the best expertise available. It is not a prediction of the future. The AT-A-GLANCE ratings suggest the scope, scale, and uncertainty associated with this outlook. Each outlook is also a working document, with contributors adding comments and edits to improve the forecast over time. Please see the revision history for earlier versions.

Category:	Science and Technology
Domain:	Biology and Biotechnology
Keywords:	Developing World - health care, economics, intellectual property, medicine, poverty
Outlook:	Advances in technology and medicine, as well as the expiration of patents on medicine, will open up wider opportunities in health care in developing regions.
Summary Analysis:	The convergence of widespread health care research (and the ensuing knowledge) with the expiration of patents on medicines and medical devices, could make quality health care much more widely available in underdeveloped regions. The developed world has been providing structured funding for 50+ years to address the unique health care challenges faced in poor regions (such as sanitation and nutrition). While these have contributed to significant progress in life expectancy within these regions, economic disincentives have prevented investment in research to address developing world diseases. Now many medical discoveries from the mid-20th century onward are coming into the public domain as patents expire and developing nations with drug industries (South Korea, Israel, India, and China) are waiting in the wings to manufacture generic versions of biologics (that is, follow-on biologics). Furthermore, as information technology is likely to play a growing role in health care in developing nations, these nations are likely to benefit from the enormous number of health care applications now becoming freely available as 'open source'. While these developments alone are unlikely to be sufficient, these, coupled with growing economies, improving educational systems and political priorities, could bring significant benefits to healthcare and life-expectancy in some of the poorest parts of the world.

	Implications:	Increased pressure on First World drug and device prices from black and grey markets Reordering and growth of developing economies thanks to increased life span and quality of life for citizens Potential for widespread health problems stemming from misapplication or misuse of powerful drugs and devices because of improper training (for example, overuse of antibiotics) Potential jumpstarting of experimentation and drug research by development of basic manufacturing competency in previously underdeveloped regions
	Early Indicators:	Dr. Peter Lansbury's testing of more than 1,000 drugs on which the patent has expired for their treatment effects on Parkinson's Disease (Harvard Medical School) India's increasing production of pharmaceuticals, making it the fourth largest producer worldwide, according to the World Health Organization
	What to Watch:	Foundation grants, together with the support of the UN and Western donor nations, enable development of inexpensive medicines for widespread illnesses. Developing nations collaborate to create a complete drug development industry, from basic research through preclinical and clinical development to generic and new drug production.
	Parallels/Precedents:
	Enablers/drivers:	Upcoming expiration of the patents of some early biotech discoveries Development of creative approaches to intellectual property that help to create domestic industries for generic drugs (such as India's policy of allowing process patents for drugs that are product patented elsewhere)
	Leaders:	Institutions: Ranbaxy, Cipla, Dr. Reddy's, and Sun Pharmaceutical Industries (India's first, second, third, and fourth largest drug producers, respectively) Teva Pharmaceutical Industries Ltd. (Israel), Mylan Laboratories Inc. (U.S.) (production of generic drugs) AIDS Law Project, Centre for Applied Legal Studies, University of the Witwatersrand, South Africa [link] Canadian Program on Genomics and Global Health, University of Toronto, Canada [link] Indian Council of Medical Research [link] Department for International Development Health Resource Centre, UK [link] Nuffield Centre for International Health and Development, Leeds University, UK [link] Science Commons Open Source Health Care Alliance OneWorld Health
	Figures:
	Sources:	"Nature Biotechnology: Health Biotechnology Innovation in Developing Countries." Nature 22 (Dec. 2004) [link] Maurer, SM, A. Rai, A. Sali. 2004. "Finding cures for tropical diseases: Is open source an answer?" Public Library of Science Medicine 1(3): e56. [link] Rai, AK. 2005. "Open and collaborative research: A new model for biomedicine" in: Hahn R, editor. Innovation in Frontier Industries. Biotech and Software. Washington, (D.C.): AEI-Brookings Press. In press. Thorsteinsdóttir, Halla. "The Different Strands of International Collaboration in Health Biotechnology in Developing Countries." "Drugs: Round One to Africa." Observer. April 22 2001 [link] Shadlen, K. "Patents and Pills, Power and Procedure: the North-South Politics of Public Health in the WTO." Studies in Comparative International Development. Fall 2004 [link] "Genomics and World Health." World Health Organisation. 2002 [link] United Nations Millennium Project Task Force on Science, Technology and Innovation. 2004 [link] "Fatal Imbalance: The Crisis in Research and Development for Drugs for Neglected Diseases." Médecins Sans Frontières. Brussels. Sept 2001 [link]

At A Glance:	When:	11–20 years
	Where:	Global
	How Fast:	Months–Years
	Likelihood:	Medium-High
	Impact:	Medium
	Controversy:	Medium