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2 February 2015

Does Western medical research still have #firstworldproblems?

When more money in Britain is spent on researching cures for baldness than for malaria, then there's a problem.

By Fiona Rutherford

In a society obsessed with appearance, a healthy head of hair is to die for. We spend more money worldwide on curing baldness than malaria, which killed half a million people in 2013 (that’s roughly the population of Edinburgh).

It feels like every year we’re edging closer and closer to winning the battle against baldness. Just last week it was announced that scientists may have found a cure for male pattern baldness using stem cells. That’s great news for old balding men, though not so great for the 1.4 billion people suffering from fatal diseases ignored by the Western world.

When it comes to medical research and funding, some diseases are favoured more than others. David Cameron named dementia as “one of the greatest enemies of humanity”. He said this last year during the launch of a government-funded research campaign, which put forward £100 million to help find a cure for dementia by 2025.

Forty million people suffer with dementia worldwide. Yet there are other equally devastating diseases that fail to attract the same sense of urgency, attention, and money. For example, elephantiasis, which globally afflict 120 million people, and soil-transmitted helminthiasis, which afflicts over 1 billion people. These are just a few of the “neglected tropical diseases — a term describing a group of infectious illnesses that cause suffering to people in the poorest countries due to lack of basic health care services. They are known for affecting the economically and politically marginalised, and pose little threat to high-income countries.

Over the past ten years the West has become somewhat more concerned with neglected tropical diseases, and has taken steps to address the problem. Last month, a new initiative was launched in Parliament called the University Global Health Research League Table (GHRLT), which aims to create awareness of how university research policies can positively impact the health needs of developing countries. This is the first of its kind in the UK – a disappointing fact when you consider how influential they are, with more than 30 per cent of new drugs developed at universities. However, research and medicine is difficult to access and often unaffordable for those in developing countries. Perhaps the increased attention to neglected tropical diseases is owed to the realisation that one day they might become not-so-tropical – and hair loss may not be as much of a priority as diseases that cause death.

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Ebola, for example, also a neglected tropical disease, very recently saw the largest, deadliest, and most complex outbreak since its discovery in humans almost 40 years ago. Prior to this epidemic, the World Health Organisation (WHO) has records of 26 outbreaks, and nearly 2000 cases of the virus between 1976 and 2013, most of which were in sub-Saharan Africa. But when the WHO declared Ebola as an international health emergency in August of last year, it highlighted the fact that there were no proven cures, treatments, or vaccines to prevent infection. It caused a global panic, which even lead CNN to ask whether Ebola was the “Isis of biological agents”.

Diseases shouldn’t become a concern only when it threatens the adults, children, family and friends of the wealthy western populations. Even though Ebola was unlikely to cause a major outbreak in the UK, the symptoms – bleeding from the eyes, ears, anus and other orifices, before finally dying – were difficult to ignore. It forced many to look at global health issues from a different perspective.

However, sudden surges of western interest in tropical diseases are not new. They’ve historically been linked with politics, war and colonialism – for example, research into tropical diseases, such as Yellow Fever, only became an area of concern when it caused settlers and soldiers to become ill, therefore interfering with Europeans attempt to control Africa. People in developing countries make up 80 per cent of the global population, yet only account for approximately 20 per cent of global medicine sales. Without economic incentives it’s unlikely that drug manufacturers would dedicate money, time and research into creating new drugs for populations unable to afford them.

The GHRLT showed that, of the 25 top-funded universities, most were not investing a substantial proportion of their research budget into global health. This includes the University of Cambridge, which ranks 15th in the league table. Eight universities were awarded a grade D or worse (on a scale from A+ to D-) for their commitment to global health. And only seven showed commitment to making their findings easily accessible to those in developing countries. “Most universities are not doing enough to tackle the needs of the poorest”, said co-lead of the initiative, Dzintars Gotham. “Universities should take seriously their ability to do work in areas that are neglected by profit-seeking companies.”

Medical research is expensive even for wealthy countries like the UK, let alone for developing countries. Universities should invest more of their research budgets into global health and medicine, as well as sharing their knowledge and discoveries in ways that are easily accessible to the world’s poorest countries. The unrestricted availability of scientific research papers is important for everyone, but particularly for global health as it helps scientists from developing countries progress in their own research.

While Cameron may consider dementia “one of the greatest enemies of humanity”, I disagree. The greatest enemy of humanity is not just one disease, or many – it is the West spending more money on curing baldness than malaria, and ignoring the medical needs of the marginalised, unless or until it becomes a threat.