December 2015

by James Kallman

Just imagine the productivity gains if malaria, hepatitis-C, measles, mumps, rubella and so on became extinct diseases.

Many are familiar with Moore’s Law regarding the number of transistors in a dense integrated circuit doubling approximately every two years, yet few have even heard of its inversion, Eroom’s Law (Moore’s spelled backwards). This is based on the observation that since the 1950s the number of new U.S. Food and Drug Administration-approved drugs the pharmaceutical industry has brought to market per $1 billion spent on research and development has halved every nine years. Moreover, the average cost of ushering a new drug to market has more than doubled this past decade.

These are unhealthy symptoms for an industry that is facing momentous challenges, as thanks to the imprudent use of antibiotics many bacterial diseases have developed and continue to develop immunity to drugs currently in use. Moreover, as this past year’s Ebola outbreak showed, the convenience of today’s international airlines can swiftly carry diseases far from their source and threaten largely unprepared populations. Add to this the effects of global warming and the inexorable northward movement of former tropical diseases and “out of Africa” may soon take on a whole new meaning.

Yet it is also an era of great opportunity. I remember when a smallpox vaccination was imperative when going abroad, yet thanks to a global immunization campaign it was declared eradicated in 1980. We’re almost there with polio too, although lack of political will and hostilities keep it present in Afghanistan, Chad, Pakistan and Nigeria.

Scientific advances allow us to engineer new approaches to not just counter ancient diseases but also totally eradicate them. Just imagine the productivity gains if malaria, hepatitis-C, measles, mumps, rubella and so on became extinct diseases. The latter three are already subjects of extensive immunization campaigns worldwide. It would take just political will and funding to turn these campaigns into ones of total eradication. Meanwhile, human trials of a vaccine for hepatitis-C look promising too.

Like HIV/Aids, malaria offers a different challenge, and maybe the greatest reward. One viable approach envisages genetically engineering the introduction of a gene into the host anopheles mosquito that renders it highly resistant to the malaria parasite. This change will swiftly break the link between the parasite and humans while keeping the mosquito in the ecosystem. Though widespread release of doctored mosquitoes may be five years away, it could help eradicate malaria by mid-century with concomitant gains in productivity.

Success stories continue to appear, like a recently approved drug for treating melanoma. Nevertheless, the pharmaceutical industry is still dogged by pricing controversies such as the recent jump from $13.50 to $750 per pill for a drug that’s been around since 1953 and sells for less than $1 in the UK. Indeed, the cost of prescription drugs grew 14% in the U.S. last year, helping boost the industry’s profit margins to roughly twice that of banks. Yes, regulation is needed to bring such gross exploitation into line, but let’s also give kudos to those in the industry seeking to help rid the world of pestilence.

**This article was published in the Forbes Indonesia, December 2015. You can also read this article on Forbes Indonesia.