Introducing the "10/90 gap"

March 9, 2005 by admin

What is the ‘10/90’ Gap?

The ‘10/90 gap’ is the disequilibrium within health research whereby only 10% of global health research is devoted to conditions that account for 90% of the global disease burden. First acknowledged by the Commission on Health Research for Development in 1990, it has become one of the most contentious issues in the international research community.

How did it come to exist?

Basic market forces bear significant responsibility for this massive disproportion in health research: a simple case of economic incentive. The pharmaceutical industry is based in the private sector which, in the free market economy of capitalist society, is driven by capital profit, as is true of any private industry that produces a marketable profit.

Leaving drug development in the hands of the private sector has led to the emergence of a “social contract” regarding drug development, with societies relying on the industry to provide drugs for its health needs. The industry’s provision of drugs is equated with profit and hence drugs are developed for which there is a market incentive. This has lead to the pharmaceutical industry investing less in R&D (research and development) for diseases that predominate within the developing world and consequently a massive global ‘drug gap’ has developed.

Just how big is this ‘drug gap’?

The Global Forum for Health Research (GFHR) estimates the extent of the ‘10/90 Gap’ to be less than 10% of the total US $73 billion spent annually on health research being spent on the diseases or conditions that constitute 90% of the global diseases burden.

A study by the Drugs for Neglected Diseases (DND) Working Group, an international body of health experts convened by the independent humanitarian medical aid agency Médecins Sans Frontières (MSF), investigated the state of R&D for drugs for diseases that affect people in the developing world. It found that of the 1,393 new drugs approved between 1975 and 1999, only 13 were indicated for tropical diseases – an illustration of just how large the ‘drug gap’ has become.

David Baguley
david.baguley@almamata.net
Advocacy

References

Commission on Health Research for Development. Health research: essential link to equity in development. New York: Oxford University Press; 1990.

Reich M. The global drug gap. Science 2000; 287: 1979–1981.

Global Forum for Health Research. The 10/90 Report on Health Research 2003–2004. Geneva, Switzerland: Global Forum for Health Research; 2004.

Trouiller P, Olliaro P, Torreele E, Orbinski J, Laing R, Ford N. Drug development for neglected diseases: a deficient market and a public-health policy failure. Lancet 2002 Jun 22; 359 (9324): 2188-2194.

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