Wired News: A Drug to Eradicate Diarrhea

The possibilities of such an approach are discussed in an excellent book, "The Fortune at the Bottom of the Pyramid: Eradicating Poverty Through Profits," by C.K. Prahalad. I highly recommend it.

Wired News: A Drug to Eradicate Diarrhea: "Napo Pharmaceuticals is poised to launch the first Third World blockbuster drug.

It sounds counterintuitive -- drugs marketed to poor people don't typically lead to big profits. But Lisa Conte, Napo's founder and CEO, hopes not only to bring an affordable diarrhea medication to millions of people in developing nations, but also to reshape the pharmaceutical industry.

The current development model for drug companies is fizzling, she said. More and more prospective blockbuster medications are failing in the final stages of development, and companies will have to consider selling at a lower price to larger numbers of less affluent customers."...

The deals bypass the typical pharmaceutical approach: Target rich people and charge a high price. Under that model, drugs typically are available in the developing world about 15 years after they've been introduced in premium-price markets like North America and Europe, when patents have expired or companies can afford to distribute excess drugs at a loss.

This is one of the first times a drug will be introduced in poorer markets.

The strategy could lead to a profitable business, said Dr. Seth Berkley, president and CEO of the International AIDS Vaccine Initiative, and a Napo board member.

"The idea is to scale up production and lower the cost of goods," Berkley said. "If you do that, then sell in primary markets, you get a higher profit because you're selling a larger quantity of drugs." ...

Crofelemer has an advantage over other treatments such as Immodium. While drugs like Immodium are absorbed into the blood and distributed throughout the body, Crofelemer acts locally only in the gut, preventing interactions with other drugs the patient might be taking.

Also, "anti-motility" drugs like Imodium slow down flow of material through the intestine. While this stops diarrhea, it also allows whatever toxin is causing the diarrhea to linger in the body longer, giving it an extra opportunity to infect its host. That's why children, whose immune systems are not fully developed, as well as adult patients with immune problems like AIDS, can't take anti-motility medications.

Crofelemer instead stops the flow of excess water, which makes it possibly the first effective treatment for children and AIDS patients.

Over 1 million children die from diarrhea every year in developing nations where water is often contaminated. And it's the top complaint of many AIDS patients, Berkley said.