This week I’ll take the opportunity to discuss a Nature Biotechnology commentary that has generated a little buzz in the health-biotech community, in addition to a recent publication in Science that is particularly impressive.
Making the Invisible “Visible”: The elucidation of protein structure is essential for our understanding of protein function. Despite having sound methods for the determination of protein structure in the native folded state, thus far it has been particularly challenging to determine the structure of transient intermediates along the protein folding pathway. Now researchers have developed a protocol combining a unique form of nuclear magnetic resonance (NMR) with chemical shift-based methodology (CS-Rosetta) allowing for structural determination of “invisible” metastable intermediates. These rare conformational states form rapidly and last only for microseconds before folding to the native state. The methodology, published in Science, can also be used for the determination of excited states crucial to function, for example enzyme catalysis and ligand bonding, and is expected to provide a wealth of data on conformational states that so far have proven highly elusive. The study was led by Dr. Lewis Kay of the Department of Molecular Genetics at the University of Toronto.
A fine balance
Peter A. Singer and Rahim Rezaie, both of the McLaughlin-Rotman Centre for Global Health at the University of Toronto, bring an interesting debate to the table in a recent Nature Biotechnology commentary:
“As health biotech enterprises in emerging economies move from imitation to innovation, will they become less relevant to local global health priorities?”
Countries such as China, India, and Brazil have played a pivotal role in supporting local and global health priorities through the production of low-cost health products. Now it seems we may begin to see more and more integration of health-biotech companies in the developing world into the global product development value-chain. The concern, however, is that a movement towards more costly innovative products and lucrative markets may lead to the neglect of poorer market segments that health-biotech firms in the developing world have traditionally focused on. Rezaie and Singer pose an eloquent question:
“..as enterprises in the emerging markets take on more costly innovative projects, would they be compelled to choose between global health and global wealth?”
A force driving integration is the exchange of service-provision arrangements between health-biotech enterprises in emerging economies and large multinational pharmaceutical companies (MNCs). For example, China’s Wuxi PharmaTech and India’s Advinus Therapeutics have entered service-provision arrangements with MNCs. The movement is further supported by an increase in collaborative development between firms in developing countries and MNCs, as they work together to produce innovative health products.
Despite the “innovative” interests of health-biotech firms in emerging economies, data suggests the priorities of global health may continue to be met. Growth in pharmaceutical markets in emerging economies has risen sharply over the last several years. India and Brazil have seen average annual growth rates of 10% in their pharma markets, and China even greater at 21%, suggesting the interests of MNCs may be shifting from developed to developing markets. Hence, the global integration of health-biotech firms operating in the developing world may in part be balanced by the evolving mindset of multinationals towards less developed markets.
Rezaie and Singer believe that the objectives of global health and global wealth can be satisfied simultaneously. Providing the proper support mechanisms are put in place, they argue, development of health products for poor market segments can be secured. An interesting instrument discussed is an orphan drug-like legislation plan for emerging economies, where the intended purpose is to incentivize products for diseases of the poor rather than diseases of low prevalence. The Global Health Accelerator platform, health funds directed at emerging economies (see NY-based Acumen Fund, Ventureast Biotechnology Fund in India, Bioveda China Fund, among others), and tactics such as public-private partnerships, advance market commitments, and patent pools to share intellectual property are also posed as mechanisms for bolstering interest and investment in global health challenges.
This article, published in Nature, is well worth a read for any interested in the evolving trajectories of the healthcare and biotech sectors, and the implications these changes will have on global health.