Drug Development for Maternal Health Cannot Be Left to the Whims of the Market 英文参考文献.docVIP

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Drug Development for Maternal Health Cannot Be Left to the Whims of the Market 英文参考文献.doc

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Drug Development for Maternal Health Cannot Be Left to the Whims of the Market 英文参考文献

Editorial Drug Development for Maternal Health Cannot Be Left to the Whims of the Market The PLoS Medicine Editors I n an essay published in this month’s PLoS Medicine, Nicholas White and colleagues [1] lament obstetric causes, as highlighted by Clara Menéndez and colleagues, who analyzed deaths from a tertiary hospital in Mozambique [3] and found that infectious diseases accounted for at least half of all maternal deaths, “even though effective treatment is available for the four leading causes, HIV/AIDS, pyogenic bronchopneumonia, severe malaria, and pyogenic meningitis.” For surgical treatments that are known to be effective for obstetric complications, another PLoS Medicine article this month [4] argues that “the lack of basic surgical supplies and equipment limits the delivery of surgical services” in sub- Saharan Africa, for obstetrics as well as for other surgical conditions. In developed countries, with low rates of maternal and perinatal deaths, it is perhaps easy to be complacent about the lack of new drugs for pregnancy and the perinatal period, but globally the situation is urgent. According to the World Health Organization, there were more than half a million maternal deaths in 2005 and over 6 million child deaths in the perinatal and neonatal periods [5]. Most of these deaths are in low-income countries—a huge, and potentially avoidable, loss of life. Appropriately, therefore, maternal and child health are part of the United Nations Millennium Development Goals, with specific goals between 1990 and 2015 to reduce the under-five mortality rate by two-thirds and the maternal mortality ratio [6] by three-quarters. Unfortunately, 18 years into the however, innovations that work for other areas of health care simply do not suffice for maternal and infant health, and new ways of thinking are needed. As Fisk and Atun argue, the current business model of the pharmaceutical industry provides no real incentive but rather, because of potential litigation in de