While the world "takes AIDS seriously" in the sense that "rich countries provide money, drug companies have lowered their prices and accepted generic competition and poor countries ... are scrambling to provide free treatment to all who need it," the same is not yet true for people with malaria, tuberculosis or many other diseases prevalent in developing countries, columnist Tina Rosenberg writes in a New York Times opinion piece. Even in the case of HIV/AIDS, children in developing countries are at a disadvantage compared with adults, because wealthy countries have reduced mother-to-child HIV transmission and thus have nearly eliminated a "paying market for pediatric AIDS medications and ... lobbying by those whose children have gotten sick," she says. In addition, there is a "dearth of affordable child-friendly" HIV/AIDS medications, Rosenberg says. Although "more needs to be done" to combat HIV/AIDS, efforts to eliminate malaria, TB and other conditions such as sleeping sickness, kala azar and Chagas disease are even further behind because the diseases offer researchers "no profitable market ... have little political constituency" and have "no well-connected group of sufferers who stage protests and lobby pharmaceutical companies and Congress," Rosenberg says. She adds that in the last few years, "things are finally beginning to look up" for neglected diseases with 63 new drug compounds in development since 2000, compared with only 13 new drugs from 1975 to 1999. Rosenberg says that part of the "surge of interest" in neglected diseases is related to HIV/AIDS, which "has awakened world interest in Africa and poor-country diseases" and has taught the pharmaceutical industry the "important lesson" that "its efforts to maintain high prices and keep out cheap generic drugs ... led to worldwide notoriety and even public comparisons with the tobacco companies." Further, the HIV/AIDS pandemic led to the creation of the Global Fund To Fight AIDS, Tuberculosis and Malaria, a "remarkably efficient ongoing source of money," as well as the creation of the Bill & Melinda Gates Foundation, the source of $5.8 billion in "active global health grants," Rosenberg says (Rosenberg, New York Times, 3/29).

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