Press: The lesson of Red Nose Day
Authors: Tony Delamothe
Journal: BMJ (2005)

The tsunami that recently devastated South East Asia was a one time natural event that mobilised individuals and eventually governments to donate on an unprecedented scale. But more children have been killed by infectious diseases since 26 December than by the tsunami, an audience in London heard last week. Their deaths have been private events, out of our sight and therefore out of mind.

But money spent on the right things can make a profound difference: for example, in its first five years of operation the Global Alliance for Vaccines and Immunization has saved more than 670 000 lives, by improving access to childhood vaccines in the world's poorest countries. Who will get such messages out to the men and women in the street?

“The problem is that people are not much interested in helping the poorest,” said the moderator of last week's forum, which was organised by the Wellcome Trust to discuss “Global Health: putting Science to work for the Developing World.” Somewhat giving the lie to the moderator's claim were the panellists that the Wellcome Trust had assembled. They included Bill Gates, the world's richest man; Jean-Pierre Garnier, the chief executive office of GlaxoSmithKline, one of the world's biggest companies; Salim Abdool Karim, deputy vice chancellor, University of KwaZulu-Natal; and Mark Walport, director of the Wellcome Trust, one of the world's richest medical charities.

The Bill & Melinda Gates Foundation has spent billions of dollars on health projects so far, concentrating on vaccination programmes because these give the biggest bang for the buck. But there are lethal infectious diseases without vaccines, and who will pay to find and test them? “Only a pharma or a biotech company could do a malaria trial in Africa,” said Gates.

Drug companies would like to help, Garnier explained. However, they can't justify the risks of embarking on costly phase three studies if there's little prospect of financial reward at the end. He thought that public private partnerships were the way ahead. These are where “pharmas put their expertise on the table and third parties pay.”

The only serious third parties are governments. So why don't they get more involved in funding this sort of research, wondered Gates. Politicians, it turns out, are only interested in what interests voters, and world health doesn't interest them.

From the audience, Richard Curtis, co-founder of Comic Relief and Red Nose Day, asked a series of searching questions about how much attention was being given to publicising these success stories. He recommended engaging the press, using the tools they love—especially celebrity. MTV is now reaching one billion young people in 100 countries; isn't there a role for it?

Garnier admitted that drug companies found it hard to get it right. GSK has embarked on a 20 year project to rid the world of filariasis, donating albendazole tablets to the value of $1bn. It's a bigger disease eradication project than that for river blindness. Yet a press conference organised with the World Health Organization and participating non-governmental organisations was a disaster. No one showed up; the media prefer drug companies to stick to their role as baddies.

The message of the discussion was: so much that's obvious to do; so few resources with which to do it. And the next significant breakthrough in global health is less likely to occur in research laboratories than in the minds of voters, sensitised to the issues by the media.