Developing Affordable Cancer Therapeutics in Low and Middle Income Countries

Abstract

Over half the world’s cancers occur in Low-and-Middle-Income-Countries (LMICs), where cancer is a neglected disease. Despite significant advances in systemic anticancer therapy, many of these treatments are simple not available to the majority of the world’s cancer patients. For example, immunotherapy has changed the treatment paradigm for many cancer patients in developed countries, significantly prolonging survival and maintaining patient quality of life but at a cost that is currently unaffordable for many public health systems and patients in LMICs. We urgently need better solutions to treat patients more effectively, humanely and equitably. Drug discovery and novel drug development takes on average 10-15 years to go from bench to bedside at an average cost of USD1 billion. Repurposing of 'old' drugs for new indications can shorten this pathway substantially with significant cost savings. One strong drug repurposing candidate is artesunate, an antimalarial derived from traditional Chinese medicine that also displays anticancer properties. This drug is currently the subject of our drug repurposing programme which includes a number of cancers relevant to Malaysian needs including colorectal cancer, cervical cancer, nasopharyngeal cancer and Acute Myeloid Leukaemia. Alongside drug repurposing, platform technologies such as molecular pharming – using plants to grow cancer drugs, in particular immunotherapies and targeted monoclonal antibodies can also reduce the cost of cancer drug development significantly. Malaysia has the opportunity to lead on healthcare priorities facing LMICs, creating reverse linkage collaborations between Muslim countries through entities such as the Islamic Development Bank (which now has a Center of Excellence for Science, Technology and Innovation) in Kuala Lumpur and local governments. This also represents opportunities for technology transfer and halal sector manufacturing. Collaboration is urgently needed between academia, clinicians, patient advocate groups, governments, non-governmental stakeholders, regulators and responsible pharma to ensure equitable access to affordable cancer therapeutics for patients globally.