There is something rotten in the kingdom of biomedical R&D. At least that's what many have been saying for some years now. That the system is inefficient is probably difficult to dispute. It works in silos, encourages a protectionist, propriety approach, promotes duplication, multiplies failure, is costly, and importantly, is directed at markets and not at public health needs. The consequences are fatal. We often don't get the type of new medicines we really need (think new antibiotics and treatments for a whole array of infectious diseases). Medicines are often not adapted for the majority of health systems, and they are frequently priced out of reach—as in the case of a new hepatitis C drug that came out this year.
However, probably the greatest critique that can be laid at the door of the current system is that it does not truly encourage the scientific process. In many ways, it promotes a culture that works contrary to the spirit of science—free and critical thinking, openness to ideas and sharing of information. Science is, by nature, a collective enterprise. Even its geniuses are merely 'standing on the shoulders of giants.' The giant here being the collective thinking and contribution of many over time. To believe that we can put a fence around ideas, and control and exploit them to our ends is hubris.
Are we as a society ready to think about alternative models? Can we square the circle by creating a system that complements and even promotes enterprise, success and financial rewards? In order to do this we need to fundamentally let go of thinking that there is only one possible business model. We need alternatives. Open source R&D is the key.
First and foremost, we need to promote a culture of openness, crowdsourcing and data sharing. Utilizing the input of many and sharing information can truly help get us from A to B as quickly as possible. It can also tell us when we need to stop or 'park' dearly beloved ideas. The ability to also hold out our data to scrutiny is the only true way to truly validate information. It may also open up new ideas and hypotheses that may subsequently advance the field.
Sharing, however is a difficult and somewhat scary idea to promote. It sounds suspiciously 'radical'. However when one takes into account that this has been done in other areas, we need to rethink our reservations.
In the biomedical field, which is dominated by big entities and intellectual property, promoting the concept of sharing will be tough. That's because implementing open source requires us to think of two other things: How we handle assets and how we pay for progress and success. Rethinking these aspects is key to promoting open source. It means rethinking how we manage or even have the need for intellectual property. It means states and societies, which ultimately need to pay, will have to develop different but tangible new ways of amply rewarding innovation. Can we promote innovation, science and, critically, access to important biomedical technologies while at the same time making this all commercially viable? I think we can. I also think that the enterprises that move radically towards this direction will be the winners.
Dr. Manica Balasegaram has worked as a physician, public health specialist, clinical researcher, drug developer, and advocate for access to medical technologies. He currently works as the Executive Director for the Access Campaign of Médecins Sans Frontières.
Other essays in this series:
James Kassaga Arinaitwe, Global Health Corps & Aspen Institute Fellow / Kampala
Polly J. Price, Emory University law professor / Atlanta
John Wilbanks, Chief Commons Officer, Sage Bionetworks / Washington, D.C.
Dimitrios Tzalis, Founder & CEO, Taros Chemicals GmbH & Co. KG. / Dortmund
T.V. Mohandas Pai, Chairman, Manipal Global Education Services / Bangalore
Els Torreele, Director, Access to Essential Medicines Initiative, Open Society Foundations / NYC
Tomasz Sablinski, CEO of Transparency Life Sciences / NYC
Zakir Thomas, Open innovation expert & former Project Director of OSDD / Delhi
Matthew Todd, Founder of Open Source Malaria / Sydney & Cambridge