SEPTEMBER 23, 2004

Open source medicine: cure for what ails the Third World?

The big push for patent-free drug research. Nobel laureates on the warpath

In late August, a letter landed at the doorstep of US Congress demanding free and open access to the published results of taxpayer-funded medical research. The letter assailed as "prohibitively expensive" the subscription rates of the for-profit scientific journals that regularly publish this research. The letter was signed by a group of 25 Nobel laureates in chemistry, and physiology and medicine.

The Nobel laureates didn't write this letter because they gambled away their prizes at Las Vegas and can't afford the journals. Nor should we dismiss the eminent scientists as a pack of tightwads. Their motivation was much purer: these mental titans feel strongly that hoarding data, or making it only available at great cost, hinders medical research, particularly in poor countries. This letter is part of a growing movement, known as 'open source medicine,' that seeks to harness international altruism and volunteerism and develop patent-free drugs for diseases drug companies have little profit incentive to study.


The WHO's Commission on Intellectual Property Rights, Innovation and Public Health hosted a conference on September 8 called "Patents and Biotechnology:
A US Patent System for the 21st Century:"
The Open Source Biotechnology Project:
"Finding Cures for Tropical Diseases: Is Open Source An Answer?" free download:

The term 'open source' has been borrowed from the freely distributable, patent-free software movement, most famously exemplified by the Linux operating system developed by Finnish ?ber-nerd Linus Torvalds. Instead of jealously guarding his work, or trying to sell it to the highest bidder, in 1991 the young programmer decided to give away the program and its source code to anyone who wanted to look at it.

The genius of the open source setup is that it allows skilled folks around the world to scrutinize the code and contribute improvements. The approach has largely worked for Linux, and the software has improved over time and, more importantly, filled a niche ignored by the private sector. In medicine, there's a rather large, unprofitable niche area just waiting to be filled ? the search for tropical disease cures.

After Linux sparked the code-sharing free for all, medical research realized its potential for their own patent-heavy realm. Law professors Stephen Maurer (Berkeley) and Arti Rai (Duke University), and biopharmaceutical researcher Dr Andrej Sali (University of California at San Francisco) recently wrote a paper in the (naturally free) e-book Biotechnology: Essays From Its Heartland that asks the question: "Finding cures for tropical diseases: Is open source an answer?" According to the authors, the answer to that question is an unequivocal 'yes.'

There are about 500 million, mostly poor, people afflicted by tropical diseases, and drug discovery is badly lagging is this area. Professors Mauer and Rai and Dr Sali think they've got the solution to this problem. They propose setting up an international project to be called the Tropical Disease Initiative (TDI). Its goal would be to pool the brains of international researchers and discover patent-free tropical disease drugs that could be cheaply distributed in poor countries.

The proponents of the TDI recognize that the status quo works well in discovering drugs for conditions common in the developed world, but that a different model is needed for Third World ills. In fact, they feel the TDI would be a great outlet for drug company corporate philanthropy ? for instance, drug companies could donate lab time to projects. Moreover, the TDI proponents don't think their plan is the answer for everything: "Open source is not magic," they write. "In the end nothing will happen unless Western governments and charities foot the bill."

To understand how a project like the TDI would work, the best model to use for comparison is probably the international Human Genome Project (HGP). The HGP was not exactly like an open source medicine project (for example the leadership structure was quite a bit more 'top-down' than the TDI proponents envision), but it's a pretty close match.

Dr Thomas Hudson, professor of human genetics and immunology at McGill, and the founder and director of the Montreal Genomics Centre, worked on the HGP and saw firsthand the good, the bad and the ugly sides of massive international cooperation in scientific research. "There was much controversy about approaches used by the international consortium," says Dr Hudson. "The controversies over what approaches should be used yielded both positive ? that is scientific ? and negative ? ego-related ? debates."

But on the issue of public access, there was a broad consensus. "There was no controversy on the need to make the data publicly available every day," says Dr Hudson. "In the 'high throughput phase' of the project, findings were posted on public websites within 24 hours."

Dr Hudson feels that some of the private biotech firms (he names Celera as an example) involved in the HGP behaved contemptibly at times. "Sequencing by private companies yielded tremendous controversy," he says. "The initiative forced the international consortium to get their act together more quickly."

The problem lay with a tendency for these firms to keep findings under wraps. "The non-release of this sequencing data, except with exorbitant subscription costs, was criticized heavily ? for good reasons," says Dr Hudson. When asked if he thought the structure and scale of the HGP could be up to the task of discovering new drugs, Dr Hudson doesn't hesitate: "Yes ? I do!" open source medicine online



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