Amid growing pressure on the pharmaceutical industry to ensure people in low- and middle-income countries have access to needed medicines, a new report finds five large drug makers are doing most of the heavy lifting, but much of the R&D is focused on only five diseases, leaving many illnesses unaddressed.

Specifically, 45 different maladies have been identified as areas in which R&D should be a priority for developing medicines, vaccines, and diagnostics, but these represent only one-fifth of the total product pipeline numbering more than 1,300 projects. Most work, instead, is overwhelmingly focused on malaria, HIV/AIDS, tuberculosis, Chagas disease, and leishmaniasis. The least attention is being paid to maternal and neonatal health conditions, and to neglected tropical diseases.

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  • As R&D costs rise, primarily driven by increased regulations that have no safety benefit, drug companies will have to abandon antibiotic and other critical research if they wish to recover their development costs. Only 2-3 marketed new drugs do that, so the industry has become increasingly dependent on blockbuster drugs to cover the 7-10 losers (

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