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Drug Development

Does Baldness Get More Funding Than Malaria?

OK, let’s fact-check Bill Gates today, shall we?

Capitalism means that there is much more research into male baldness than there is into diseases such as malaria, which mostly affect poor people, said Bill Gates, speaking at the Royal Academy of Engineering’s Global Grand Challenges Summit.
“Our priorities are tilted by marketplace imperatives,” he said. “The malaria vaccine in humanist terms is the biggest need. But it gets virtually no funding. But if you are working on male baldness or other things you get an order of magnitude more research funding because of the voice in the marketplace than something like malaria.”

Gates’ larger point, that tropical diseases are an example of market failure, stands. But I don’t think this example does. I have never yet worked on any project in industry that had anything to do with baldness, while I have actually touched on malaria. Looking around the scientific literature, I see many more publications on potential malaria drugs than I see potential baldness drugs (in fact, I’m not sure if I’ve ever seen anything on the latter, after minoxidil – and its hair-growth effects were discovered by accident during a cardiovascular program). Maybe I’m reading the wrong journals.
But then, Gates also seems to buy into the critical-shortage-of-STEM idea:

With regards to encouraging more students into STEM education, Gates said: “It’s kind of surprising that we have such a deficit of people going into those fields. Look at where you can have the most interesting job that pays well and will have impact on society — all three of those things line up to say science and engineering and yet in most rich countries we see decline. Asia is an exception.”

The problem is, there aren’t as many of these interesting, well-paying jobs around as there used to be. Any discussion of the STEM education issue that doesn’t deal with that angle is (to say the least) incomplete.

28 comments on “Does Baldness Get More Funding Than Malaria?”

  1. lynn Silver says:

    Propecia – for baldness – was developed after finasteride, marketed as Proscar for BPH, showed side effects of hair growth. No one started out looking for a baldness cure – they took advantage of serendipity. Same for minoxidil. And viagra, for that matter.

  2. Electrochemist says:

    A quick query on Clinical Trials dot Gov returns 698 clinical trials focused (partially or wholly) on malaria, while there are only 165 on baldness (and only 53 on androgenic alopecia – male baldness, which was the implied point of Gates’ remark).

  3. TD says:

    One can imagine that his original speech said “Erectile Dysfunction” and someone (if not Bill himself) crossed that off and wrote in baldness.

  4. Chris Swain says:

    I wonder if he meant there is more money spent on bringing forward and promoting treatments for male baldness? Whilst there is probably little spent in basic research, there is a fortune spent later down the line.

  5. Kazoo Chemist says:

    I am certain that funding for malaria research will skyrocket now that the disease will have a new spokesperson.

  6. Electrochemist says:

    @#3, TD – The serendipity in discovery of ED drugs mirrors that for alopecia. Development costs (e.g., CTs) is another story, however…

  7. Polynices says:

    It continues to surprise me how utterly bog standard PC all of Bill Gates’ views on everything are. For a billionaire supposed genius he’s terribly dull.
    I mean, kudos for him spending his fortune on something other than yachts and luxury but it’s still a bit of a shame.

  8. exGlaxoid says:

    I think that if someone found a serendipitous drug for malaria, lots of money would be spent on it, just like the growing effort in artemisinin synthesis, clinical testing, and development. The problem so far is that few people have found such new drugs, they are much harder to find my accident (that is why hair growth and ED drugs were found so readily), and once a drug is found, there will be tremendous pressure on the discoverer to develop it, run the trials, and then give it away free, since it treats such a critical need. The same thing happened for AIDS, where many new treatments were immediately either copied, the suppliers extorted to lower their price, and likely, they will be sued by someone. GSK had a malaria treatment which, due to sometimes very serious side effects, was withdrawn, despite it being useful in many cases and providing a useful risk benefit ratio in some cases. Compare that to Choramphenical, which is still being used today in some countries, which also causes some series side effects, but is very cheap and very stable, and is still used. But being generic, it is much harder to sue the maker.

  9. luigi says:

    Thank you @8 Polynices – Gates’ efforts for a malaria vaccine have been a waste predicted back in 2004 by those KoLs not affiliated with the Gates Foundation.

  10. I don’t know about funding, but certainly, there is a much larger market for beauticeuticals than pharmaceuticals. Among many reasons, healthy people are more numerous than sick people. If money is the goal, rather than curing baldness, a topical cream that reversibly prevents hair growth would be a huge success.

  11. R says:

    Gates is not some magical visionary wizard just because he backed into a billion dollars. He is like the Forrest Gump of computing.

  12. His general point was that a few rich people’s diseases get more funding that many poor people’s diseases, which is true.

  13. hairy chemist says:

    “The problem is, there aren’t as many of these interesting, well-paying jobs around as there used to be. Any discussion of the STEM education issue that doesn’t deal with that angle is (to say the least) incomplete.”
    Over the weekend, NPR did a story on the alleged “scientist shortage” where they actually almost addressed this issue:

  14. DH says:

    market failure (n): Condition in which other people’s uncoerced spending choices are other than what I wish they were.

  15. dearieme says:

    “tropical diseases are an example of market failure”: not in the sense that economists use the term.

  16. metaphysician says:

    Indeed. While its true that the market does not solve this problem, that is because the market is not a magic tool that solves all problems. This problem just happens to be market-irrelevant.
    Frankly, the market *could* solve this problem, except for the other, much harder problems afflicting the third world: socio-cultural development, or lack thereof. The market can’t work where a functional market can’t exist.

  17. gippgig says:

    The STEM education issue should be about scientific literacy, not jobs. People need to understand how the world works (regardless of whether they are in the workforce).

  18. TX raven says:

    Do you think Viagra would have been discovered if the key in vivo pharmacology work where ED was serendipitously encountered had been conducted at a CRO in the Far East?

  19. Cyrus says:

    “The problem is, there aren’t as many of these interesting, well-paying jobs around as there used to be. Any discussion of the STEM education issue that doesn’t deal with that angle is (to say the least) incomplete.”
    Gates said almost the exact same thing about declining enrollment in computer science. Almost all MS product development is now done overseas. He doesn’t see any connection.

  20. Anonymous says:

    @8 There is no intrinsic value in having controversial opinions, unless you count entertainment. I think it’s fair to say that the world already spends enough (perhaps rather too much) much on entertainment.
    At least Mr. Gates is doing something rather more beneficial with his fortune than the widely admired Mr. Trump or late Mr. Jobs.
    And while I tend to agree that there is not a glut of STEM jobs needing to be filled, I think there is great societal value to be had by promoting and encouraging the development of a sound science background for the pleebs.

  21. noko marie says:

    @21 “Wordly wisdom teaches that it is better for reputation to fail conventionally than to succeed unconventionally.”
    -John Maynard Keynes
    Not sure this is such a good thing, though.

  22. MoMo says:

    Bill is stirring up controversy and why not? He is putting his money where his mouth is, even if he isn’t correct.
    The WHO told me a decade ago that only 5 million a year was going to malaria-5 MILLION! Is that all? Then the MMV was just getting started and was adding way more than that.
    But is he getting anywhere with it? Look at the MMV website and you see the same ol’ same ol’ and the compounds aren’t exactly rolling off the assembly line. But at least Bill and Melinda are doing something about it. Compare that to the millions dumped by our country into the Sen. Thad Cochran Center in Mississipi which hails future malaria cures yet does nothing! MILLIONS AND MILLIONS FOR NOTHING!
    Funny, the guy who ran Pfizer Global and was in in charge of the compound now called Viagra, was once in charge of of the MMV!Synchronicity in action!
    Leave Bill alone and Get Back to Work!

  23. spoons says:

    The “market” is working fine, it’s the people (all of us) that are failing to make finding the cure a truly high priority.
    Nothing against Gates of course, I just think passing the buck from us to a anthropomorphized concept lets us all off a bit to easy.

  24. Kaleberg says:

    Latisse is another cosmetic drug discovered by accident. It’s the same drug as latanoprost used for glaucoma, except optimized to stay on one’s eyelashes rather than one’s cornea. It grows eyelashes – long, longer, longest – rather than lowering eyeball pressure.
    It would be interesting if someone taking Viagra woke up one morning and realized “My malaria is cured.” The ad campaign almost writes itself.

  25. Anonymous says:

    To be fair, Derek and #2 Electrochemist are referencing journal publications and trials, rather than actual funding. I have yet to see sources on dollar amounts (though I will concede that a large fraction of money spent on a drug stems from trials, so that isn’t an unfair comparison).

  26. lighterfluid says:

    An interesting tidbit, the old antimalarial drug chloroquine could have a cosmetic application:
    That is, if you don’t mind the increased sensitivity to light.

  27. Lucas says:

    Gates comes from the world of software.
    Speaking as a software engineer who recently switched jobs, there seems to be a genuine shortage of qualified people. Indeed software seems to have absorbed a lot of STEM graduates from other fields. Several of my new coworkers are biologists or physicists who couldn’t find work in their chosen fields but knew enough statistics/math/programming to get a job in software. It’s an easy mistake to make, really. If you see a big shortage of software engineers, it’s easy to assume that people in related fields of similar technical difficulty must also be experiencing a shortage. Not so, apparently.

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