The Grandest Challenge: Taking Life-Saving Science from Lab to Village. By Dr. Abdallah Daar & Dr. Peter Singer

The Lab finally meets the Village 

Book Review by Gabriel Oguda

 Have you ever wondered why 10% of global spending on health research was used to study conditions in developing countries yet people there suffered 90% of the global disease burden? And have you ever wondered why in the last quarter of the 20th century, pharmaceutical companies developed 1,393 new drugs, but only 16 of them were created to combat tropical diseases? This book is about the emerging call for global health equity and what can, and should, be done to address the currently lopsided policies in global health. It is a combined autobiographical account of two medics – Peter Singer and Abdallah Daar – who were jolted into action – one after two close family members died of preventable and treatable diseases, and the other who was grappling with ethical controversies that the medical profession was not addressing fast enough.

This book is a mixed tale of tribulation and triumph. The authors narrate how their scientific colleagues in the developed world initially brushed them aside as they embarked on lobbying for biotech innovations that target the developing world.  They asked fellow scientists to consider the real issue; for instance, who will stand to benefit from the profound changes like tweaking the genome of the Anopheles mosquito to stop it from transmitting malaria. To the authors, it is a costly mistake – both to drug companies and their target clients – for medical labs to be situated in the developed world when the vaccines and drugs being tried and tested in the lab are meant for the developing world. Hence the term; from lab to village.

Yet the journey from lab to village would still have been bumpy had Bill and Melinda Gates not have stepped in with the financial ignition the drivers urgently needed to jumpstart their quest to solve the Grand Challenges in Global Health. In his own words, Bill Gates asked why “some lives were worth saving, and others were not” (p. 58). This disturbing question had previously led the couple to establish the Bill & Melinda Gates Foundation (mid 1990s) with the motto, “All lives have equal value.”

Through highlighting this incredible journey, the authors underscore the monumental role of public private partnerships in moving the lab to the village. They challenge innovators in the developing world to believe in the ability to make drugs at home, which are relevant, reliable, easily available and affordable to their people.  They also encourage scientists in the developed world to enter into partnerships with scientists in the developing world, as this could spark a scientific revolution, which would have a major impact in the developing world.

The challenges relating to taking the lab to the village have also been exhaustively discussed.  They include; sensitivity to cultural values of individual communities, deep-rooted suspicion of multinational companies funding the development of drugs, vaccines and diagnostic devices, and political obstacles blocking the road from lab to village. In short, the lab needs to be part of the village.

This book is directed to policy makers who are tasked with the role of equitable distribution of (scientific) resources. It also speaks to biomedical and social science researchers particularly those working (or those who are interested in working) with projects that touch on the lives of people at the community level – especially for researchers undertaking sensitive studies that are prone to ethical controversies. It also encourages health promoters who are out there, sometimes as the lone voice, not to lose hope in trying to bring change adding, “ultimately, when the lab meets the village, and when the possibility of leading a healthy life is the same throughout the world, our journey will be over” (p. 252).

 

Published: March 2012 HPC

 

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