Landscape of Medicines Development for Five Pregnancy-Related Conditions 2000-2021
By Policy Cures Research (now Impact Global Health) 31 July 2021
R&D gap for maternal health medicines
Despite improvements in maternal health outcomes over the last two decades, approximately 295,000 women still died from pregnancy-related causes in 2017, the vast majority in low- and middle-income countries (LMICs). The prioritisation of maternal health within the SDGs has focused largely on improving access to and quality of existing interventions and services. While this has had positive outcomes – including a 38% drop in the global maternal mortality ratio between 2000 and 2017 – there has been little attention or credence given to biomedical R&D for new or improved maternal health medicines. This is a gap.
Current medicines available to prevent or treat pregnancy-related conditions responsible for the majority of maternal and neonatal deaths – including postpartum haemorrhage, preeclampsia/eclampsia and preterm labour/birth – are either suboptimal, not appropriate for LMIC contexts, or both. For others, such as intrauterine growth restriction and intrapartum foetal distress, no effective medical management exists at all.
Inclusion of women in drug R&D
There are several reasons for this. Primarily, industry’s profit-driven R&D model is discouraged by a perceived low return on investment (a small market of pregnant women, with short-lived pathologies, many of whom are in LMICs with limited ability to pay), and the heightened litigiousness of developing drugs for use in pregnant women, particularly following the fall-out from thalidomide. Indeed, including women at all – let alone pregnant women – in drug R&D is a well-documented problem. Without disruption, this current model will ensure little progress is made to meet the SDGs, and avoid countless more deaths, particularly for women in LMICs.
Full report
This report was written as part of the ‘Accelerating Innovation for Mothers’ (AIM) project spearheaded by the Concept Foundation and delivered in partnership with Impact Global Health (then Policy Cures Research) and Burnet Institute.
AIM was created to foster greater investment in and development of critical maternal health medicines for five significant pregnancy-related conditions, where biomedical product gaps exist:
- preterm labour/birth (PTL/PTB)
- preeclampsia/eclampsia (PE/E)
- intrauterine growth restriction (IUGR)
- postpartum haemorrhage (PPH)
- intrapartum foetal distress (‘foetal distress’)