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Comment by EGreg | Hacker News Reader

Going forward, open source would work much better for drugs than for-profit models. It does the long tail better. Bill Gates famously said that baldness is treated before malaria because of the aggregate economic power of the "customers". Similarly, Microsoft etc release Windows for x86 while Linux even runs on Toasters. Because without patents, anyone in the world can build on the work of others. Like they do in, you know, science. If they help the third world it will be by standing on the shoulders of giants, legally:

http://magarshak.com/blog/?p=93

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> baldness is treated before malaria because of...

To be fair, the top two baldness treatments were side-effects of drugs aimed at curing more "serious" conditions.

Rogaine was first developed as a cure for ulcers. That didn't work, but the researchers noticed that it served as a vasodilator and it was sold as a treatment for high blood pressure. That didn't work out either, but researchers noticed one weird side effect... [1]

Same for Propecia / Proscar, which started out targeted at prostate growth. It's effective at controlling prostate growth and in this case researchers realized that the same hormone channel that controls prostates (DHT) also affects hair loss. They then set out to find another way to monetize the existing drug.

Attempts to target baldness only have struggled (there has been a line of smaller companies trying to get baldness-only drugs through trials, which have mostly failed.)

[1] https://en.wikipedia.org/wiki/Minoxidil#History [2] https://en.wikipedia.org/wiki/Finasteride#History

While I agree with the premise that open source could, in theory, serve the long tail better, I think the barrier to entry of pharmacological research is far higher than that of software development. It should be noted that this is not without reason. Controlled, double-blind studies are necessary for development of medicine and they are hard to do without a substantial amount of funds.

This barrier to entry may decrease as biological models become cheaper and more accessible, but even as a hopeful bioinformatician, I am skeptical of this happening in the near term (10-15 years).

Governments have lots of money.

Even if a government research department was 20% less effective than an equivalent private sector research department (which I strongly doubt; they're probably equivalent), it would still be more cost effective. Pharma marketing budgets are titanic and that's an epic waste of money.

I decided to look into this. I pulled the financials for Pfizer, Merck, and AstraZeneca. Their research and development (R&D) spending, while significantly less than their Selling, General, and Administrative (SGA) spending, it is still comparable. Considering SGA includes a lot more than just advertising I would wager that their actual ad budgets (at least for Merck and AstraZeneca) are less than their R&D budgets.

Pfizer: $7,690 million R&D, $14,809 million SGA

Merck: $6,704 million R&D, $10,313 million SGA

AstraZeneca: $5,997 million R&D, $9,951 million SGA

"Bill Gates famously said that baldness is treated before malaria because of the aggregate economic power of the "customers"."

If he actually said that, it was a pretty stupid thing to say. Somewhat effective treatments against malaria have been available to western medicine since the 1600s (quinine bark) and pretty good synthetics since the early 20th century.

The first treatment for baldness that was even moderately effective (minoxidil) didn't even enter use until the late 1980s, and note (this is key) that its anti-baldness action was a serendipitous side effect -- the drug was originally developed for high blood pressure, not baldness.

Same thing with the other common whipping boy, V%%%%%a (not spelling it out lest it trip a spam filter). It was for high blood pressure and angina.

By "before" I meant the baldness-related research gets a lot more funding NOW, not that some sort of treatment was available historically, back when people were all a lot poorer:

http://www.independent.co.uk/news/world/americas/bill-gates-...

“Our priorities are tilted by marketplace imperatives,” he said at the Royal Academy of Engineering’s Global Grand Challenges Summit.

“The malaria vaccine in humanist terms is the biggest need, but it gets virtually no funding. 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.”

And if you think that is stupid, here is what others say:

Mr Gates’ complaint is echoed by the Global Forum for Health Research, which estimates that only 10 per cent of worldwide expenditure on health research is devoted to the problems that afflict 90 per cent of the world’s population – the so-called 10/90 gap. Malaria is estimated to have killed 660,000 people in 2010, most of them African children. About half of the world’s population is at risk. The transmission of the disease can be controlled by distributing cheap mosquito nets treated with insecticides. Research into a vaccine for the disease has so far failed to yield any results.

1) "The malaria vaccine in humanist terms is the biggest need, but it gets virtually no funding."

2) "Research into a vaccine for the disease has so far failed to yield any results."

Maybe it gets "virtually no funding" because it's seen as an insurmountable problem given the current state of the art? The malaria organism is an entirely different kind of life form from the organisms for which human vaccines have historically been effective. It's a protozoan, not a bacterium or virus. As far as I know (and Google seems to confirm this) there is no vaccine for any human disease caused by protozoa.

Edit: this article describes some of the hurdles. It's not just funding.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3961066/

60 minutes to swing from "malaria is a solved problem" to "malaria is an insurmountable problem". Deft maneuvering!

There are treatments for malaria, and have been for a long time.

None of those treatments are vaccines.

I'm not sure what makes stating those facts "deft maneuvering".

treatment != vaccine

Exactly.

Linux runs on toasters because people with a vested interest in selling toasters running Linux pay people to do that work.

They could pay Microsoft to do the work too, then pay for licenses to use the software. Yet they (almost universally) choose not to, because the costs of even setting up such a deal are far too high.

Open source reduces transaction costs and it also reduces startup costs.

The resources required to work on open source software: a computer for maybe $200-$300, an internet connection, and curiosity. The resources required to discover a new therapy and prove that it is safe and effective: Literally hundreds of millions of dollars to pay for tools and equipment needed for biotechnology research and to fund the salaries of the researchers and support staff. Hundreds more to run large scale clinical trials.

This article on the Motley Fool estimates around $3 billion total.

http://www.fool.com/investing/general/2016/04/30/the-cost-of...

Aye, which supports the argument I was trying to make even more strongly. We will not realistically replace drug discovery as currently practiced in academia and industry with open source efforts.

where does the money come from to open source these things?

Where does the money come from for any discoveries in any science where researchers can build freely on each other's results?

Also - read my link!

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