Freeman Spogli Institute for International Studies Program on Energy and Sustainable Development Stanford University


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Responding to Market Failures in Tuberculosis Control

Journal Article

Rajesh Gupta, Jim Y. Kim, Marcos A. Espinal, Jean-Michel Caudron, Bernard Pecoul, Paul E. Farmer, Mario C. Raviglione

Published by
Science, Vol. 293, page(s) 1049-1051
August 10, 2001

The specter of multidrug-resistant tuberculosis (MDR-TB) threatens the gains achieved by tuberculosis control through international recommendations currently accepted by 127 countries. The high cost of second-line drugs is a clear example of a market failure serving as a barrier to treatment of MDR-TB cases. Gupta et al. describe an approach based on policy development, consolidating and increasing demand, and increasing supply to decrease the cost of second-line drugs. As a result, prices decreased from 48-97% for a treatment regimen and competition was increased in monopoly markets. An independent scientific committee fosters access to the drugs under tightly monitored pilot projects to prevent the creation of resistance to second-line drugs. This strategy may be applicable to other infectious-disease treatment efforts.