Intended for healthcare professionals

Observations Border Crossing

Orphan diseases: which ones do we adopt?

BMJ 2008; 337 doi: https://doi.org/10.1136/bmj.a1225 (Published 11 August 2008) Cite this as: BMJ 2008;337:a1225

Medicine--A sacred profession or a kind business

Ihave been in the field of medicine since 1980, first as an
undergraduate and postgraduate student and then as a teacher. I have been
lucky to have worked in teaching institutions with very good teachers.

Over the past 27 years the dynamics of practicing medicine have changed a
lot. Once considered to be a profession with a mission, medicine now has
become an industry. This industry is busy in 'kind business' in some countries and
'dirty business' in others. Market forces and political goals of
the governments take preference over the needs of the society. This is
more obvious in developing countries.In such a scene, those wanting to
invest in research, want their money back with a lot of profit.

Pharmaceutical firms are pioneering this approach. Every pharmaceutical
company is ready to invest in expensive molecules for common illnesses
like hypertension, diabetes mellitus etc. This approach is profit driven,
I am sorry to say. In the given circumstances, I believe that governments
should take responsability for allocating funds for common illnesses that
can be prevented or cured cheaply. Non-Governmental Organisations (NGO's)
should take interest in providing funds for research into rare diseases.
They should do it on 'No profit, No loss' basis. A molecule so developed
or a discovery so made should be the property of the NGO who should market
it on 'NO profit, No loss' basis. This would break the monopoly of joint
pharmaceutical companies.

Competing interests:
None declared

Competing interests: No competing interests

13 August 2008
Noor ul Iman
Associate Professor of Medicine
Khyber Medical College, Peshawar, Pakistan