Poor countries need inexpensive vaccines, diagnostic tests and medications to combat diseases like tuberculosis and malaria, which kill millions of people each year.

Of the nearly 1,400 new medicines approved between 1975 and 1999, only 1 percent were developed for tuberculosis or tropical diseases mainly confined to poor nations.

"These diseases affect hundreds of millions, yet we lack safe, affordable, effective field-adapted vaccines, diagnostics and drugs to tackle them," the group said. "Without bold, new steps, disease will continue to ravage the developing world, with global consequences. Governments should act now."

Wrong Priorities

Signatories of the campaign include medical research and humanitarian groups such as the Pasteur Institute, the Indian Council of Medical Research, Oxfam and Medecins Sans Frontieres. Nobel laureates, including Literature Prize winner Nadine Gordimer, Peace Prize winner Desmond Tutu and Sir John Sulston, a leader of the team that decoded the human genome, also signed.

They demanded political leadership in drawing up a global health research plan, ensuring sustained funding for the work and in reducing regulatory barriers.

Between 1986 and 2001, global funding for health research soared from $30 billion a year to $106 billion, but progress on treatments for the poor has been insignificant, experts say.

"Money spent today is spent on the wrong priorities. We have to take a look at the way the whole system is functioning. There is a total lack of innovation for diseases that affect poor people," said Dr. Tido von Schoen-Angerer of Medecins Sans Frontieres.

"Determining whether a patient has tuberculosis or not with the exiting diagnostic test only works about half the time. For children, or people infected with both TB and HIV, the test is even more unreliable," he said. "We cannot accept that we must practice second-class medicine just because our patients live in poor countries."

Medical Research Agenda

Progress has been made in the last few years, the group said. Awareness has grown, but the response is patchy and largely dependent on charity for funding. That's not sustainable for a global problem, von Schoen-Angerer said.

A major problem is that drugs are developed only when drug companies can make enough profit to satisfy their shareholders, said Dr. Helen Lee, who left the pharmaceutical industry to create the Diagnostic Development Unit at Cambridge University in England, which develops diagnostic tests appropriate for poor countries.

The medical research agenda must be determined by what's needed, not what will make money, otherwise the world will not win the fight against diseases afflicting the poor, the experts said, adding that relying on the drug industry is not a solution.

The drug industry should be included, and paid for participation, but pharmaceutical companies are not the only source of innovation, Lee said.

"This is not a pipe dream. It's utterly attainable," said Sulston, adding that an alternative to the reliance on a profit-driven pharmaceutical industry has been demonstrated.

An organization set up to push through new medical tools for neglected diseases, the Drugs for Neglected Diseases Initiative, has developed two new malaria drugs that will become available next year. The drugs are easier to take, cheaper and are expected to be a major boost to the fight against malaria.