OPEN SOURCE EVERYTHING:

Tuberculosis kills more people than HIV and malaria combined

So imagine you shared those choices in an open, free and transparent way. You would get results quicker as competing labs would learn from each other's mistakes, exchange ideas and perspectives -- you'd collaborate.

It does happen. Large firms and academia do share their compound "tool boxes." But it could probably also happen more broadly.

Torreele mentions a recent discovery of two new tuberculosis drugs.

Tuberculosis, according to the WHO, kills more people than HIV and malaria combined.

So when the new drugs hit the market, it was a win for patients. Perhaps not as big a win, however, as may have been possible. The drugs were developed in isolation, but it turns out they may work better together, complimenting each other. 

"It's the TB community that's trialing those drugs together, now, not the companies, because they have no incentives," says Torreele. "If we had developed these drugs in an open way, we would have combined them during the development phase, not six years after they had got to market."

But still one of the greatest inefficiencies in drug discovery is that most drug candidates fail very late in the process, when most of the money has gone.

About 80-90 percent of candidate drugs fail in Phase 2 trials, and of the 20 percent that progress to Phase 3, a further 50 percent fail as well, says Bountra.

With those statistics, is it any wonder that publicly-traded companies are risk-averse? That's a lot of wasted cash. With more people working on a shared project, though, developers could fail fast and move on together.

Divisions of labor remain. You often hear both industry and academia say that universities are incapable of bringing drugs to market. They can do the early leg work, the mantra goes, but only the industry can turn candidates into viable products.

Oliaro, however, says no.

"I challenge the idea that only pharma can do clinical trials. That is wrong," Oliaro says. "They farm out clinical trials to contract research organizations and that adds enormously to the cost of R&D. But people in the not-for-profit sector also know how to do clinical trials, and we do it with patients in mind."

If Oliaro is right, then academia pitching in right through to the end in an open source setup would bring down costs even more.

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