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Sometimes a single image reflects a view of mankind that touches the heart and brings tears to the eyes. I had occasion to look again at the photograph taken by

According to USFDA, a combination product is one composed of any combination of a drug and device; biological product and device; drug and biological product

Huynh Cong Ut, now better known as Nick Ut. This photo won him a Pulitzer Prize and may be viewed on widipedia under the photographer's name. It shows a terrifie

; or drug, device, and biological product and fixed dose combination would include two or more combinations of drug.

Examples of combination products may in

little 9 year old girl running towards the camera to flee a South Viatnamese napalm attack on the Trang Bank village during the Vietnam War.

Somehow this image

lude drug-coated devices, drugs packaged with delivery devices in medical kits, and drugs and devices packaged separately but intended to be used together.

35 years down the line, is as horrific and shaming as it must have been when it first appeared in print. That little girl's pain is so real, so desperate, so lo

here is enormous increase in the number of combination products entering the market in the recent years. Combination products have proven advantages but fixe

t and you can see and hear the terror this child is going through. For me this image represents the children in the world who have been let down by adults and th

d dose combinations are still in the process of convincing regulatory authority on their advantages over the single ingredient formulations.

Combination pro

e society they live in. I'm not just talking about the kids that have been bullied into labour, into armed combat, torture and turned into sex slaves in under d

ucts have become life saving products for the pharmaceutical companies who doesn’t have many innovative molecules in their product pipeline and have been inc

veloped countries.

What pain are the children of Darfur suffering. What about the kids in Iraq who have to step over corpses on the way to school, if they are l

easingly used in the product life cycle management. Even the companies having product patents are trying to extend their product life cycle through the combi

cky enough to still be able to go to school. What about the girls in Africa who are subjected to genital mutilation. What about the children in China who are wor

nation products and maximize the revenues. But the companies involved in this practice are overlooking that they are burdening the patients both economically

ing in factories.

What about the multitude of children born in Africa where the parents have no hope of feeding them, but they still continue to breed. What abo

and physically. They need to rightly judge the benefits of the combination products and they have to even look at the risks involved when combining the produ

ut the kids killed in American schools because of inadequate gun laws. And what about little Madeleine who was abducted from her bed while she and her family wer

ts. Some of the combination products were well accepted by physicians while others suffered. Companies involved in development of combination products are fi

on holiday in Portugal.

When I look at that picture I can hear that scream. A child has different kinds of screams. There are the screams that denote temper, f

ding difficulty in defining their combination products and facing various challenges from selecting a combination to marketing it.

Following aspects would a

ustration and small little pains like a stubbed toe. And then there is that scream. When my kids grew up, there were a few times, when they had really, really hu

dd to the challenges in developing combination products:

Which markets to tap where the combination products can do fairly well?
Which combination prod

t themselves, when they have a special scream that just goes right through you. I can hear that little Vietnamese girl screaming like that.

Children are unthink

cts are meaningful and rational?
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin

ingly brought into the world. And then neglected, ignored or exploited depending on what selfish adults feel they need them for. I don't think the world has imp

tions increase the patient compliance?
What would be the developing cost?
How to tackle the risks encountered during combination product developmen

oved on this in the 21st century. The world is as neglectful of its children as before.

Sure, you will look at this and say that you can't be counted amongst th

t?

As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel

se. You look after your kids, they are the centre of your universe. And I know the majority of parents really do care for their children and follow through on th

ping new procedures for reviewing their safety, efficacy and quality.

Professional from academic institutions, pharmaceutical industries, health care indust

caring by providing a protected, nurturing and stimulating home life for them. However, what percentage of neglected children is acceptable? Is it acceptable to

y and representatives from various regulatory agencies are working out to design the regulatory requirements for manufacture and sale of combination products

have any children who are abandoned by the society they live in.

No matter the numbers, those kids are screaming just like that little Vietnamese child. It doe

.

As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de

n't have to be napalm that frightens them. It can be the other evils that the 21st century has thought of, from child molestation to child pornography, to straig

elopment. They need to be wiser in analyzing the market trends and the regulatory requirements.

Companies that provide selfless information through particip

t parental abuse. We have it all. That little girl was in Vietnam, but those children that are screaming from absolute anguish, they are everywhere in the world

tion in industry events and feedback to regulatory authorities would be able to face the challenges and will be successful in developing combination products

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