Posts Tagged ‘neglected tropical diseases’

Ending NTDs by 2020: Increased investment for R&D required

Monday, January 30th, 2012

Today in London, some of the biggest players in global health committed a renewed and intensified focus on neglected tropical diseases, a group of diseases affecting the world’s poorest people. One in six people, or 1.4 billion people around the world, have an NTD and one in three people are at risk. Though NTDs don’t always kill, they cause disabilities, making it difficult or impossible for children to attend school and for adults to work and support their families.

The international, cross-sector meeting marked collaboration between governments, the World Health Organization (WHO), the World Bank, the Gates Foundation, pharmaceutical companies, and global health NGOs. It is also an historic pledge that brings new promise and hope to those affected and advances science and health for all. Sir Andrew Witty, CEO, GlaxoSmithKline noted that the variety of different commitments across sectors demonstrates these collaborations want to “travel far” to end NTDs. “If you want to travel fast, travel alone. If you want to travel far, travel as a group,” he said, quoting an African proverb.

Making best use of existing tools to combat diseases will only get us part of the way. The 2020 goals are achievable only with new tools—including drugs, vaccines and diagnostics. Nine of the ten targeted NTDs required new investment in research and development.

To take just one example, visceral leishmaniasis is almost always fatal if untreated, and there are approximately 500,000 cases each year, largely in South Asia and the horn of Africa. The cost of treatment plus loss of income due to one case of VL represents at least 50% of the average spent per family member per year. What’s worse, more than half of people who seek treatment must do so more than once to cure the disease. Available therapies are sometimes toxic or ineffective. New, more effective medicines are needed, at a lower cost, and with fewer side effects.

A consortium project led by Drugs for Neglected Diseases Initiative, in partnership with California-based OneWorld Health and TDR, WHO’s Special Programme for Research and Training in Tropical Diseases, aims to establishing and implementing new treatment modalities as successful tools to control and support the elimination of VL in most endemic regions of South Asia. California-based pharmaceutical company Gilead is investing in further research to reduce the cost of treatment.

In addition to narrowing funding gaps, new licensing or collaboration agreements have opened up “libraries” of scientific knowledge and research compounds. As a result, one pharmaceutical company recently shared 300 compounds with a lab in Argentina to conduct research on Chagas, an NTD common in rural parts of Central and South America, and sometimes found in poor parts of the United States.

Something as ambitious as this takes commitment from the public, private and philanthropic sectors, but the public must become increasingly engaged as well. The names of diseases like visceral leishmaniasis don’t exactly roll off the tongue of those of us in developed countries, and fewer people could tell you why the condition is so devastating. To increase public awareness and advocacy of NTDs, the Sabin Vaccine Institute-based Global Network’s new END7 campaign aims to end seven of the most common NTDs by 2020. It’s going to take an increased effort on all our parts to make NTDs a thing of the past.

Investing in Global Health R&D

Wednesday, September 14th, 2011

In an article in PLoS Neglected Tropical Disease, Peter J. Hotez, MD, PhD, proposes the U.S. government set aside approximately 1% to 2% of President Barack Obama’s Global Health Initiative (GHI) for research and development for neglected tropical diseases. Neglected tropical diseases are the most common diseases among the world’s poor: 1.4 billion who live on less than $1.25 a day, according to the World Bank. These diseases cause disabilities, often lifelong, and effect long-term earnings of those in poverty. A reallocation of funds within the GHI, Hotez writes, would help to support new health products for neglected tropical diseases to combat these illnesses and provide capacity building activities for key countries of strategic interest to the US.

By investing more in R&D for neglected tropical diseases, an increase in funds to product development partnerships (PDPs) would be essential. PDPs focus on creating technologies for global health, especially for neglected tropical diseases. Many PDPs are based in the U.S. and partnerships often extend to overseas organizations. These unique partnerships allow opportunity for improved science and technology diplomacy and perpetuate goodwill, peace and security in foreign countries.

Most of the world’s neglected tropical diseases are believed to occur in areas of the greatest U.S. geopolitical interests. The most heavily affected nations include those comprising the Organisation of the Islamic Conference, as some of the worst affected nations include the poorest Islamic countries, such as Indonesia, Bangladesh, Sudan, Mali and Chad; they also include powerful middle-income nations with nuclear weapons capabilities such as India, Pakistan, Iran and North Korea.

The U.S. government is committed to global health R&D and, under the GHI, has committed to invest $15 billion annually on development assistance for global health. However, only a small amount of funds are allotted for R&D for neglected tropical diseases. By investing more in R&D for neglected tropical diseases, greater opportunities and security could be provided for the U.S.

GHC Gets Us Up to Speed on Efforts Against Polio, Malaria and NTDs

Thursday, April 21st, 2011

The Global Health Council has produced a number of interesting papers in the past few months, detailing the worldwide fight against continuing global health problems. Polio, malaria and neglected tropical diseases all still play a major role in global health; each has its own successes, and each has areas that are cause for significant concern.

Polio, for instance, is nowhere near the threat it once was; since 1988, cases of polio have decreased 99% worldwide, according to the GHC’s fact sheet on polio vaccination and challenges to eradication. But as has been noted elsewhere, eliminating the final 1% has proven a difficult task.

The GHC’s fact sheet notes that cases are primarily limited to four countries: Afghanistan, Nigeria, India and Pakistan. But closing the book on polio has been hampered by viral mutations, uneven vaccine effectiveness and – in the case Afghanistan and Pakistan – regional conflicts hindering vaccine distribution.

Complicating efforts is the way in which polio spreads. Many who host the polio virus are never affected by symptoms; unaware they are infected, they can easily pass the virus to others. Moreover, people with compromised immune systems may shed the virus for years after receiving a vaccine which contains the weakened virus; those with healthy immune systems shed the weakened virus for only a few weeks.

Unlike the nearly-extinct polio, malaria continues to be a threat across the globe, putting half the global population at risk. GHC’s malaria position paper, released last month, finds that the disease disproportionately affects those living in poverty. In some high-burden countries, GHC writes, the cost of treating the disease can account for one-quarter of household incomes. Imagine, then, the average American spending more than $11,000 annually.

The fact sheet notes that research will play a critical role in the battle against malaria. The basis for the most common treatments, artemisinin, may be on the verge of becoming obsolete; thus, new treatments are desperately needed. And though no vaccine for malaria has yet emerged, there are a handful of promising candidates.

NTDs are perhaps a larger problem than malaria and polio combined. GHC’s fact sheet on NTDs, released in February, states that between 18 to 57 million years of life are estimated to have been lost because of premature death and disability.

If those numbers aren’t large enough, consider this: One billion people around the world are currently infected with an NTD; two billion others remain at risk. That’s just under half of the world’s population.

As with malaria, research can have considerable influcence. For some NTDs without adequate control – the fact sheet lists Chagas’ disease, leishmaniasis, sleeping sickness and Buruli ulcer among them – research is critical. Several others depend on a key ingredient in treatment; as with malaria, resistance develops? Here too research, in the form of drug development, plays an important role.

Even if global health is not an area of focus for you, the fact sheets are well worth reading.