Fwd: Despite decade of innovation, much left to do on neglected tropical diseases

[Elisabeth Janaina]

---------- Forwarded message ----------
From: IRIN <no-r...@irinnews.org>
Date: Thu, 6 Jun 2013 16:26:43 +0100
Subject: Despite decade of innovation, much left to do on neglected
tropical diseases
To: Elisabeth Janaina <elisabet...@gmail.com>

Despite decade of innovation, much left to do on neglected tropical diseases

NAIROBI, 6 June 2013 (IRIN) - Ten years ago, the main treatment for
kala azar - a disease that kills up to 40,000 people every year - was
a 30-day course of injections, a difficult undertaking both for
patients and for the poorly equipped health centres in the remote
areas where many cases of the disease occur. Today, combination
therapy has cut the treatment period to 17 days in some affected
areas, but scientists and health officials continue to work towards
developing a simple pill that would replace painful injections and
further ease treatment.

The sand fly-transmitted disease [ http://www.irinnews.org/Film/4171/
], also known as visceral leishmaniasis, causes painful lesions and is
fatal without treatment. It is found in Ethiopia, Kenya, Somalia,
South Sudan and Uganda, as well as parts of Asia, eastern Europe and
the Middle East. It is just one of 17 illnesses on the UN World Health
Organization's list of neglected tropical diseases [
http://www.who.int/neglected_diseases/diseases/en ], which cause an
estimated half a million deaths annually.

For the past 10 years, the Drugs for Neglected Diseases Initiative
(DNDi) [ http://www.dndi.org/ ] has been involved in research and
development (R&D) for neglected diseases around the world, developing
six new treatments for malaria, sleeping sickness, kala azar and
chagas.

A two-day event was recently held in the Kenyan capital, Nairobi, to
take stock of the last decade of health innovations for neglected
diseases in Africa. There, more than 400 scientists, government health
officials and members of the organizations that make up DNDi agreed
that while significant progress has been made in the fight against
several neglected diseases, better leadership, coordination and
funding will be necessary to eliminate them from the continent.

Better, simpler drugs

"When I first started practising medicine about 20 years ago, I
remember losing two patients, both aged about 20, to sleeping
sickness. The disease didn't kill them; the toxicity of the treatment
did...It was terrible for their families, and for me," Wilfried
Kalonji Mutombo, a government doctor working in the Democratic
Republic of Congo's southwestern province of Bandundu, told IRIN.
"Now, we treat sleeping sickness with a much less toxic regimen of
tablets and intravenous infusions. It's much less stressful."

But Mutombo still struggles to get the drugs from the capital,
Kinshasa, to Bandundu. "I have to drive 10 hours from Kinshasa, and
can only carry drugs for a few patients. Treatment for four people -
boxes of pills and intravenous kits - weighs 30kg," he said. "Once I
arrive in Bandundu, I will usually get on a boat for about six or
seven hours to get to the health centres that need the drugs, and even
then, they may not have trained staff to administer the medicine...
It's hard to maintain trained staff in these remote areas."

DNDi is currently involved in clinical trials [
http://www.dndi.org/media-centre/press-releases/1505-new-oral-drug-candidate-hat.html
] of fexinidazole, a new 10-day, oral-only treatment for sleeping
sickness in DRC and Central African Republic, which would
significantly simplify the treatment of sleeping sickness.

Speaking at press conference on 5 June, Marcel Tanner, chair of DNDi's
board of directors, said that in order to successfully eliminate
neglected diseases, Africa would need to overcome the "fatal triangle"
of neglected diseases, neglected people and neglected health systems
that continued to hold back progress.

But it is not just health systems that need improvement; poor road
networks, inadequate local research capacity, corruption, conflict and
the remoteness of many of the areas where these illnesses are found
all hinder efforts to control neglected tropical diseases.

Wider than healthcare

"First you have to ensure that you develop the best, most appropriate
drugs, but the people affected by these diseases are the poorest of
the poor, so we must convince pharmaceutical companies that they will
find a market if they invest in R&D for them ," John Amuasi, head of
R&D at Ghana's Komfo Anokye Teaching Hospital, told IRIN.

Patent pools, where patent holders license their technology for use by
generics manufacturers, and advance market commitments, in which
donors commitment to subsidize the purchase of vaccines not yet on the
market, have been useful, he said.

"Once you have a cheap drug, you then need a solid, reliable supply
chain so people who need the drugs are able to access them wherever
they are," he added.

Innovative ways to deliver drugs, such as the so-called Coca-Cola
model [ http://www.theglobalfund.org/en/donors/private/cocacola ] -
which uses the private distribution mechanisms to improve access to
medicines - and the increasing use of mobile phones to report
shortages and coordinate deliveries, can help improve supply chain
mechanisms.

"Corruption is another problem. Under the Affordable Medicines
Facility for malaria [AMFM] [ http://www.theglobalfund.org/en/amfm/ ],
some drugs that were meant to be sold for US$1 were found on the
market for as much as $10 in countries not involved in the programme,"
Amuasi added. "We can improve awareness among communities about what
they should be paying for medicines. For instance, with the AMFM,
communities need to be aware that drugs bearing the green leaf logo of
the AMFM should cost no more than $1."

Building the capacity of African governments and research facilities
will also be important for the fight against neglected tropical
diseases. DNDi is working with a number of African governments to
create a regional authority for drug regulation. It also supported the
creation of the Leishmaniasis East Africa Platform in 2003 and the
Human African Trypanosomiasis Platform in 2005 to strengthen research
capacity around the two diseases.

"As the African scientific community, we need to strive to build the
scientific excellence to take ownership of research for health," James
Macharia, Kenya's Cabinet Secretary for Health, said at the press
conference.

"Even with such integrated strategies, and the political will required
to propel them, in addition to the resources required... we must not
forget that the right tools for elimination are necessary to really
see the elimination of many of these diseases."

kr/rz

[END]

This report online: http://www.irinnews.org/report.aspx?reportID=98175



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