Forgotten and with few treatment options, Chagas debilitates and kills

[Rio de Janeiro, Brazil – July 9, 2009]
100 years since Chagas disease was discovered, DNDi launches an international campaign “Wake Up. Time to Treat Chagas Disease!” with a call for better medicines and treatment of patients
[Português]

One hundred years after the discovery of Chagas disease, 100 million people remain at risk and the disease continues to debilitate and kill the poorest of the poor. Drugs for Neglected Diseases initiative (DNDi) today, alongside Médecins Sans Frontières (MSF), called on governments, scientific community, private sector and civil society to increase their commitment and support for research and development for better health tools (diagnostics and treatments) and improved access.

The global campaign “Wake Up.Time to Treat Chagas Disease!” was launched during a three-day international scientific conference on the 100th anniversary of the discovery of Chagas disease, and also comes at the time of a publication of a series of articles in PLoS Neglected Tropical Diseases on the unfinished public health agenda of Chagas disease.

“We hope this campaign will bring Chagas disease out of the shadows and helps patients with Chagas disease to gain access to better treatment options, ” said Michel Lotrowska, DNDi’s Regional Director for Latin America. “Little public or political capital currently exists for Chagas disease as the disease most affects the most vulnerable populations in some of the poorest regions in Latin American countries. Only a global effort can put Chagas disease on the top of national and international agenda.”

Few of the millions of patients needing treatment for Chagas disease are ever diagnosed with the disease and receive treatment. When they do, there are only two medications available – benznidazole and nifurtimox, both of which have a number of disadvantages: treatment is long (30 to 60 days), with side effects and high rates of patient non-compliance. There is limited efficacy in the advanced stages of the disease, and no pediatric strength or formulation is currently available.

“This international meeting shows there is renewed interest by scientists and practitioners to find new and better treatments to fight Chagas, but we also need sustainable funding and political commitment to make it,” commented Dr. Carlos Morel, Director of the Center for Technological Development in Health (CDTS) of FIOCRUZ. “We must unite the growing capabilities of developing countries to combine innovation in health with the scientific advances being made in research and development at leading institutes worldwide.”

As reported in PLoS articles, Chagas disease remains at the top of the list of most neglected diseases today despite improved control and regional research efforts.1-3 Despite being responsible for one of the highest estimated disease burdens due to infectious diseases in Latin America, Chagas disease received only 0.25% (approximately US$10 million) out of 2.5 billion dollars invested in neglected diseases in 2007.4

The Chagas Campaign launched by DNDi (www.treatchagas.org), aims to raise awareness of the burden of Chagas disease and calls upon those in power to foster innovation for this silent disease by supporting innovative partnerships in R&D and facilitating new and sustainable financing mechanisms.

“Chagas patients have been forgotten because they are poor and live in remote and rural areas, but we see that the science exists to develop better treatments,” said Bernard Pecoul, Executive Director of DNDi. “The first step to making progress at an international level is through sustainable funding and strong public support in both endemic and non-endemic countries. The draft resolution on neglected diseases, which is being considered by PAHO/WHO this year, is one example where we are moving forward and must follow through with concrete action.”

Note for Editors

About Chagas disease

Chagas is primarily transmitted by large, blood-sucking reduviid insects widely known as “the kissing bug”, Chagas is endemic in 21 countries across Latin America, With an average of 14,000 deaths per year, Chagas kills more people in the region each year than any other parasite-born disease, including malaria. These are mostly poor people who live in rural areas or migrate to the outskirts of larger urban centers and therefore don’t represent an attractive enough consumer market for private industry.

Without an adequate diagnosis and treatment, one in every four Chagas patients develops a fatal symptom of the disease, usually swelling of the heart muscle. Often, patients will require a pace-maker and in some cases even need to undergo a heart transplant. Many patients, however, die suddenly, some without even realizing that they had been infected.

Children born to mothers who know that they are infected by the Trypanosoma cruzi parasite can benefit the most from treatment and the cure rate is high.  Yet, there are no pediatric treatments available that have been adapted to their needs. Children are treated with adult medication, broken up into as many as 12 pieces, depending on the child’s body weight. As the medication is non-soluble, mothers have to crush the medication to dissolve it in liquid. This not only puts the continuity of the treatment at risk, but also its safety and efficacy, as it is difficult to ensure a correct dosage.

This problem is beginning to be resolved with the production of pediatric benznidazole that will be available in 2010 thanks to a partnership between DNDi and LAFEPE (the pharmaceutical lab of the state of Pernambuco in Brazil), the only producer of benznidazole in the world.

About DNDi

The Drugs for Neglected Diseases initiative (DNDi) is a not-for-profit product development partnership founded in 2003 by five publicly-funded research organisations –  Brazil’s Oswaldo Cruz Foundation, Indian Council of Medical Research, Kenya Medical Research Institute, Malaysian Ministry of Health, and the Institut Pasteur; an international research organisation WHO’s Tropical Diseases Research programme; and an international humanitarian organisation Médecins Sans Frontières. DNDi has developed the largest ever R&D portfolio for kinetoplastid diseases and has, with its partners, already made available three new treatments for neglected diseases. For further information, please visit www.dndi.org.

This month, in a DNDi has published a policy paper in PLOS NTD outlining the urgent need for new treatments for Chagas disease, examining barriers to development and evaluation of new drugs, and reporting on progress in bringing new treatments to patients.  In the short term, DNDi is working on better use of existing treatments through therapeutic switching, new formulations (including the first pediatric formulation of benznidazole), and combination therapies based on the success of such treatments in HIV/AIDS, malaria and tuberculosis. DNDi’s long-term objectives are to deliver an effective, non-toxic, inexpensive treatment proven effective in both acute and early chronic phases, and to improve research & treatment capacity for Chagas disease.

References
1. Franco-Paredes C, Bottazzi ME, Hotez PJ. The unfinished public health agenda of chagas disease in the era of globalization. PLoS Negl Trop Dis. 2009;3(7):e470.
2. Ribeiro CH, Lopez NC, Ramirez GA, et al. Trypanosoma cruzi calreticulin: A possible role in Chagas’ disease autoimmunity. Mol Immunol. Mar 2009;46(6):1092-1099.
3. Yun O, Lima MA, Ellman T, et al. Feasibility, drug safety, and effectiveness of etiological treatment programs for chagas disease in honduras, guatemala, and bolivia: 10-year experience of medecins sans frontieres. PLoS Negl Trop Dis. 2009;3(7):e488.
4. Moran M, Guzman J, Ropars AL, et al. Neglected Disease Research and Development: How Much Are We Really Spending? PLoS Med. Feb 3 2009;6(2):e30.

Contacts
For further information or to arrange interviews with Michel Lotrowska or Carlos Morel, please contact:

Flávio Guilherme Pontes – DNDi Rio de Janeiro, Brazil, (21) 8123-4133; (21) 8298-6294; press@dndi.org.br

Samantha Bolton – DNDi Geneva, Switzerland, (41) 79 239 2366, (41) 22 906 9250; sbolton@dndi.org

Michelle French – DNDi New York, USA, (1) 646 616 8681; (1) 646 552 4600; mfrench@dndi.org.

Please visit the Chagas Campaign website: www.treatchagas.org