Graeme Bilbe, Research & Development Director, DNDi
Addressing the lack of patient-adapted treatments for those suffering from neglected diseases is no easy task. DNDi’s initial short-term strategies were designed to quickly provide improved treatments through new formulations or combinations of existing drugs, and/or improved treatment regimens. Six new treatments have been delivered since 2003.
Filarial diseases are caused by parasitic worms of the helminth family. They include onchocerciasis (also known as River Blindness), lymphatic filariasis (also known as elephantiasis), and loiasis (also known as African eye-worm). The worms are transmitted by insect vectors to humans, mainly in Africa and Southeast Asia. About 168 million people are infected by the three diseases.
Human African trypanosomiasis (HAT), also known as ‘sleeping sickness’, is transmitted by the bite of a tsetse fly. While currently its prevalence is declining, 21 million people are still at risk across 36 Sub-Saharan Africa countries with most of the cases occurring in the Democratic Republic of Congo (89% of all cases in 2013).
The parasite that causes leishmaniasis is transmitted by the bite of a sandfly. Leishmaniasis is a complex group of diseases with over a million new cases occurring every year and 350 million people living at risk worldwide in 98 countries. The most common forms of the disease are visceral leishmaniasis (VL), which is fatal without treatment, and cutaneous leishmaniasis (CL).
The parasite that causes Chagas disease is transmitted by the ‘kissing bug’ and also by blood transfusion, organ transplantation, and congenitally. The disease is endemic in 21 countries in Latin America, where 70 million people are at risk.
Mycetoma is a neglected tropical disease characterized by deformity and disability with various health and socio-economic impacts on the affected communities. It is endemic in many tropical and subtropical regions, with cases reported globally. Mycetoma is a chronic inflammatory disease caused by true fungi or certain bacteria and hence the classifications eumycetoma and actinomycetoma respectively.
HIV can be transmitted to children during pregnancy, delivery, and through breastfeeding. An estimated 2.6 million children below the age of 15 were living with HIV in 2014, close to 90% of whom were in sub-Saharan Africa.
DNDi has produced a new report on ‘Pioneering ways of working through innovative partnerships – 2002-2015 – The successful development of a fixed dose combination of artesunate plus amodiaquine antimalarial’. This document reviews the development of DNDi’s first-delivered treatment, ASAQ FDC, and forms part of a broader reflection on DNDi’s business model and its lessons learned over a decade after its creation in 2003.
The Drugs for Neglected Diseases initiative (DNDi) has joined Médecins Sans Frontières/Doctors Without Borders (MSF), the Global Alliance for TB Drug Development (TB Alliance), and other not-for-profit public health organizations in calling for amendments to the Food and Drug Administration (FDA) Priority Review Voucher (PRV) programme for neglected diseases.
Nineteen years ago, while playing on the school field, Alsadik Mohamed Musa Omer pricked his foot on a thorn. Like any other 15 year old boy, he continued playing and later cleaned the small wound caused by the thorn. Soon, the thorn prick was forgotten. A few weeks later, however, he developed an infection around the thorn prick that he again ignored. The infection continued growing and soon developed into sores.
For Juan Bautista Corzo Veloza, a 53 year old, father of three, life is
not the same since that day in January 2013 when a stroke left him
“dead for three days,” he says. He was changing a tire while performing
his duty as a driver, a job to which he had dedicated himself after
retiring from the National Police, when he began to feel a sharp
pain in his chest along with a slow loss of consciousness.
Jean-René Kiechel, Senior Pharma Advisor & Product Manager, DNDi
The beginning of the current millennium saw a radical change in the way malaria was treated. In 2001, in response to rising chloroquine resistance, the WHO recommended replacing this monotherapy with artemisinin-based combination therapies, known as ACTs. The Drugs for Neglected Diseases Working Group of the MSF Access Campaign and WHO-TDR came together with other experts and stakeholders from both non-endemic and endemic countries to form the Fixed-Dose Combination Therapies (FACT) consortium in 2002, with projects subsequently transferred to DNDi when it was established in 2003.
2015 is the year the malaria community hoped to achieve universal coverage with existing interventions, near zero deaths, and a 75% reduction of global incidence from 2000 levels. The world is edging closer to these ambitious goals – malaria mortality rates fell by approximately 47% worldwide and incidence rates by 26%.
The Japanese Global Health Innovative Technology Fund (GHIT Fund) has invested $4 million in a partnership between Takeda Pharmaceutical Company and DNDi. The partnership is developing a new drug for visceral leishmaniasis based on a promising new series of aminopyrazoles.
Two fixed-dose artemisinin combination therapies (ACTs) developed by Drugs for Neglected Diseases initiative (DNDi) and partners, artesunate-amodiaquine (ASAQ) and artesunate-mefloquine (ASMQ), will now be managed by MMV’s Access and Product Management team to help maximize their impact for the patients who need them most.
[30 April 2015]
An estimated 3.3 million children under 15 years of age were living with HIV worldwide in 2012. During that one year alone, some 260,000 children were infected with HIV (over 90% of these were in sub-Saharan Africa). A further 210,000 died of the disease, the vast majority before reaching the age of two and without having been diagnosed. Most of these deaths could have been avoided had diagnosis been carried out in the first weeks of infection and treatment immediately commenced. While the absolute number of infants newly infected with HIV is now declining due to international efforts made in prevention of mother to child transmission, the need for paediatric treatment will continue to increase at least until 2020.
Rafael Vilasanjuan, ISGlobal and Eric Stobbaerts, DNDi Latin America – members of the Global Chagas Disease Coalition
During the month that celebrates International Chagas Disease day, Colombia, via its Ministry of Health has confirmed its commitment to the disease, a reason for optimism for the entire region. Aware of the difficulty of access to diagnosis and treatment (less than 1,000 patients treated), an action plan has been proposed to tackle Chagas Disease under the leadership of the Ministry of Health and Social Protection. A model project supported by DNDi and capable of being implemented in other locations arose as an example and brings hope not only to the 437 thousand infected persons and roughly 4.8 million people at risk of being infected in the country, but also for other affected countries.