Neglected Tropical Diseases
This morning in London, 13 pharmaceutical companies, the US, UK and UAE governments, the Bill & Melinda Gates Foundation, the World Bank and other global health organizations announced a new plan to eliminate or control 10 neglected tropical diseases, which disproportionally affect 1.4 billion of the world’s poorest people.
Dr Caroline Anstey of the World Bank said: “These are not neglected diseases -– but rather diseases of neglected people.”
The aim is to eliminate Guinea worm, leprosy, lymphatic filariasis, blinding trachoma and sleeping sickness by 2020, and control schistosomiasis, river blindness, soil-transmitted helminthes, Chagas disease and visceral leishmaniasis. These diseases cause misery, suffering, disfigurement and death -– and when they don’t kill the seriously affect the lives of many people.
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Kim Koporc from Children Without Worms (CWW) writes about an illness that affects children all over the world, including Africa: intestinal worms.
When I visited Cambodia with Johnson & Johnson for a deworming day at Poek Ho (waterfall) school in Kandal Province, I was struck by the sheer number of students who lined up to receive mebendazole. These children showed up to receive treatment for intestinal parasites with mebendazole donated by Johnson & Johnson. They also received a meal, which for some was likely the only meal they received that day.
These children were at particular risk of infection with intestinal worms because worms thrive in the warm climate. The lack of access to sanitation facilities in Cambodia doesn’t help much, either. In America, it is hard for us to imagine that more than 1.2 billion people living in developing countries are infected with intestinal worms. Worms are most prevalent in children between the ages of 6 to 14 and can lead to malnutrition, robbing them of the energy they need to learn and grow.
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This entry in our series on “Vaccines: The Next 10 Years” comes from Dr. Peter Hotez of the Sabin Vaccine Institute:
We are in an exciting new era of vaccine development. After a decade or more in which major pharmaceutical companies left the vaccine manufacturing space for more lucrative opportunities, there has been a resurgence, such that major companies have either returned or entered into this market.
Yet despite this time of great opportunity, there is still an urgent need to develop vaccines to combat the neglected tropical diseases (NTDs)—which primarily affect the world’s poorest people (the “bottom billion”) residing in developing countries—and to increase access to affordable vaccines for diseases and infections like Human papillomavirus (HPV), rotavirus, and pneumococcal disease.
The effects of these diseases and infections range from iron-deficiency anemia and inner ear infections in the case of hookworm infection and pneumococcal disease, to cervical cancer and death for HPV and rotavirus. Except for hookworm infection for which a vaccine does not currently exist (more on that later); pneumococcal disease, HPV, and rotavirus are all preventable with vaccines. Vaccines have the power to save lives if individuals are able to access and afford them.
For NTDs, the vaccine development sector climate is a bit different. Because NTDs almost exclusively affect the world’s poorest people, there is no traditional market for NTD vaccines. Through the support of the Bill & Melinda Gates Foundation and other philanthropies, however, the Sabin Vaccine Institute has established an innovative product development partnership (PDP) to develop vaccines for hookworm infection and schistosomiasis.
At the Sabin Vaccine Institute we sometimes refer to such vaccines as “antipoverty vaccines” because of their ability to both improve economic development as well as health. NTDs have been shown to represent a major reason why the poorest people in developing countries remain trapped in poverty.
On the flipside, once vaccines are developed they need to be affordable and easily accessible by the individuals who need them. Sabin has taken two interesting approaches to addressing these issues. Our international advocacy and education team aims to raise awareness on, and increase utilization of, both traditional and new and underutilized vaccines. Sabin’s Sustainable Immunization Financing (SIF) Program takes the issue of affordability one step further by working with developing country governments to help them increase their share and amount of immunization funding.
Another innovative approach to ensuring that vaccines are affordable and accessible is working with the in-country health institutions to develop vaccines, test them on endemic populations, and directly transfer technology and build capacity in-country. Our hookworm and schistosomiasis vaccines are being developed in collaboration with Brazilian government institutions including FIOCRUZ and Instituto Butantan to ensure that the future vaccines will be directly tailored to, and accessible by, the individuals who are suffering from the NTD.
While the vaccine development sector is certainly experiencing a time of renewed interest and innovation, it’s easy to understand how complex the atmosphere can remain even after a vaccine has been developed. We have a tremendous opportunity to tackle these issues during the “golden age” of vaccines.
George Washington University is the big winner in the Global Network’s “Just 50 Cents Campus Challenge”. They were 1 of 21 university individual and group campaigns that participated in the contest that provided an opportunity for full-time undergraduate and graduate college students to become Student Ambassadors in the fight to prevent and eliminate the world’s most common neglected tropical diseases (NTDs).
According to Erin Finucane of the Global Network for Neglected Tropical Diseases:
George Washington University students swept both the individual and group segments of the contest, which raised $12,195.31 total.
Manuel Claros, who raised $1256, will receive a 4-week long paid internship with the Global Network. The team from GWU Medical School, who raised $3892.81, will receive a matching donation in their honor from actress and Global Network Ambassador Alyssa Milano, doubling their impact to $7785.62.
Check this press release for more background on the contest and how George Washington University pulled it off.
In a period of intense fiscal restraint, domestically and globally, there are going to be many global health and development advocates that are displeased by the release of President Obama’s FY2011 Budget Request today. But as one of ONE’s newest employees—and only a month out from my previous job doing policy work for the Global Network for Neglected Tropical Diseases—President Obama’s request of $155 million for neglected tropical diseases (NTDs) is a huge step forward in an area that has been underfunded in the past.
At ONE, we recognize that there is no silver bullet to fighting poverty in Africa and across the developing world; similarly there is no one intervention that will ensure that those living in poverty can enjoy good and sustainable health. Yet the scale of the NTD infections around the world—more than one billion people are infected—also suggests that a growing US financial commitment to NTD control means we can make a cross-cutting impact on the diseases that are perhaps the most common denominator for the world’s poorest people.
The NTD story is a remarkable one: thanks to unprecedented donation programs from major pharmaceutical companies, we can treat all seven of the most common NTDs for just 50 cents per person, per year. Hundreds of millions of people have benefitted from this simple, cost-effective treatment; 546 million people were treated for one NTD (elephantiasis) alone in 2007! Yet these diseases still remain largely unknown. Advocacy groups including the Global Network work to promote global awareness, and the Gates Foundation dedicates substantial funding to support the creation of regional financing mechanisms to absorb new investments for NTDs. Still, many leaders across the public and private sectors have a difficult time advocating and providing funding for diseases with bizarre names like “schistosomiasis.”
That’s where high level leadership comes in. Though President Bush was better-known for his landmark investments in HIV/AIDS, he also made the US’ first major commitment to NTDs, recommending that $350 million over five years be dedicated to NTD control and elimination efforts. With the Global Health Initiative and now in his budget, President Obama has transitioned and grown President Bush’s work on NTDs, and has signaled that the US can be a leader in NTD control efforts, including a push for elimination targets around lymphatic filariasis, onchocerciasis, and leprosy.
The magnitude of NTDs is so great—approximately one in six people worldwide are infected—that the problem can seem daunting or intractable. But particularly at a point in which funding for other global accounts was not as high as we hoped, ONE members can applaud President Obama for his expanded commitment to NTD control and for ensuring that the US can one day claim a major role in the elimination of many of these horrific diseases.
We’ll have more analysis of President Obama’s FY2011 Budget soon.
In the global health world, we often hear discussion of HIV/AIDS, malaria and tuberculosis – but what about the other diseases that fly under the radar? According to the Global Health Progress initiative, “More than one billion people around the world are afflicted with one or more neglected diseases, and this topic is of critical importance to US foreign aid and global health policy.”
The Tufts Center for the Study of Drug Development took on this issue of neglected diseases last Friday at their daylong event, “Neglected Diseases in the Developing World: Progress, Current Challenges and Promising Approaches.” Held in the Dirksen Senate Building, the event featured a distinguished group of speakers, including representatives from the Food and Drug Administration (FDA), National Institute of Health (NIH), Duke University, BIO Ventures for Global Health and the U.S. Agency for International Development (USAID).
Christopher Milner, Associated Director of the Tufts Center for Drug Development, started the morning by introducing Mary Moran, Director of the Health Policy Division of the George Institute. Ms. Moran spoke about the issue of obtaining global funding for research and development to treat neglected diseases. She explained that many countries and organizations are participating in the development of new neglected disease products, which is a welcome and relatively new phenomenon. However, there is a dire need, particularly during the economic crisis, for the broadening of funding efforts so that all diseases receive the attention they deserve.
Joshua Cohen of the Tufts University Center for the Study of Drug Development also took the floor to discuss progress in neglected disease drug development. Mr. Cohen emphasized that financial support for neglected disease research is very lopsided, with the majority of funding flowing into HIV/AIDS, malaria, and tuberculosis. He also stressed that a comprehensive approach to addressing neglected diseases should include not only effective drug development, but also attention to health infrastructure, affordability, and improved accessibility.
The morning ended with a panel discussion in which public and private sector experts discussed how to prioritize and facilitate the discovery and development of new medical products for neglected diseases. The panelists also highlighted public health impacts and current efforts to address this global threat.
The event provided a unique opportunity to hear leaders from a variety of fields share their views on both the progress and challenges surrounding the development and distribution of products for combating neglected diseases in the developing world.
-Robyn Mitchell, Hallie Tosher, & Jen Fraser
There’s an important editorial in the LA Times today about drug-resistant tuberculosis.
A couple of excerpts:
“A new survey by the World Health Organization shows that drug-resistant tuberculosis is even more widespread than had been feared — on average, it’s present in 5% of new TB cases. That’s 500,000 drug-resistant cases a year. If most Americans aren’t concerned by this, it’s because they don’t yet understand that drug-resistant tuberculosis is no longer a disease that threatens mainly HIV and AIDS patients and the Third World poor. It threatens us all. Worldwide, only 8% of TB cases occur in HIV/AIDS patients…
Even after the panic last year caused by Andrew Speaker, the jet-setting honeymooner found to have MDR TB, funding to stop the disease has lagged. The WHO, which gets its money from United Nations member states, estimates it needs $4.8 billion for global TB control. But despite increases in funding from the U.S., Britain and private donors, it still faces a $2.5-billion shortfall.
You can read the full piece here.
