Key tropical diseases ‘suffering funding neglect’

Even a small increase in research and development (R&D) funding could vastly improve the diagnosis and treatment of three major neglected tropical diseases (NTDs) affecting the world’s poorest regions, according to a report by the international humanitarian charity, Médecins Sans Frontières (MSF).

But the political will from drug developers and policymakers to do so is lacking, says the charity in a report published last month (11 June).

‘Fighting Neglect’ charts 25 years of MSF experience in dealing with kala-azar (visceral leishmaniasis), sleeping sickness (African trypanosomiasis) and Chagas disease, in Latin America, South Asia and Sub-Saharan Africa.

Together, the three diseases — caused by a group of parasites called kinetoplastids and transmitted by insect vectors — kill around 70,000 people every year and affect hundreds of thousands more.

Disease hotspots exist in the world’s poorest regions, often in rural areas and war-torn countries, including Bolivia, the Central African Republic, the Democratic Republic of Congo, Ethiopia, India (particularly Bihar state), Paraguay and South Sudan.

Julien Potet, one of the report’s authors and an NTD policy adviser for MSF’s Access Campaign, said the report shows that "with current tools, it is possible to diagnose and treat the majority of patients… even in remote areas. But it is resource intensive as it requires skilled staff and intensive logistics."

More sustainable funding sources are needed to improve the safety and ease of use of existing diagnostics and treatments, the report says, but also for the development of new, "desperately needed" drugs and diagnostic tests.

It is also crucial that the number of drug suppliers increases. Currently almost all drugs rely on a single supplier, rendering supply vulnerable to the risk of a major shortage.  

Yet, Potet said, "private investments in NTD R&D remain minimal" with some 90 per cent of R&D funding for the three disease coming from public and philanthropic sources.

And most of the recent pledges by the US and UK governments and the Bill & Melinda Gates Foundation to boost funds for neglected disease go towards worm diseases and trachoma, so the need for new, reliable and sustainable funding sources for other NTDs remains, the report says.

It calls upon pharmaceutical companies to make open access innovation platforms available for all endemic countries, and upon donors to boost pharmaceutical R&D investment through prizes and similar innovative initiatives.

Ted Bianco, director of technology transfer at the Wellcome Trust, a London-based health charity, told SciDev.Net that "learning from MSF’s experience is terrific, because they have expertise and this is key to unlocking problems".

But he said the report did not fully acknowledge that the pharmaceutical industry was now increasingly engaging with these diseases.

"The truth is that the pharmaceutical industry is doing an enormous amount. The report should have focused on how we can build on that," said Bianco.

Simon Croft, professor of parasitology at the London School of Hygiene and Tropical Medicine, told SciDev.Net: "Let’s not just ask for more funding from the pharmaceutical industry — let’s be more specific and realistic".

For example, pharmaceutical industry could provide expertise and data, not just funding for such research, said Croft, adding that this is already happening.