18/05/09

New drugs raise hopes for sleeping sickness

A patient receives a melarsoprol injection at a clinic in Uganda Copyright: WHO/TDR/Crump

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Two new treatments for one of Africa’s most deadly and neglected diseases may soon replace current options, which are either life-threatening or cumbersome to administer.

The Drugs for Neglected Disease Initiative (DNDi), a public–private partnership, has announced two potential treatments for sleeping sickness (African trypanosomiasis) — one ready to be rolled out to patients and one ready for clinical trials in humans.

Drugs in use at the moment are either toxic or difficult to administer. Melarsoprol, an arsenic-based drug, is painful and kills one in twenty patients. Eflornithine, on the other hand, must be given by infusion every two hours for 14 days — almost impossible in the under-resourced health systems where sleeping sickness is common.

One of the new treatments, Nifurtimox eflornithine combination therapy (NECT), is infused only twice a day for just ten days. The WHO has approved it and affected countries are ready to start using it, according to Els Torreele, senior project manager at DNDi.

But the ultimate goal is to produce a simple treament, says Torreele. Fexinidazole — a simple pill — will be tested in health volunteers in Paris this year before researchers test it on patients in Africa.

"There has never been quite so much optimism," says Torreele.

The UK’s Department for International Development announced last week (15 May) that it would contribute £18 million (US$28 million ) to advance DNDi’s work in the area.