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Aid agency launches latest initiative to tackle diseases in the developing world

Ganapati Mudur New Delhi

The quest for drugs to fight the world’s most neglected tropical infectious diseases gained fresh momentum with the formal launch of the "drugs for neglected diseases" initiative this week.

Médecins Sans Frontières has teamed up with five international public organisations to promote affordable and effective drugs against leishmaniasis, human African trypanosomiasis, and Chagas’ disease, among other infections that affect millions of people across Asia, Africa, and Latin America.

"Existing drugs for such diseases are too expensive, too toxic, or just do not exist," said Bernard Pecoul, director of Médecins Sans Frontières’s campaign for essential medicine, in New Delhi last week.

The charity has pledged $25m (£15m; €22m) for the initiative until 2008. It will also seek funding from governments, private donors, and drug companies to raise $255m over the next 12 years. "We cannot rely on market forces to deliver new drugs for neglected diseases," said Dr Pecoul.

Public health experts estimate that just 10% of worldwide funding of pharmaceutical research goes into infectious diseases that affect the world’s poor people. Of the 1450 new drugs introduced in the global market since the 1970s, just 13 were specifically designed to treat neglected diseases. With help from the drugs industry the new initiative will exploit existing but fragmented research capabilities in developing countries and complement these with additional expertise, to function as a "virtual drug development organisation."

"Candidate drugs to combat neglected diseases might be sitting on the shelves of drug companies," said Dr Nirmal Kumar Ganguly, director general of the Indian Council of Medical Research, a partner in the initiative. He said clinical trials have shown that miltefosine and paromomycin—drugs developed by Western drug companies—work against leishmaniasis.

"One of our goals is to reduce the costs of these two drugs and move them into other countries," Dr Ganguly said.

Leishmaniasis, which is spread by the bite of a sandfly, affects more than 12 million people in Bangladesh, Brazil, India, Nepal, and Sudan. The initiative will also seek drugs for human African trypanosomiasis, or sleeping sickness, which affects 500000 people across 36 African countries, and Chagas’ disease, which affects an estimated 16 million people in Latin America. The initiative also plans to introduce two fixed dose combinations for chloroquine resistant malaria within the next three to six years.

"Some neglected diseases have no drugs at all," said Dr Pecoul. Buruli ulcer, for instance, which is endemic in 32 countries in Africa, Asia, Latin America, and the western Pacific, is the most common mycobacterial infection after tuberculosis and leprosy. But the only treatment is surgical excision, which requires hospitalisation and is expensive.

The initiative has set a target of making available six to eight drugs for a range of neglected diseases over the next decade. "We believe large drug companies have the potential to absorb the costs of their participation," said Dr Robert Ridley, coordinator for product research and development division at the World Health Organization.

The other partners in the initiative are the Institut Pasteur, the Kenya Medical Research Institute, the Oswaldo Cruz Foundation, and the Malaysian Ministry of Health.

© 2003 BMJ Publishing Group Ltd