By Sharon Atieno

Despite Neglected Tropical Diseases (NTDs) affecting one in eight people worldwide, the trend over the years shows that there are very few drugs developed to deal with these diseases.

Dr. Monique Wasunna, Director Drugs for Neglected Diseases Initiative (DNDi) Africa, speaking during an Africa Science Media Centre press briefing noted that just 1.1% of the 1,393 new drugs brought to the market between 1975 and 1999 were for NTDs, while between 2000 and 2010 only 4% of new drugs and 1% of new chemical entities ( drugs that are developed from scratch and go through various stages until they are ready for human use) were for neglected diseases.

“Currently, less than 0.5% of the 88,000 drugs in the global innovation pipeline worldwide are aimed at NTDs even though these diseases represent more than 10% of the global disease burden,” she said.

Ray of hope

However, there has been tremendous effort put in research and development to come up with treatment options for some of the NTDs listed in the World Health Organization (WHO) list.

Sleeping sickness caused by parasites transmitted by tsetse flies is endemic in 36 sub-Saharan African countries. Dr. Wasunna noted that for decades the only treatment available for the disease was melarsoprol, a toxic treatment-said to cause “fire in the veins” – that killed one in 20 patients.

However, in 2018, the European Medicines Agency recommended Fexinidazole, the first all-oral treatment for sleeping sickness, taken once a day over 10 days that DNDi developed in partnership with Sanofi, she said.

Currently, DNDi is working on a new chemical entity to facilitate sustainable elimination of sleeping sickness called acoziborole, which will be ready by 2022.

In a 12-month long treatment with serious side effects and only 25-25% effective and unaffordable, Ketoconazole and itraconazole are used to treat the fungal form of Mycetoma, a disease caused by sandflies and endemic in 11 countries across the world.

By 2023 to 2025, Dr. Wasunna noted that a more effective, affordable, shorter-term treatment appropriate for rural settings called Fosravuconazole will be available.

15 years ago, treatments for the various forms of Leishmaniasis- cutaneous (CL), kala-azar /visceral (VL) and mucocutaneous- were toxic, painful, not registered, expensive, lengthy, not field-adapted, explained the DNDi Africa Chief.

Since 2010, there has been a move towards new generation of treatments including new first-line for kala-azar in Latin America, new HIV/VL combination, new treatments for Africa (miltefosine/PM), new combination treatments for CL among others.

By 2025 to 2027, she said, there will be radically improved treatments with new chemical entities, all oral for a treatment shift.

DNDi whose mission is to develop new treatments for people living with neglected diseases, has been in the forefront of these efforts and since 2007 has managed to deliver 8 new treatments including for paediatric HIV and malaria.