Fabiana Frayssinet
RIO DE JANEIRO, Mar 31 2010 (IPS) – Experts from around the world are trying to attract attention to deadly but little-known illnesses, such as Chagas disease, visceral leishmaniasis and sleeping sickness, that have been neglected by the pharmaceutical industry.
So-called neglected tropical diseases, which also include malaria, dengue fever and schistosomiasis, in conjunction with tuberculosis are responsible for 11.4 percent of the global burden of illness, but only 1.3 percent of the 1,556 new drugs registered between 1975 and 2004 were specifically developed for these diseases.
Pharmaceutical laboratories give these diseases zero priority, Tania Araújo-Jorge, head of the state Oswaldo Cruz Foundation (FIOCRUZ), told IPS.
The Brazilian Foundation hosted a Monday through Wednesday meeting of experts and health managers from all over the world in Rio de Janeiro.
The World Health Organisation (WHO) sponsored the meeting in order to channel resources and formulate strategies for studies leading to treatment for the diseases.
Private companies do not invest in research on these diseases because they are not profitable, there is no market (for drugs), said Araújo-Jorge. The governments of countries where the diseases are endemic are a potential market, but they have no policies to guarantee purchases, and therefore do not help attract investment, she added.
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According to the Drugs for Neglected Diseases Initiative (DNDi), originated by Doctors Without Borders/Médécins Sans Frontières, these diseases kill or disable millions of people who represent a huge unaddressed medical need.
Indeed, one of the aims of the meeting, co-organised with the Oswaldo Cruz Institute and the Pan-American Health Organisation, was to discuss how to fill this gap in public health provision.
At present there are greater opportunities to obtain funds from companies and foundations, but the priorities have yet to be defined. Financing is being dispersed among a number of different research studies, Araújo-Jorge said.
The results of meetings like this one will provide the basis for drawing up a global report in 2011 to provide guidance for the concerned agencies and countries.
The goal is to harmonise and streamline financing efforts by deciding on priorities, she said.
The meeting focused on the most neglected of the tropical diseases: Chagas disease, sleeping sickness and visceral leishmaniasis, all of which are caused by parasites and affect over 500 million people.
In an interview with IPS, Isabela Ribeiro, the coordinator of DNDi projects in Latin America, emphasised that these diseases represent an enormous social and economic burden in terms of public health.
Ribeiro talked about Chagas disease, caused by the parasite Trypanosoma cruzi, which is transmitted to humans by a blood-sucking insect regionally known as the vinchuca bug.
Chagas disease affects about eight million people worldwide, and is endemic in 21 Latin American countries. It frequently goes undiagnosed, and serious cases result in cardiopathy and digestive problems, causing disability with a high social and economic impact that is often unrecognised, she said.
The DNDi programme lists unemployment and loss of years of productive life among its consequences.
Another study cited by DNDi, carried out in Brazil between 1979 and 1981, found that over a period of 15 years, more than 1.3 billion dollars were lost in wages and industrial productivity by workers with Chagas disease in this South American giant.
Sleeping sickness, caused by two sub-species of protozoa that are transmitted to humans by the tse-tse fly, affects between 50,000 and 70,000 people a year and causes 48,000 deaths a year.
It mainly affects African countries, and according to DNDi has a serious social and economic impact. Epidemics of sleeping sickness affect up to 50 percent of the population of some rural villages in Africa.
Visceral leishmaniasis is also linked to poverty. At present, the most serious form of the disease affects 500,000 people in 88 countries, the worst-hit of which are Bangladesh, Brazil, Ethiopia, India, Kenya, Nepal and Sudan.
These diseases have different levels of mortality and morbidity, but they all have large potential social and economic impacts, Ribeiro said.
Associated as they are with the most vulnerable populations, that are generally outside the system, they do not generate much interest in terms of research or drug development, she said.
In spite of the overall scenario, Ribeiro is optimistic. She emphasised the increasing emergence of partnership models between the public and private sectors to develop treatment drugs, promoted by organisations like DNDi.
In Brazil, for instance, the state laboratory Farmanguinhos, belonging to FIOCRUZ, is developing drugs to treat diseases like malaria, and promoting specific research studies on Chagas disease.
In the private sector, meanwhile, a partnership with multinational pharmaceutical laboratory Sanofi-Aventis is making an anti-malarial drug which will be available at cost price to the public health sector, Ribeiro said.
Another hopeful sign, according to Araújo-Jorge, is the fact that international organisations have begun to give more say, and a greater leadership role to countries where these diseases are endemic.
The fact that a country like Brazil was chosen to host this international meeting of experts is a sign that the debate is being decentralised and is occurring outside of Geneva, where the WHO is based, she said.
