|Parallel session PS03, Wednesday, August 30 2006, 16:00-17:30|
|Chair(s): Jean Jannin, Switzerland, Suman Rijal, Nepal|
|Overview of a Shameful Situation|
|François Chappuis, Travel and Migration Medicine Unit, Geneva University Hospitals, Geneva, Switzerland|
|Alternative Approaches to New Drug Development: Two R&D Initiatives|
|Philippe Desjeux, Bernard Pécoul, Executive Director, Drugs for Neglected Diseases Initiative (DNDi), Geneva, Switzerland|
|Matching Technology to Need: Diagnostics for Poverty-relates Diseases|
|Giorgio Roscigno, Foundation for Innovative New Diagnostics (FIND), Cointrin, Switzerland|
"The illnesses of invisible people usually stay invisible." With all the technological progress and the advances made by global health alliances, can this still be the reality? Indeed, 18 million people are suffering from Chagas' disease and 500,000 new infections with visceral leishmaniasis (kala-azar) occur per year. Who can and will take action to solve this problem? New ways, based on solidarity, knowledge sharing, and the collaboration of trans-national partnerships and countries were presented in this symposium on the most neglected diseases.
Numerous neglected diseases primarily affect the marginalised citizens of the most impoverished nations. The speakers of this symposium focused on sleeping sickness (African trypanosomiasis), leishmaniasis and Chagas' disease (American trypanosomiasis), which infect millions of people and are frequently fatal if left untreated.
Several problems in dealing with neglected diseases were raised. The current diagnostics and drugs are inadequate and often inaccessible due to their cost, ineffectiveness and lack of availability. New technologies for diagnosis and can be too difficult and complex to use in rural areas. Another problem is posed by the development of the disease itself, when chronic infections are more difficult to detect than an acute infection. This is the case for Chagas' disease, as described by Dr. François Chappuis from the Travel and Migration Medicine Unit at Geneva University Hospital in Switzerland. Drugs available today still pose problems such as toxicity, pain during delivery, follow-up difficulty, inadaptability to patients' needs (such as a lack of paediatric formulation), as well as compliance problems. Apart from the challenge of producing satisfactory drugs, these also have to be distributed effectively.
The following points were suggested to address these problems:
- Development of generic drugs available at preferential prices
- Production of safer drugs
- Region-specific clinical trials
- Simplified, sensitive and rapid diagnostic methods, favouring diagnosis on site
- Instrument-free diagnosis if possible
- Overcoming logistic nursing and mental barriers, such as the "nursing" barrier (reluctance to administer new treatment)
- More practical screening approach
- Promotion of combination drugs
- Stronger transfer of technology into the developing world by facilitating the translation of promising platform technologies into global health products
- Stronger capacity building effort for local research and development
- Proper and wider distribution of medications by designing effective local strategies and networks to ensure access
According to Dr. Bernard Pécoul, Executive Director of the Drugs for Neglected Diseases initiative, neglected diseases fall outside the realm of the world pharmaceutical market because most of the afflicted are very poor, live in remote areas and often have no or limited political influence. He stated that a market-driven model would not be able to solve this problem, but that a new strategy needed to be developed.
The model proposed and established by the presenters is the public-private partnership (PPP), which comprises a network of private foundations and companies, research and academic institutions, governmental bodies and non-governmental organisations working towards the same goal in a collaborative, cooperative and non-competitive manner. Each panel member represented a particular PPP, namely the Institute of OneWorld Health (iOWH), the Drugs for Neglected Diseases initiative (DNDi), and the Foundation for Innovative New Diagnostics (FIND). Each of these PPPs addresses one or more of the most neglected diseases within their portfolio of projects.
In conclusion, the speakers remained optimistic despite the challenges in accomplishing the goals of treating the most neglected diseases. To overcome these challenges, the speakers emphasised the necessity of sharing knowledge and expertise by profiting from research previously carried out in pharmaceutical companies, such as Eisai in Japan on Chagas' disease. However, certain proven treatments in one country may not be entirely applicable to another region of the world. As an example, Dr. Pécoul presented encouraging results obtained from studies on combination drugs against leishmaniasis drugs to provide a shorter treatment regime in India, which could not be directly transferred to Africa.
Showing a hopeful outlook for the future, Dr. Jean Jannin, co-chair of this symposium, anticipates that access to health care will be facilitated by new agreements due to be signed between PPPs and the pharmaceutical industry in the near future. Agreements will also be arranged to address the issues of production and distribution. In sum, the speakers expressed the necessity of firm commitments and the duty to use the best science to provide the best tools in the fight against neglected diseases.