Chronic tropical diseases targeted by lethal mix: Medical science and the Pharma companies

Horrific tropical diseases with shocking symptoms causing deformities, blindness, impaired development and damage to internal organs are affecting up to one billion people worldwide, according to the latest report issued by the WHO, which also claims that millions more people are at risk. However, the Pharma companies charge in to the rescue.

The World Health Organization report "Working to overcome the global impact of neglected tropical diseases" refers to seventeen different diseases* endemic in underdeveloped regions which usually go hand in hand with inadequate accommodation and sanitation systems. The diseases thrive in the filth and can easily be carried by the insects and animals which abound in these types of conditions, it states. These diseases are endemic in 149 countries and, according to the WHO, "impair the lives of at least one billion people". To give an idea of the dimension of the problem, Chagas disease costs 1.2 billion USD to Latin America per year, according to the report.

Dr. Margaret Chan, WHO Director-General, calls the strategies listed in the report "a breakthrough" against "debilitating, sometimes horrifying diseases that are often accepted as part of the misery of being poor". She claims that if the recommendations are implemented on a worldwide scale, then the WHO can substantially reduce the disease burden, break infection cycles "the disability and lost opportunities that keep people in poverty".

The breakthrough referred to by Margaret Chan is that finally, the severe lack of resources hampering policy implementation has started to be addressed. Enter the Pharmaceutical companies. This time, with actions and not just words.

Novartis has committed itself to donating multidrug therapy and loose clofazimine to combat Hansen disease (Leprosy); GlaxoSmithKilne has launched a five-year commitment to supply 400 million doses per year of albendazole against lymphatic filariasis (elephantiasis); Sanofi-aventis has pledged to the WHO to eliminate human African trypanosomiasis (sleeping sickness) and will support the campaign against Buruli ulcer disease (Mycobacterium ulcerans infection), Chagas disease (American trypanosomiasis) and leishmaniasis (Leishman's disease); Bayer is having negotiations with a view to supporting the effort against Chagas disease and sleeping sickness; EISAI has committed itself to the global campaign to eliminate lymphatic filariasis, supplying diethylcarbamazine (DEC), while Johnson&Johnson declares it is to expand its policy of donating 200 million treatments of mebendazole per year to fight intestinal worms.

Margaret Chan declares: ""The evidence is now overwhelming. Existing interventions, including safe, simple and effective medicines, are having an impact. By expanding coverage, we can actually prevent many of these diseases. This is a first-time opportunity for some very ancient diseases".

Having the resources available (1) and delivering the medicines to those in need (2) are the first two stages of the ten-point UN strategy. Following this, innovative treatments such as preventive chemotherapy (3) are producing excellent clinical results, while health education occasioning behaviour change (4) will be the vector behind the elimination of dracunculiasis (Guinea worm disease).

Further measures will be (5) strengthening delivery systems, (6) the use of primary schools to treat millions of children for diseases such as schistosomiasis (bilharziasis) and helminthiasis; (7) broadening existing health education schemes for future generations through school curricula, (8) coordinating veterinary public health in order to control zoonotic diseases; (9) public health systems have to update themselves with climate change and environmental patterns (changing temperatures can occasion the appearance, as well as the eradication, of diseases) and (10), sustained environmental and vector management to address vector-borne neglected tropical diseases.

The results of this new approach are already tangible. According to the WHO report, preventive chemotherapy already reached 670 million people (in just one year, 2008), reported cases of sleeping sickness are at a 50-year low, while elephantiasis is expected to be eradicated by 2020 as a public health concern.

Since 1999, the number of cases of Guinea worm disease has dropped by over 99%.

In future, better coordination among the authorities is bound to have effects upon rabies, which causes tens of thousands of deaths every year in Africa and Asia, 60 per cent of these in children under 15 years of age, infected by rabid dogs.

*Buruli ulcer disease (Mycobacterium ulcerans infection), Chagas disease (American trypanosomiasis), cysticercosis, dengue fever, dracunculiasis (guinea-worm disease), echinococcosis, endemic treponematoses, foodborne trematode infections, human African trypanosomiasis (sleeping sickness), leishmaniasis, leprosy (Hansen disease), lymphatic filariasis (elephantiasis), onchocerciasis (river blindness), rabies, schistosomiasis (bilharziasis), trachoma, and soil-transmitted helminthiases.

Source: WHO

Timothy Bancroft-Hinchey



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Author`s name Timothy Bancroft-Hinchey