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Neglected in Research and Development (Part 4)

September 16, 2010

[tweetmeme] The Clinton Global Initiative, UN Summit on Millennium Development Goals, and TEDxChange are only one week away. We present this series of five daily blogs on Neglected Tropical Diseases as an example of an area where philanthropists can make a big social impact. This is the fourth in a series of five posts that look at the impact of neglected tropical diseases and why philanthropists focused on health may be interested. Although neglected tropical diseases affect a large number of people, they receive relatively little attention in health care research.1 In the previous blogs we’ve seen how inexpensive antibiotics can drastically reduce suffering, but for some neglected diseases more research is needed. 

A few neglected tropical diseases are still considered “tool deficient”, meaning they do not have safe and inexpensive treatment options or ways to diagnose them. Investment in neglected tropical disease research offers a promising gap to be filled. 

While the development of new pharmaceuticals can take time, investments toward finding safer drugs or vaccines could change how diseases are treated in large scale ways. One new drug or vaccine that is deemed safe and effective can have a global impact on millions of lives.

The difficulty of drugs:

Drug treatment research is difficult because it is costly and time consuming. Cancer drug research companies may invest millions of dollars before successfully finding a useful drug, which in turn makes those drugs extremely expensive. However, the people consuming drugs for NTDs are often too poor to afford them, so there is decreased revenue incentive for companies to invest in research and development in this area. Through charitable donations, public-private partnerships of commercial drug companies and nonprofit research efforts (e.g. Drugs for Neglected Disease Initiative DNDi) can focus on improving treatment for these neglected diseases. 

There are still some NTDs that do not have safe and simple drug courses available. African sleeping sickness (African trypanosomiasis) is one such disease, spread by fly bites. Unlike many of the other neglected diseases, sleeping sickness can be deadly if left untreated, yet because there is no safe remedy, treatment can be deadly too.

NTD Snapshot2

Better drugs are needed:

The lack of adequate drugs for diseases like African Sleeping Sickness is not a new concept. This topic has been mentioned by Donald McNeil in a 2000 New York Times article, MEDICINE MERCHANTS: A special report.; Drug Makers and 3rd World: Study in Neglect, and again in Jump-Start on Slow Trek to Treatment for a Disease from 2008, highlighting a $19 million donation from the Gates Foundation. McNeil discusses the great hurdles facing drug companies who embark on developing new drugs for this devastating illness. For African Sleeping Sickness, controlling the population of tsetse flies that spread the parasite is one preventive approach. That includes spraying pesticides at breeding sites and using simple fly traps in homes.3 Currently there are four drugs to treat sleeping sickness that are used at different phases of the disease. Some of these drugs are very toxic and up to 10% of people treated will die or have a severe reaction to the drug.4 The discovery of safer and more effective drugs could have significant effects on many neglected tropical diseases.

Takeaway Message for Philanthropists:

  • Investments in research and development could have game-changing effects
  • Safer and less expensive drugs can allow the poor and vulnerable to be treated
  • Research in drugs for neglected tropical diseases is underfunded and can benefit greatly from donor support

In our final blog post, we’ll see the silver lining in the battle against neglected tropical diseases, and see how effective change can come to many through the dedication of donors and organizations on the ground.

Thanks to the authors, Isobel Harvey, former CHIP researcher and master’s candidate at the Thomas Jefferson University School of Nursing, and Carol McLaughlin, CHIP research director, for their contributions to this series.


1 Hotez, P., Pecoul, B. (2010). “Manifesto” for advancing the control and elimination of neglected tropical diseases. PLoS Neglected Tropical Diseases 4,5.
2 World Health Organization (2010). Human African Tropanosomyasis. Retrieved from http://www.who.int/trypanosomiasis_african/en/
3 Molyneux, D., Ndung’u, J., Maudlin,I. (2010). Controlling sleeping sickness-“When will they ever learn”. PLoS Neglected Tropical Diseases, 4,5.
4 Hotez, P. (2008). Forgotten People, forgotten Diseases: The neglected tropical diseases and their impact on global health and development. ASM press: Washington, DC.

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