Home » Neglected Tropical Diseases » Why failure to innovate in the field of NTDs is not an option

Jamie Bay Nishi

Director, Global Health Technologies Coalition

More innovation is needed — and urgently — to create better tools and strategies to combat neglected tropical diseases. Otherwise more lives will be needlessly lost.

It’s obvious that neglected tropical diseases (NTDs) cause unimaginable suffering to those who are affected by them — estimated to be over 1 billion people globally. What might be less obvious is that NTDs also create a particularly pernicious, vicious circle, notes Dr Julie Jacobson, President, American Society of Tropical Medicine and Hygiene. “The majority of NTD patients live in poverty,” she says. “Being sick keeps them in poverty because it takes away their ability to go to school or work. And if they become blind or disabled it places a huge burden on their families.”

There’s a reason why they are known as neglected tropical diseases. For most NTDs, there are no vaccines, while for some existing treatments can be toxic, ineffective or too expensive. For example, the existing treatment in Eastern Africa for visceral leishmaniasis — a fatal parasitic disease — requires a 17-day hospital stay to receive painful twice daily injections; while existing treatments for mycetoma, a disabling disease of the skin and tissue, have only a 35% cure rate for the fungal form of the disease. It’s clear that more tools are urgently needed to combat these deadly yet preventable illnesses.

Thinking differently to create the next generation of NTD tools

“For example, we need more NTD diagnostic technologies, because the ones we have are limited,” says Jamie Bay Nishi, Director, Global Health Technologies Coalition. “That’s a real problem because before we can treat, we have to be able to diagnose. We also need tests to confirm NTD patients have been treated effectively.”

It is, however, critical that diagnostics, vaccines and treatments are affordable, fit-for-purpose and tailored to the specific needs of NTD populations, including pregnant women, children and those living in remote areas. “We need to innovate around both products and delivery systems — to find out how best to get these tools to the people who need them,” warns Dr Jacobson. “That’s why we have to bring all stakeholders together — governments, industry, academia, NGOs and affected populations — to work out what needs to be done.”

We need more funding commitments to advance NTD research and innovation — and we need it now.

Dr Monique Wasunna

Dr Monique Wasunna — Director, Drugs for Neglected Diseases initiative (DNDi) Africa — agrees, stressing that multisector collaboration really does yield results. For instance, in 2018, through a public-private partnership, Sanofi, the Democratic Republic of Congo Ministry of Health, DNDi and local communities were able to introduce the first all-oral treatment for sleeping sickness. Crucially, this cures all stages of the disease in 10 days, replacing previous treatments that involved weeks of intravenous injections in hospital.

A stark message for policymakers about urgent investment

There are still major challenges to overcome, however. To begin with, non-COVID-related research has been knocked off course by the global pandemic. There is also a worry that cuts to international aid could jeopardise R&D progress, such as the recent decrease to the UK’s aid budget. “Any money redirected away from NTDs is going to have a negative impact on patients,” says Nishi. “Yet we know that eliminating NTDs doesn’t have to be a dream. Just look at what the world has accomplished with COVID-19 vaccines, thanks to targeted financial resources and technical expertise.”

Dr Wasunna echoes this sentiment with a stark message for policymakers. “We need more funding commitments to advance NTD research and innovation — and we need it now,” she says. “Otherwise affected populations will remain trapped in a cycle of poverty. I would also remind governments that many NTD patients are children, so if we don’t make a concerted effort to innovate in this space then we are going to lose the next generation. The youth are our future — so please get involved. If not, we are potentially signing the death warrants of more than a billion people. We can’t do that. Failure is not an option.”

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