Sunday, May 17, 2009

DNDi makes new drugs for sleeping sickness

The Drugs for Neglected Diseases Initiative (DNDi) has made two new breakthroughs in treatment for African Sleeping Sickness (trypanosomiasis), reports the UK Guardian.

DNDi, a consortium of seven international aid and research organizations including MSF (Doctors Without Borders) and the UNDP/World Bank/WHO Special Program for Research and Training in Tropical Diseases (TDR), was founded in 2003 in order to ensure equitable access to drugs and promote the development of drugs for developing-world diseases. It attempts to work off of existing Research and Development (R&D) frameworks by “filling in gaps” and taking on projects that for-profit organizations don’t want to pursue.

The two new treatments, NECT (nifurtimox eflornithine combination therapy) and fexinidazole, will replace existing treatments that are often toxic or hard to administer. (One of those treatments, melarsoprol, kills about 1 in 20 patients who use it.)

NECT has already been approved for use by the World Health Organization. Fexinidazole, promising because it is a simple, single-pill treatment, will start human trials in Paris this year.

Sleeping sickness is relatively unheard of in the US and Europe, but it’s an enormous problem in sub-Saharan Africa, where its vector, the tsetse fly, lives. It infects between 50,000 and 70,000 people each year, and is a primary cause of mortality in some parts of sub-Saharan Africa, ahead of even HIV/AIDS.

After the tsetse fly bites, trypanosomes (the parasites) multiply in human tissues and eventually cross the blood-brain barrier to infect the central nervous system, causing sleep-cycle disturbance as well as confusion, poor coordination, and ultimately death, if left untreated.

It’s wonderful that collaborations like DNDi exist to develop drugs for neglected, incredibly harmful diseases like trypanosomiasis. But it’s still incredibly frustrating to think about how much we spend on refining, marketing, or re-developing new versions of existing drugs in the US every year (think Viagra). I’m not sure how sustainable such collaborations can ever be, or if there’s any way to change the current, profit-driven system of drug development to favor these neglected diseases more of the time.


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