HEALTH | NTDs | WASUNNA

Over one billion people worldwide are affected by Neglected Tropical Diseases (NTDs) of which 500 million of them are children. 

“Most of the NTDs are a group of preventable and infectious diseases that affect the marginalised and poor populations living in remote areas, urban slums, or conflict zones all over the world,” Dr Monique Wasunna, Director Drugs for Neglected Diseases Initiative (DNDi) Africa explained in an online press briefing from Nairobi. 

They include among others; Bilharzia, Trachoma, Buruli ulcer, Elephantiasis, Guinea worm disease, Intestinal worms, Leprosy, River blindness, Rabies, Scabies, sleeping sickness, and snakebite, diseases most people know nothing about. 

For example, throughout Uganda, Bilharzia is endemic in 90 districts but a survey on NTDs indicated that the majority population in Uganda is not aware of the magnitude of the effects of NTDs. 

Dr Wasunna says they are generally referred to as neglected diseases owing to the little financial incentive to support desperate need for medical research and innovation to bring new tools to help such a cluster of people. 

As a result of this financial mismatch, about 1.7 billion people worldwide are affected by NTDs. 

One person in eight people in the world suffers from at least one, of the 20 known neglected tropical diseases. 

Also, almost every country worldwide is at least infected by one of the NTDs, but at least 40% of the global burden of the NTDs is on African continent. 

“Since NTDs are diseases which are neglected, there are very few treatments that exist for neglected patients. And even if there is, the treatment could be toxic (not safe) and low cure rate and effective yet again with minimal options available to access,” Dr Wasunna regretted. 

She emphasized that countries in other continents may have the NTDs but fewer compared to Africa with most countries having at least six of NTDs. 

In the previous years, many kinds of research have been carried out on NTDs unsuccessful showing lack of research and developments. 

Providing treatment 

“Before 1991 to 1999 a desk review showed that 1.1% of at least 1,393 new treatments brought to the market between 1975 to 1999 were for NTDs representing 12% of the global disease burden,” Dr Wasunna recalled. 

“A follow-up 10 years later, in 2000 and 2010 was done and it showed that 4% of the new drugs were for NTDs,” she added. 

“Chemical entity is a drug that is started from scratch and developed gradually through pipelines until it’s ready for human use. So, the new chemical entities were just 1% again showing lack of research and development.” The NTDs expert emphasized. 

However, Dr Wasunna disclosed that currently there is less than 0.5% of the 88 000 drugs in the global innovation pipeline target NTDs even though they represent more than 10% of the global disease burden. 

According to Dr Wasunna, 90% of research and development being done are for diseases that affect only 10% of the population hence an ineffectual imbalance. 

She explained that this was the reason for DNDi establishment to respond to the frustration of clinicians and the patients. 

“Dr Wasunna explained: “To date DNDi has been developing new treatments for people living with neglected diseases, thereby acting in the public interest and bridging existing research and development gaps, in essential drugs for NTDs.” 

Dr Wasunna affirmed that since 2007 to date, at least 8 new treatments have so far been delivered by DNDi.

They include super booster therapy, more effective treatment for children with HIV who also have TB introduced in 2016, and Fexinidazole a paradigm shift for sleeping sickness introduced in 2018. 

She revealed DNDi is now aiming at 25 patient-friendly treatments by 2028. “By 2025-2027 the target is radically improving treatments with new chemical entities, all oral for a treatment shift,” Dr Wasunna said.