DNDi Strategy For The Decade: Delivering And Developing Treatments For Neglected Tropical Diseases
A man with symptoms of the deadly NTD African trypanosomiasis (sleeping sickness), is examined by Dr Victor Kande in the Democratic Republic of Congo (DRC). Kande was principle investigator for clinical trials of fexinidazole, the first oral sleeping sickness treatment approved by the European Medicines Agency (EMA) in 2018. Developed by DNDi, it is being rolled out in  DRC.

Global health experts expressed their frustration with the lack of research and attention towards neglected tropical diseases (NTDs) and vulnerable populations, calling for health systems to address NTDs in a more sustainable and holistic way.

Speaking at the launch of a new strategic plan for the Geneva-based Drugs for Neglected Diseases initiative (DNDi) on Tuesday, DNDi Executive Director Bernard Pécoul said greater emphasis should be placed on expanding access and developing treatments for patients in low- and middle-income countries (LMICs) affected by neglected tropical diseases (NTDs), as well as neglected viral diseases like HIV/AIDS, and also pandemic-prone and climate-sensitive diseases.

“Treatments were abandoned for years or decades because they fell outside commercial markets,” said Pécoul, at the launch of the plan that charters an eight-year journey to 2028, aiming to deliver 15 – 18 additional treatments, in addition to eight already developed, for a total of 25 new or improved, and highly effective, NTD treatments. 

“The frustration is where the idea was born – from the experience of humanitarian doctors, frustrated, while treating patients with vaccines that were ineffective, unsafe, or unaffordable, or never developed at all because the research and development was abandoned,” Pecoul added, speaking of his own experience in the past working with Medecins Sans Frontieres (MSF). 

DNDi, a WHO-supported organization of private and public sector actors, has committed to five strategic imperatives for the next eight-years: to deliver new treatments and expand access for neglected patients of NTDs and related viral diseases; join with public health leaders and Research and Development (R&D) stakeholders in low- and middle-income countries to advance sustainable health systems; contribute to building a proactive agenda for maternal, child health, and gender-responsive R&D; champion open science and transparency; and leverage new technologies to accelerate R&D. 

“It is our hope that we will identify safe, effective, and affordable medicines to help countries fight the health and social burden put on them by COVID-19. While all global attention is focused on development and purchase of COVID-19 vaccines, we should not forget about treatment and diagnostics,” said Marie-Paule Kieny, Director of Research, INSERM and DNDi Board Chair, at the Tuesday DNDi launch.

Challenging The Status Quo

DNDi’s Strategic Plan launch event panel: clockwise: Patricia Amira, moderator; Dr Somya Swaminathan; Dr Marie-Paule Kieny; Dr Jeremy Farrar; Dr Bernard Pecoul; Dr Berhards Ogutu

Also appearing at the event, Jeremy Farrar, director of the Wellcome Trust. also expressed frustration with the ‘status quo’ that has defined R&D for global health, and called for more attention to be brought to three areas that would ‘define the 21st century’ – neglected and infectious disease, climate change, and mental health

“These three things are going to define our time – which have a focus on youth, and which have an inequitable impact on societies around the world. [DNDi is committed to] not just doing the science, but making sure that science is shared equally with everybody in the world,” he said. 

Over the next decade, DNDi will work to accelerate sustainable disease elimination in diseases with existing treatments, such as sleeping sickness and Chagas disease, and increase access to lifesaving and safer treatments for HIV and leishmaniasis. 

DNDi –  founded in  2003 to discover, develop, and deliver safe, effective, and affordable treatments for neglected and marginalized patients –  will also work with leaders and institutions in LMICs to bolster research capacity and generate more sustainable production and supply of NTD treatments. 

The initiative has grown into a network of over 200 partner institutions, and has so far delivered eight new treatments for people with sleeping sickness, visceral leishmaniasis, Chagas disease, HIV, and malaria.  

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COVID-19 has highlighted the need to prioritize and finance research in LMICs, as well as government preparedness to ensure both transparency and equitable access.  

In addition to working on NTDs and viral illnesses, DNDi will also address unmet medical needs, utilizing its ‘dynamic portfolio’ approach to explore new interventions in diseases with clear R&D gaps, including snakebite, dengue fever, schistosomiasis, and pandemic-prone diseases. 

At the start of the strategic planning period, DNDi also is coordinating ANTICOV – the largest African-led clinical trial testing for mild-to-moderate COVID-19. 

The ANTICOV platform  deals with the outpatient population, which is the majority of people with COVID, and is trying to answer the question of how to treat people to prevent them from getting ill and needing hospitalization, said Dr Soumya Swaminathan,  WHO Chief Scientist.

Carried out by a group of 26 prominent African and global R&D organizations in 13 countries, ANTICOV will simultaneously test and adjust treatments for COVID-19, and identify new treatments, fast-tracking research for patients and health systems in resource-limited settings. 

Swaminathan said that the high costs of the COVID-19 pandemic should not come at the expense of cutting or reducing budgets for NTDs, saying that the ‘collaborative science’ seen over the past year as proof that knowledge could be shared openly and freely. 

“Because of this vision, and the collective mission to solve the problem of COVID and develop new tools, it is possible to [share knowledge more widely].”

Though DNDi is primarily focused on R&D, the organization will also identify gaps in access to care, and build the partnerships needed to overcome them, laying the groundwork for more affordable care.  

Said Swaminathan: “When there’s a new technology, which can make a big impact, especially when it’s related to health and disease, it should be considered a global public good, and be made available to people who need it, regardless of their ability to pay.”

Image Credits: DNDi, DNDi, ClimateWed/Twitter.

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