references
7 NEW TREATMENTS delivered, recommended, and implemented
MALARIA SLEEPING SICKNESS VISCERAL LEISHMANIASIS
DNDi’s ACHIEVEMENTS
Two new fixed-dose combinations (2007 and 2008)
With older antimalarials increasingly ineffective due to growing resistance, WHO recommended the use of artemisinin-based combination therapies in 2001. In 2006, WHO urged companies to stop marketing artemisinin monotherapies, and to re-direct their production efforts towards artemisinin-based fixed-dose combinations (FDCs), in order to keep the malaria parasite from becoming resistant to the new drugs.
Better, simpler treatment (2009)
Before 2009, the best available treatment for sleeping sickness, involving over 50 intravenous infusions and 14 days in hospital, was so complex to distribute and administer in resource-poor settings, that all-too-often clinicians chose melarsoprol, a highly toxic, arsenic-based drug that kills 5% of those treated with it. In 2009, DNDi clinical trials demonstrated the safety and effectiveness of a simpler and shorter nifurtimox and eflornithine combination therapy (NECT), with considerable benefits for patients, while reducing the logistical and staffing burden on treatment centres in remote locations.
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Cheaper, more effective treatment in Africa (2010)
Following DNDi clinical trials in East Africa which showed that sodium stibogluconate & paromomycin (SSG&PM) was as safe and effective as the existing standard treatment, WHO recommended the combination be used in the region. Treatment now lasts almost half as long and costs less. More patients can be treated during outbreaks, and the regimen has the potential to fend off resistance and prolong the life of both drugs.
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ASAQ (Artesunate+Amodiaquine Fixed-Dose Combination)
Thanks to an innovative partnership between DNDi and Sanofi, over 430 million ASAQ treatments have been distributed since 2007. The FDC reduces the pill burden for adults and children alike, and because it dissolves in water, it is easy to administer to infants and young children.
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Prequalified by WHO in 2008, registered in 32 African countries plus India, Ecuador, and Colombia, and included on the WHO Essential Medicines List for adults and children Available at low prices: US$1 for adults, $0.5 for children No patent: ASAQ was developed as a public good, so provided they met certain quality standards, a generic company interested in producing the drug can do so. Technology transfer to Tanzanian manufacturer Zenufa is ongoing
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ASMQ (Artesunate+Mefloquine Fixed-Dose Combination)
Thanks to partnerships across four continents addressing formulation, production, clinical trials, and registration, a second safe and efficacious artemisinin-based FDC treatment was made available to treat patients in resource-poor settings. The project was a first-of-its-kind example of South-South technology transfer, as the manufacturing process was transferred from Brazilian public sector laboratory Farmanguinhos to Indian generic company Cipla.
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Partnership between DNDi, MSF, national control programmes, Bayer, Sanofi, and WHO 100% of stage 2 HAT gambiense patients treated in all 13 endemic African countries NECT included on WHO Essential Medicines List for adults and children
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Partnership between DNDi, the Leishmaniasis East Africa Platform (LEAP), national control programmes of Kenya, Sudan, Ethiopia, and Uganda, MSF, and WHO Recommended by the WHO Expert Committee on the Control of Leishmaniases for East Africa Helped shape the national guidelines in Sudan, South Sudan, Kenya, Ethiopia, and Somalia Paromomycin registered in Uganda, Kenya, and underway in other East African countries
Ongoing activities: DNDi continues to support access to NECT in endemic countries.
Main partners: National Trypanosomiasis Control
Programme, DRC; Epicentre, France; Médecins Sans Frontières, Switzerland; Swiss Tropical and Public Health Institute, Switzerland; Ministry of Health, DRC; HAT Platform
