A lifelong researcher in and advocate for improved global health, Gerardo Priotto is the father of the NECT study.

An Argentinean native and medical epidemiologist by training, Gerardo has devoted much of the past 20 years of his professional life to Médecins Sans Frontières (MSF). Teaming up with the leading medical charity, and later with its satellite, Epicentre, applying research projects aimed at improving public health programmes, Gerardo has been guided by a strong motivation to alleviate the suffering of patients affected by war or disease in places such as the Democratic Republic of the Congo, the Republic of the Congo, Uganda, Kenya, Brazil, Guatemala, and Thailand. Seeing children and adult patients die from sleeping sickness while he was on mission in Uganda stirred Gerardo’s strong commitment to improve treatment options. After discussions with health experts at the international level and faced with the health dilemma described above, the decision to study an experimental combination of existing drugs came as the obvious option. Among the three available therapy options, the combination of nifurtimox associated with eflornithine therapy (NECT) was soon revealed to be the most promising.

Barriers encountered
As HAT-endemic countries often lack the adequate infrastructure to conduct clinical trials at Good Clinical Practice (GCP) standards, Gerardo had to be pragmatic and practical in overcoming the logistical barriers of conducting clinical research in remote and inaccessible areas. Moreover, leading a research study, especially by teaming with experts hailing from different horizons and organisations, is not an easy task. Regarding all these difficulties, G. Priotto comments, "the trial took us more time and energy than expected as we had to adapt and be more flexible in points we judged crucial. One should keep in mind that unless you have a strong personal motivation, the risk-taking is high and the remuneration poor."

Challenges ahead
While Gerardo firmly believes that this treatment will provide something very much needed for those suffering from the disease, he also cautions that more is still needed. Apart from the dire need to improve and develop field-adapted diagnostic tools, a big challenge remains in rendering NECT accessible to those patients who need it the most. In this respect, "the HAT Platform could play a key role in pushing and making [it] possible for people to receive the treatment. We are clearly not there yet, but NECT shows just what we can do when we set our minds to improve patients options, even in the most dire conditions," as Gerardo suggests.