Focusing on the needs of children and elders
In medical research, children like Ivana and Rodrigo are often excluded from clinical trials because research involving children poses a unique set of challenges, including heightened safety concerns and complex ethical considerations. Cutaneous leishmaniasis (CL) treatment guidance for children therefore remains uncertain due to the lack of robust evidence. Similar challenges exist for older adults, who are also often excluded from clinical research.
To help address this challenge, DNDi partnered with redeLEISH member institutions in Brazil, Bolivia, Colombia, and Peru to collect and share key data with the aim of using existing data to develop a more complete understanding of the effectiveness and tolerability of several CL treatments for children up to 10 years old and adults aged 60 or older.
Completed in 2021, the collaborative study could be the largest of its kind in Latin America. Assembling data from 1,325 patients treated from 2014 to 2018 in 10 participant sites, the study provided important new insights. A majority of patients, especially children, lacked follow-up information for two post-treatment visits, underscoring the need for strategies to improve patient follow-up, with special attention to the paediatric population. It also demonstrated the importance of increasing access to alternative treatments, such as thermotherapy and miltefosine. Access to such alternatives is particularly important for older patients, given the toxicity and long duration of antimonial treatments.
The next step of this successful collaboration is to encourage other regional initiatives to effectively address the important unmet needs of children and older adults through similar inter-institutional cooperation.
Drug discovery: New partnership for COVID-19 antivirals
At the end of 2021, DNDi, the University of São Paulo, and Medicines for Malaria Venture (MMV) joined forces to identify and develop new lead molecules targeting the SARS-CoV-2 PLpro enzyme, an important coronavirus cysteine protease. The new collaboration is focused on enhancing the antiviral activity and physicochemical properties of the lead compounds for development into new safe, effective, and affordable antiviral treatments for COVID-19.
The new project is an extension of earlier DNDi-MMV collaborations that shared collections of ‘boxes’ of hundreds of investigational open-source compounds for screening by researchers to foster early-stage research into new treatments for pandemic-prone diseases, malaria, and NTDs. The new collaboration will focus on the optimization of these and other newly emerging compounds, with the aim of enhancing their antiviral activity against COVID-19.
The discovery partnership builds on DNDi’s longstanding commitment to fostering international networks for open and collaborative drug discovery that attract world-class researchers to neglected disease research, enabling better, faster, and more cost-effective results.
‘All drug discovery projects at DNDi are driven through mutual collaboration between DNDi and partners. In the case of this project, generated data will be combined with preliminary data from DNDi/MMV open boxes and information available in the literature to define the most promising compounds for further investigation. Our goal is to reduce bureaucracy, delays, and logistical costs while also preparing more professionals to work in this field,’ explains Jadel Müller Kratz, Discovery & R&D Partnerships senior manager for DNDi Latin America.
Expediting access: The iChagas app
Chagas disease affects over 6 million people worldwide and is endemic in 21 countries in Latin America. Yet, despite being the deadliest parasitic killer in Latin America, fewer than 30% of people are diagnosed and just 1% receive proper treatment.
Health workers often lack access to the information they need to identify and care for people with Chagas. To help overcome this barrier and support health workers, DNDi launched the mobile application iChagas in 2021, developed with partners across the region.
The iChagas app provides health workers with access to the latest medical and scientific information on how to diagnose and treat Chagas. Designed in an easy-to-digest format, it meets the needs of clinicians and patients in remote areas, far from large hospitals and diagnostic and treatment facilities. The iChagas app is available free of charge in Spanish, with Portuguese and English versions coming soon.
Photo credits: Vinicius Berger-DNDi; Ana Ferreira-DNDi
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