Driving innovation through South-South collaboration
Recent years have seen a revolution in medical innovation for hepatitis C, which can now be cured with just 8 to 24 weeks of safe, simple treatment. But in many low- and middle-income countries (LMICs), treatments are simply priced out of reach, standing in the way of ‘test-and-treat’ strategies that have the potential to eliminate hepatitis C altogether.
Our R&D alliances are proving that another way is possible, as evidenced by recent progress in Southeast Asia.
In 2016, DNDi established an innovative partnership between the Ministry of Health in Malaysia, the Ministry of Public Health in Thailand, Pharco Pharmaceuticals in Egypt, Pharmaniaga in Malaysia, and Médecins Sans Frontières (MSF) to develop ravidasvir for hepatitis C through an alternative R&D pathway centred on patients’ needs and affordability.
In June 2021, the Malaysian National Pharmaceutical Regulatory agency granted conditional approval of ravidasvir as part of an affordable, safe, and highly effective all-oral cure for hepatitis C – the first developed through South-South collaboration.
DNDi teams are now leveraging our experience joining essential government, science, and industry partners across LMICs to find a safe, effective, and affordable treatment for dengue fever within five years. Dengue is a climate-sensitive disease and growing threat to public health worldwide, but with an estimated 390 million dengue infections each year in more than 100 countries, there is no specific treatment available for the disease.
In 2021, we concluded extensive consultations with partners and dengue experts to establish research priorities, and by early 2022, our first government partners from India, Brazil, Malaysia, and Thailand had joined the new initiative. We look forward to additional partners from other dengue-endemic regions joining soon and to showing how global health R&D coordination, collaboration, and financing can be re-imagined to support a more distributed, decentralized, and democratic approach to the production of knowledge and innovation as global public goods.
Paving the way for the elimination of visceral leishmaniasis in India
In India, the first cases of kala-azar, or visceral leishmaniasis (VL), were recorded in the area of West Bengal in the mid-1800s. Endemic in the country ever since, major outbreaks of the disease have represented an acute public health challenge. However, thanks to government commitment and partnerships to identify and scale up access to shorter, simpler treatments, elimination of VL as a public health problem in India is now within reach.
Since the start of intensified VL detection and treatment activities in India, VL cases have plummeted by 98%, from 77,100 registered cases in 1992 to just 1,275 in 2021. However, the ‘last mile’ of India’s push towards VL elimination presents unique challenges, as will sustaining elimination, once achieved. Strengthening access to effective treatments for VL relapse, VL/HIV co-infection, and other complications will be crucial – including for post-kala-azar dermal leishmaniasis (PKDL), which can develop months or years after a person completes VL treatment. While not deadly, PKDL can be disfiguring and stigmatizing and can also act as a reservoir of VL infection, challenging elimination efforts.
To support the final stages of India’s VL elimination strategy and safeguard sustainability, DNDi has joined with the National Centre for Vector Borne Diseases Control and the Rajendra Memorial Research Institute to establish VL Centres of Excellence (COEs) at two pilot sites in Bihar that manage complicated VL cases requiring hospitalization and specialized care.
With funding from the Takeda Pharmaceutical Company Limited Global CSR Program, the COEs will train healthcare staff and ensure access to necessary tools to strengthen care for patients with VL, PKDL, and VL/HIV, including appropriate diagnostics and treatments. DNDi teams are also working to support the development of standard operating procedures for managing complicated cases at the COEs, which will act as reference and referral centres that can be replicated as required in other endemic areas.
Photo credits: Matt Bouch-DNDi; Black Visuals-DNDi;Manis Gupta-DNDi
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