2023 Highlights
Responding to the climate crisis
Innovation and advocacy for the most neglected
For the second time in just a few years, Brazil’s army has been forced to deploy field hospitals to cope with an overwhelming number of patients in need of medical care. This time, the problem isn’t COVID-19, it’s dengue. Millions of infections have occurred in only a few short months – Brazil’s worst dengue crisis on record.
Explosive recent dengue outbreaks have also overwhelmed hospitals in other Latin American countries. Other continents have seen similar outbreaks, with notable crises in places as diverse as Bangladesh and Burkina Faso. The dengue virus is carried by mosquitoes. As the climate warms, their range has been expanding, and the number of people they infect has been dramatically increasing.
Other vector-borne diseases are also expanding: Chagas disease is emerging in previously unaffected areas – including North America. Climate modelling suggests the more acute form of sleeping sickness caused by T.b. rhodesiense will spread upwards into the Eastern African highlands, putting millions more people atrisk by the end of the century. As well as allowing new threats to emerge, changing weather patterns also threaten to undo decades of progress – against leishmaniasis, for example, especially in Eastern Africa, which bears the greatest burden of disease.
Climate change has a disproportionate impact on the poorest and most marginalized communities, exacerbating insecurity and displacement and threatening access to food and clean water. The same communities are also hit hardest by vector-borne neglected tropical diseases (NTDs), many of which are on the rise due to changing weather patterns. Even small fluctuations in temperature, humidity, and rainfall can alter vector breeding patterns, biting rates, and geographic range – with devastating consequences.
Yet the data is often lacking – research on climate and health has historically been centred on high-income countries rather than on those settings where the impacts of climate change will most be felt. A recent WHO-led scoping review examined over 42,000 articles in the scientific literature and concluded that there was not yet sufficient understanding of the actual and potential impacts of changes to climate patterns on NTDs, with the link between climate change and some diseases not covered by a single paper.
Guarding against these growing threats to vulnerable communities around the world requires decisive action and sustained commitment to developing simple, safe, and effective health tools, including tests and treatments adapted specifically to the needs of patients and the health systems they rely on.
Across five continents in 2023, our teams continued advancing our response to the climate crisis.
Patients are monitored in an improvised emergency care unit set up in Belo Horizonte, Brazil to accommodate the massive influx of people in need of medical care during the country’s most recent dengue outbreak. With no specific treatment available for the disease, medical care is limited to symptomatic relief and round-the-clock monitoring for warning signs of progression to severe dengue.
Innovating for climate-sensitive diseases
There is no drug that can cure dengue or halt progression of the disease. Through the Dengue Alliance, we are joining with leading research institutes in Brazil, India, Malaysia, and Thailand to identify and develop treatments that can prevent people from developing severe dengue and its life-threatening complications. We are also conducting much-needed research into the burden of dengue in Africa, where knowledge gaps hinder the development of evidence-based responses.
With six all-new drug candidates for leishmaniasis progressing in our R&D portfolio, DNDi and partners marked a major milestone in 2023, with our first new molecular entity – LXE408 – entering Phase II clinical trials in Ethiopia and India. For sleeping sickness, we moved towards completing clinical trials of acoziborole, a single-dose oral treatment that could be incorporated into test-and-treat strategies needed to sustain elimination of the fatal disease in endemic countries.
Across our Chagas disease, mycetoma, and river blindness programmes, our teams and partners are working to replenish the R&D pipeline, advance pre-clinical research, and conduct clinical trials to deliver new and better cures to millions at risk.
Advocating for increased investment in R&D
The Intergovernmental Panel on Climate Change estimates that 70% of annual global deaths are due to climate-sensitive diseases – and this number is expected to rise.
Contributing to the first Global Stocktake of the Paris Agreement that concluded at COP28 in 2023, we highlighted the impact of climate change on the geographical spread and global burden of NTDs and called for increased investment in R&D to facilitate climate adaptation and resilience in the hardest-hit regions. The framework of the Global Goal on Adaptation (GGA) adopted at COP28 reflected growing recognition that the climate crisis is a health crisis – and included a dedicated health target on achieving resilience against climate-related health impacts, especially among the most vulnerable communities. In response, we advocated for the development and adoption of specific health metrics related to climate-sensitive diseases as part of the GGA, highlighting the need for increased investment and improved global policies to facilitate biomedical innovation and equitable access to new and existing health technologies.
At the inaugural Africa Climate Summit organized by the African Union in Nairobi in September 2023, DNDi appealed for new partnerships in medical innovation to be placed at the core of climate change adaptation strategies on the continent. And in the run-up to and during the WHO Executive Board meeting in January 2024, DNDi again spotlighted the impact of climate change on vulnerable populations, calling for concerted action to tackle climate-sensitive infectious diseases with improved health tools developed alongside affected communities and made accessible to all.
Reducing our own environmental impact
In partnership with the Climate Action Accelerator, we completed work in 2023 to assess DNDi’s baseline carbon emissions and develop specific, measurable steps to reduce the environmental impact of our operations and activities. Published in 2023, the DNDi Climate and Environmental Roadmap represents a major step forward in our environmental efforts and pledge to cut our carbon emissions in half by 2030. Making key commitments across our R&D and treatment access activities, travel, energy, offices, procurement, and people, the roadmap also aims to catalyze collective efforts with partners and suppliers to find emission-reduction solutions in pharmaceutical R&D.
Photo credits: Sydelle Willow Smith-EDCTP, Fábio Nascimento-DNDi
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