Neglected tropical diseases are ancient diseases of poverty that continue to impose a devastating human, social, and economic burden on 1.6 billion people worldwide, half of whom are children. Despite the number of people affected by them, many neglected diseases still do not have adequate treatments. Of those that do, many of the medicines were developed decades ago and are toxic, ineffective, or intensely painful for patients to receive.

A devastating failure in public health

One of the most devastating failures in public health is that so many of those suffering from neglected diseases are children. For example:

• Half of all new cases of visceral leishmaniasis are found in children under the age of 15
• Children and adolescents are at higher risk of developing severe dengue symptoms than healthy adults
• 1 in every 4 new Chagas cases is transmitted from mother to child during pregnancy
• Globally, only 57% of children living with HIV are on life-saving treatment

Children with neglected diseases are vulnerable to deep and long-lasting harms, including disfigurement, premature death, impaired cognitive development, stunted growth, chronic pain, malnutrition, social stigma, and the inability to attend school.

When it comes to treatment, children face even greater neglect than adults affected by the same diseases. In the profit-driven model of drug development, children have long been an afterthought. Clinical trials of safe, appropriate treatment formulations for children may be delayed for years following trials in adults, or never happen at all. Without sustained and sufficient investments for the development of paediatric health products, the treatment options for children remain dangerously limited.

Counting the cost of neglect

Ensuring that all children and their caregivers have access to the treatments they need is critical to breaking the cycles of poverty and illness that continue to inflict immense human, social, and economic damage on affected countries, costing the equivalent of billions every year.

Major strides must be made in reducing deaths of infants and children under five, ending neglected disease epidemics, and ensuring access to treatment for people of all ages if the world is to meet the health goals laid out in the United Nations Sustainable Development Goals and WHO’s Roadmap for Neglected Tropical Diseases.

Hope on the horizon for children with neglected diseases

The good news is that the innovation needed to make a difference for children is already, in many cases, scientifically and technically possible. As a key part of our mission to develop treatments for neglected populations, DNDi committed in our Strategic Plan 2021-2028 to accelerate the development of treatments and formulations that meet the unique needs of children with neglected diseases.

Our commitment to children is rooted in our history. Since 2003, DNDi has developed four affordable treatments for malaria, Chagas disease, and HIV specifically designed for children that have saved millions of lives, as well as treatments for sleeping sickness and leishmaniasis proven suitable for both children and adults.

The way forward for global child health

By 2028, we aim to conduct at least 6 studies on new treatments for children with neglected diseases, including Chagas disease, dengue, river blindness, leishmaniasis, sleeping sickness, mycetoma, and HIV.

To ensure access to the best and most appropriate treatments, we are:

• joining forces with partners to advocate for a more systematic approach to the development, registration, and supply of optimal, child-friendly drug formulations.
• working with the WHO Global Accelerator for Paediatric Formulations (GAP-f), a global network of more than 30 partners working to identify gaps, set priorities, remove barriers, and accelerate the development of appropriate, quality, affordable, and accessible medicines for children.
• contributing to sustainable healthcare systems in low- and middle-income countries by developing context-appropriate treatments and strengthening the in-country capacity to deliver them.

Through these concrete actions, DNDi commits to ensuring we do our part to address critical gaps in paediatric R&D and ensure that every child enjoys their full right to health and access to safe, effective treatment.