During the past decade, liposomal amphotericin B (AmBisome) has been used with increasing frequency to treat visceral leishmaniasis (VL) even though it is still only available through preferential pricing for non-profit groups in East Africa. The authors – including Catherine Royce, Shyam Sundar, and Marleen Boelaert, among other leishmaniasis experts – review the pharmacological and clinical data which have demonstrated high efficacy and low toxicity for liposomal amphotericin B.  The authors conclude with a series of recommendations the call for broadening of the research of and access to this treatment. Source: Bern et al. Clin Infect Dis. 2006;43:917-924.

DNDi and MSF will be convening back-to-back symposia on HAT at ASTMH this year.  On 15 November, the MSF session chaired by Manica Balasegaram, will provide a case for why there is a need for improved diagnostic and therapeutic HAT tools. The ensuing DNDi session, chaired by Dr. Miaka, the Secretary General of the DRC Ministry of Health, will discuss the current R&D pipeline prospects as well as the future R&D challenges – Pere Simarro, Mike Barrett, Grace Murilla, Sarah Thomas, and Miguel Kiasekoka are presenting after a brief introduction by Els Torreele. The agenda is available on the DNDi website (presentations will be available next month.)

DNDi’s fixed-dose artesunate-based combination therapies (FACT) are nearing their implementation phase. With the recent DNDiAfrica meeting (see Special section), participants brainstormed about how best to facilitate implementation. Taking into consideration the recommendations from this workshop as well as a meeting held earlier in the year with a panel of international experts, an implementation and communications plan will be drafted and used as a workplan to ensure that ACTs are accessible to neglected patients in Africa.

Two FACT symposia are being held in the month of November (see Calendar): for the primarily French-speaking international audience in Africa, a 4-speaker session chaired by Prof. Ogobara Doumbo, will discuss clinical results seen with the artesunate-amodiaquine (ASAQ) combination; for the international audience at ASTMH, a 5-presenter panel chaired by Prof. Nick White will discuss both ASAQ as well as artesunate-mefloquine (ASMQ). The agenda is available on the DNDi website (presentations will be available next month.).

Published in this month’s Tropical Medicine and International Health, results from the phase III clinical study conducted in Thailand showed the efficacy of the fixed-dose co-formulation of ASMQ to be equivalent with the loose formulation. The investigators, primarily based at the Shoklo Malaria Research Institute, also found the fixed combination to be:

• convenient to administer (a situation that tends to increase patient adherence and to improve clinical outcomes) and

• better tolerated, with less vomiting within the first hour after treatment.

The authors conclude that the fixed-dose combination will show immediate benefit upon its deployment in South-East Asia and the Amazon region. Source: Ashley et al. Trop Med Int Health. 2006; 11:1653-1660.