This silent killer urgently needs a coordinated response and action plan
The Drugs for Neglected Diseases initiative (DNDi) Latin America today announced that it will pledge the US $100,000 Carlos Slim Health Award to Chagas disease, the leading parasitic killer of the Americas..
“We are honoured to receive this award from the Carlos Slim Health Institute and we dedicate the prize to Chagas disease – the Americas urgently need a coordinated response and action plan to control this silent killer”, said Eric Stobbaerts, Executive Director, DNDi Latin America. “We estimate that 99% of people infected with Chagas are not even receiving treatment in the Americas and this has to change”, he added.
At a ceremony in Mexico City on April 11th, the Carlos Slim Health Institute will present the annual health award to DNDi in recognition of its 10 years of work and achievements in research and development (R&D) to deliver new treatments for neglected patients in Latin America. The award specifically recognizes DNDi’s achievement in developing and delivering two new treatments in Latin America, one for Chagas disease and one for malaria.
PAHO estimates that globally 100 million people are at risk of contracting the parasite causing Chagas disease, and approximately 8 million are already infected, with 55,000 new cases each year. A key challenge is that most of these cases are never diagnosed or treated.
To fight this silent killer, DNDi has developed a smaller, child-friendly tablet of benznidazole, the main drug used to treat Chagas disease. DNDi has also established a robust portfolio of new drugs for Chagas, to improve patient treatment in the early chronic stage and prevent severe heart and gastro-intestinal damage.
The award for malaria is for ASMQ, a fixed-dose combination of artesunate and mefloquine, developed in partnership with Farmanguinhós, a public pharmaceutical laboratory in Brazil. Launched in 2008, ASMQ is the first new malaria treatment developed in Latin America, and is now available for use worldwide.
“To achieve real breakthroughs for the most neglected patients, it is essential to bring together multiple partners from both the private and public sectors, to do everything from upstream laboratory research, to creating the medicines and conducting the clinical trials. The partners in Latin America have the capacity to work at all of these levels and have the added advantage of coming from a region where these diseases are endemic”, said Dr Bernard Pécoul, Executive Director of DNDi.
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Chagas disease (American trypanosomiasis) infects an estimated 8 to 10 million people, mostly in Latin America, where it is endemic in 21 countries. It kills some 12,000 people each year, making it the leading parasitic killer in the Americas. The estimated global economic burden reaches US $7.2 billion per year. The most affected are very poor and live in inadequate housing conditions and often have little access to healthcare. Cases are also rising in North America, Europe, Japan, and Australia.
Caused by the parasite Trypanosoma cruzi, Chagas disease starts with an early, acute stage lasting about two months, and is followed by a late, chronic stage lasting a lifetime, in which up to 30% of patients develop heart damage and up to 10% may have severe damage to their digestive system. In early adulthood, patients with these symptoms ultimately die, usually from heart damage.
The Chagas parasite is primarily transmitted via the bite of the blood-sucking triatome bug, sometimes called the ‘kissing bug’. Chagas is also transmitted by blood transfusion, organ transplantation, oral ingestion, or during pregnancy from mother to newborn. The latter, congenital Chagas disease, represents the most important mode of transmission in the coming years. It is estimated that over 14,000 new such cases occur annually globally.
The Drugs for Neglected Diseases initiative (DNDi) is a not-for-profit research and development (R&D) organization working to deliver new treatments for neglected diseases, in particular sleeping sickness (human African trypanosomiasis), Chagas disease, leishmaniasis, filaria, malaria, and paediatric HIV. DNDi was established in 2003 by Médecins Sans Frontières/Doctors Without Borders (MSF), the Oswaldo Cruz Foundation (FIOCRUZ) of Brazil, the Indian Council of Medical Research (ICMR), the Kenya Medical Research Institute (KEMRI), the Ministry of Health of Malaysia, and the Institut Pasteur of France. The Special Programme for Tropical Disease Research (WHO/TDR) serves as permanent observer.
DNDi Latin America is based in Rio de Janeiro and is one of the seven regional offices of the organization in the world. By establishing key alliances and platforms with the public and private sector, it manages projects for Chagas disease, leishmaniasis, and malaria, and leads communication and awareness activities for neglected patients throughout Latin America. DNDi Latin America works with partners in Brazil, Bolivia, Colombia, Argentina, and Mexico. The Oswaldo Cruz Foundation/Fiocruz, the largest biomedical research institution in Latin America and a DNDi founding partners, and Lafepe, the Pernambuco State Pharmaceutical Laboratory, are two key Brazilian partners.
Since its creation in 2003, DNDi has delivered six new treatments for neglected patients1 : two fixed-dose antimalarials (ASAQ and ASMQ), nifurtimox-eflornithine combination therapy (NECT) for late-stage sleeping sickness, sodium stibogluconate and paromomycin (SSG&PM) combination therapy for visceral leishmaniasis in Africa, a set of combination therapies for visceral leishmaniasis in Asia, and a paediatric dosage form of benznidazole for Chagas.
DNDi has helped establish three clinical research platforms: Leishmaniasis East Africa Platform (LEAP) in Kenya, Ethiopia, Sudan, and Uganda; the HAT Platform based in the Democratic Republic of Congo (DRC) for sleeping sickness; and the Chagas Clinical Research Platform in Latin America. Strong regional networks such as these help strengthen research and treatment-implementation capacity in neglected disease-endemic countries.
1Two of which were developed in Latin America – one for Chagas disease and one for malaria.
The Carlos Slim Health Institute
Every year the Carlos Slim Institute for Health gives two awards, one to an organization for outstanding institutional achievements and one to an individual for life-time achievements. Of 75 nominations from 15 countries in Latin America and the Caribbean, DNDi Latin America was selected for the 2013 Outstanding Institution award.