Research and development (R&D) project, AfriCoLeish, is supported by the European Union Seventh Framework Programme (EU FP7) through a grant of €3 million. The project will run for three years and aims to test new treatments for kala-azar (visceral leishmaniasis, or VL) and co-infection of the disease with HIV in Ethiopia and Sudan.
The AfricoLeish project, ‘Care Package for Treatment and Control of Visceral Leishmaniasis in East Africa’, aims to develop and deliver a shorter combination treatment for kala-azar patients that is equally as safe and effective as the current WHO-recommended first-line treatment for the disease (SSG&PM, sodium stibogluconate and paromomycin) in East Africa. The project also aims to determine appropriate treatment strategies for kala-azar in patients that are also HIV positive, in order to treat and also prevent repetitive relapses that are common in co-infected patients.
Kala-azar (VL) is fatal if left untreated. An estimated 300,000 cases occur per year in 70 endemic countries. Estimates suggest 30,000 new cases per year in Africa, with numbers rising sharply during an epidemic. Existing monotherapies are toxic, costly, and difficult to administer, and the treatment duration is long, requiring extended hospital stays. Efficacious and cost-effective treatments as well as prevention of relapse play a critical role in the reduction of disease reservoir, forming a vital part of disease control. In addition, co-infection of kala-azar and HIV is a growing problem and renders treatment more difficult for both diseases.
‘While we have managed to deliver a new first-line treatment for kala-azar in East Africa, sodium stibogluconate combined with paromomycin, SSG&PM, we need to continue searching for shorter, safer treatments’, said Dr Monique Wasunna, Head of DNDi Africa and one of the four principal investigators of the AfriCoLeish project. ‘Through a randomized clinical trial in Eastern Africa, the project will, for the first time, provide conclusive evidence-based data on the WHO recommendation to treat kala-azar/HIV co-infected patients using Ambisome 40 mg/kg total dose, and on the locally used regimen of AmBisome 30mg/kg in combination with miltefosine that is used by MSF in Ethiopia. To do this, AfriCoLeish has the right partners all focused on a clear goal: neglected patients’ needs’, she added.
AfriCoLeish brings together six well-respected organizations from Europe and East Africa with vast experience in R&D and treatment of HIV and kala-azar, namely the Drugs for Neglected Diseases initiative (DNDi); the Institute of Tropical Medicine (ITM) in Antwerp; the London School of Hygiene & Tropical Medicine; Médecins Sans Frontières (MSF, The Netherlands); the Institute of Endemic Diseases, University of Khartoum (IEND), Sudan; and the University of Gondar (UoG), Ethiopia.
‘We are convinced that AfriCoLeish combines the experience and expertise required to deliver new treatment options that effectively address the dire needs of patients with kala-azar and those co-infected with kala-azar and HIV in our countries’, said Dr Ermias Diro, Medical Coordinator, University of Gondar, Ethiopia. ‘At the same time, the project will contribute to strengthening capacities in our treatment centres’, he added.
The dissemination of AfriCoLeish project results will facilitate uptake of new treatments for kala-azar and for co-infection of kala-azar with HIV in East Africa, and will provide support to national programmes in the adoption of the new treatments. The improved treatment options will allow patients in East Africa to benefit from safe, cost-effective, and shorter treatments, while also reducing the treatment costs for health providers.
• About Drugs for Neglected Diseases initiative (DNDi)
A not-for-profit research and development organization, DNDi works to deliver new treatments for neglected diseases, in particular leishmaniasis, human African trypanosomiasis, Chagas disease, malaria, specific helminth infections and paediatric HIV. DNDi has established regional disease-specific platforms, which bring together partners in disease-endemic countries to strengthen existing clinical research capacity, as well as to build new capacity where necessary. In East Africa, one such platform is the Leishmaniasis East Africa Platform (LEAP). The AfriCoLeish consortium builds on LEAP’s experience in delivering new kala-azar treatments in the region (SSG&PM). www.dndi.org
• About the Institute of Tropical Medicine (ITM) in Antwerp
ITM is one of the world’s leading institutions for education and research in tropical medicine (including AIDS), travel medicine and health care development in developing countries. ITM works with many scientific institutions, governments and organizations all over the world for long-lasting improvement of healthcare and disease control in developing countries. ITM houses three scientific departments, a specialized outpatient clinic and various support services, and employs over 400 staff. The institute draws its core funding from the Flemish Ministries of Education and Science, and the Federal Ministries of Development Cooperation, Public Health and Social Affairs, international project financing and own income. www.itg.be
• About the London School of Hygiene & Tropical Medicine
The London School of Hygiene & Tropical Medicine is a world-leading centre for research and postgraduate education in public and global health, with 3,500 students and more than 1,000 staff working in over 100 countries. The School is one of the highest-rated research institutions in the UK, and was recently cited as one of the world’s top universities for collaborative research. The School’s mission is to improve health and health equity in the UK and worldwide; working in partnership to achieve excellence in public and global health research, education and translation of knowledge into policy and practice. www.lshtm.ac.uk
• About Médecins Sans Frontières (MSF, The Netherlands)
Médecins Sans Frontières (MSF-Holland) is an independent, medical, emergency relief organization that provides assistance to people worldwide, regardless of their background, religion, or political convictions. Above all, itaims to save lives and offer medical care to victims of disasters, wars, and epidemics. Sending its own teams (doctors, nurses, and other specialists) enables MSF-Holland to work as swiftly and effectively as possible. Working together with local staff, it gives direct support to the population. www.artsenzondergrenzen.nl
• About the Institute of Endemic Diseases, University of Khartoum (IEND), Sudan
The Institute of Endemic Diseases was established in 1993 as a research and training centre for endemic diseases. It acts as a platform for biomedical and clinical research within the University of Khartoum. At IEND, community service is an ever-growing objective, especially for impoverished and remote communities. IEND endeavours to be one of the leading research and training institutes on endemic diseases worldwide. www.iend.uofk.edu
• About University of Gondar (UoG), Ethiopia
The University of Gondar (UoG) was officially established with its current status and autonomy in 2004. In 1954, the university was initially established as a Public Health College and Training Centre (PHC & TC) now known as the College of Medicine and Health Sciences (CMHS). Located in the historical town of Gondar, CMHS is the oldest medical training institution in the country. The establishment of the PHC & TC was dictated by the pressing and enormous health problems that existed in the 1940s and early 1950s. www.uog.edu.et
Renee Olende, Regional Communications Manager, DNDi Africa (Nairobi, Kenya)
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