The Drugs for Neglected Diseases initiative (DNDi) has been awarded USD 60 million by the Bill and Melinda Gates Foundation towards the development of new and effective treatments for patients suffering from neglected tropical diseases in the world’s poorest communities. Announced today by Mr Bill Gates at the annual meeting of the American Society of Tropical Medicine and Hygiene (ASTMH) in New Orleans, this grant will help fill critical gaps in research and development (R&D) for human African trypanosomiasis (sleeping sickness), filarial diseases (notably onchocerciasis, or river blindness), and visceral leishmaniasis (kala-azar).
‘There is a lot of talk about eliminating neglected tropical diseases, but for millions of people affected, this will only be possible with new health tools – including new treatments that are safe and effective, and that can be used in the remote areas where patient needs are greatest’, said Dr Bernard Pécoul, Executive Director of DNDi. ‘Today’s announcement of significant funding from the Bill and Melinda Gates Foundation will support DNDi’s drug development activities from early discovery through late-stage clinical development, for a number of sorely-needed health innovations.’
These treatments include:
- The first oral-only treatments for sleeping sickness: Transmitted by the tsetse fly, sleeping sickness is fatal without treatment. While cases are currently declining, millions are still at risk in 36 sub-Saharan African countries, particularly in the Democratic Republic of Congo (DRC), which is home to two-thirds of all sleeping sickness cases. DNDi has two potential drugs in clinical development that could drastically improve treatment, both of which are simple oral pills (without injections) for early and advanced stages of the disease. Current treatments require skilled staff to carry out spinal taps to determine the stage of disease and administer intravenous injections, and require 10-day stays in hospitals that can be miles from remote areas where patients live. Together with a rapid diagnostic test, an oral treatment that cures both stages of the disease is essential to the sustainable elimination of this disease.
- New tools to address debilitating filarial diseases: The filarial parasitic worms that cause river blindness, the world’s second-leading infectious cause of blindness, and elephantiasis, which infects 120 million people, engender immense suffering and stigma in affected communities. Large-scale mass drug administration programs have been in place for the last 20 years and have been effective, but are not sufficient to reach elimination targets. DNDi aims to develop new, safe and efficacious treatments which aim at killing adult worms and thus stop reproduction, thus dramatically reducing treatment duration. Individual patient care would also be made possible.
- Safe, simple, affordable oral therapies for kala-azar: 350 million people in 98 countries are at risk of leishmania-related diseases, transmitted by sandflies. While some drug development progress has been made, notably for kala-azar in the Indian sub-continent, where the deadly disease is targeted for elimination, current drugs remain costly, toxic, difficult to administer, or ill-adapted for use in remote areas and appropriate drugs for Africa and Latin America are lacking. DNDi has a robust short-, medium-, and long-term strategy to combine or shorten existing treatments while identifying brand-new oral drugs that can be advanced to clinical development.
Sustainable research and development of treatments for neglected diseases depends on balanced and diversified funding from both private and public donors, notably to compensate for the lack of market incentives and ensure affordability and accessibility of treatments for populations in need.
Building upon the long-term partnership between DNDi and the Bill and Melinda Gates Foundation that began with a first grant in 2007, today’s announcement heralds a welcomed new form of support from the Foundation, called ‘portfolio funding’, which is no longer project earmarked, but rather can be used across the three disease areas, thus allowing for greater R&D flexibility and for leveraging vital funding from other engaged donors.
DNDi’s fundraising approach
Since its inception in 2003, DNDi has, as a matter of institutional policy, maintained maximum diversification of funding sources in order to respect a balance between public and private support and to ensure the organization’s independence from any single funding source (with no donor contributing over 25% of the overall budget). It also aims at minimizing earmarked donations to allow for the agility required to support neglected disease R&D.
The Drugs for Neglected Diseases initiative (DNDi) is a not-for-profit research and development (R&D) organization working to deliver new treatments for the most neglected diseases, in particular sleeping sickness (human African trypanosomiasis), Chagas disease, leishmaniasis, filaria, and paediatric HIV/AIDS. Since its inception in 2003, DNDi has delivered six new treatments: 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 disease. DNDi was founded by Médecins Sans Frontières/Doctors without Borders (MSF), Indian Council of Medical Research, Kenya Medical Research Institute, Brazil’s Oswaldo Cruz Foundation, Ministry of Health of Malaysia, and Institut Pasteur in France, with the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR) as a permanent observer.
Ilan Moss, DNDi Communications Manager, DNDi North America (on-site at ASTMH)
Violaine Dallenbach, DNDi Press and Communications Manager
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