By Dr Luis Pizarro, Executive Director of the Drugs for Neglected Diseases initiative (DNDi), and Pedro Bouchon, Vice President for Research at the Pontificia Universidad Católica de Chile (UC)
First published in La Tercera on 13 October 2022
Over the last few decades, we have witnessed how the progress of science and medicine has changed the global health outlook, significantly improving many people’s lives. However, one in five people in the world still remains on the margins of this revolution. Diseases still present in Chile – such as Chagas disease, with around 120,000 people carrying the parasite in our country – or Hantavirus, which since 1996 to date has infected around 1,300 people in Chile, with a lethality of up to 40% – do not receive enough investment for research and development, and treatments remain old, ineffective, toxic, or simply non-existent.
The World Health Organization classifies a group of 20 conditions as neglected tropical diseases (NTDs). These mainly affect the world’s most vulnerable populations. NTDs disable or disfigure those affected, perpetuating the cycle of poverty, and keeping millions of children out of school and adults out of work.
To address this situation, when the international humanitarian organization Médecins Sans Frontières received the Nobel Peace Prize in 1999, it allocated the funds received to conduct a study that resulted in the creation of a collaborative, non-profit model for the research and development of new drugs for neglected diseases. This led to DNDi, which works in the form of partnerships between public and private institutions, decoupling the cost of research from the final cost of treatment.
DNDi has already developed 12 affordable, available, and community-adapted treatments for six deadly diseases, such as hepatitis C that affects around 35,000 people in Chile. As it is a silent disease, the vast majority (25,000 people in our country) are unaware that they are infected and, unfortunately, a significant number develop chronic infection. That is why it is essential to promote ‘test and treat’ strategies at the primary level of care.
Thanks to collaborative work, in April 2021 DNDi published on the cover of The Lancet Gastroenterology & Hepatology journal the results of clinical trials testing an oral treatment of 12 to 24 weeks duration, which costs only a fraction of what was already available and accessible to only 13% of hepatitis C patients worldwide.
We can replicate these efforts in Chile. Our country has a fundamental role to play in leading the development of new treatments and tools that will enable us to advance in the NTD agenda and eliminate or control diseases that significantly affect Latin America.
National universities have outstanding experiences in the transfer of basic science in immunology to clinical development. In our country, successful phase I clinical studies have been carried out and developed entirely locally (UC vaccine against Respiratory Syncytial Virus). Thanks to this knowledge, together with Sinovac, we conducted two clinical studies of CoronaVac,: one study that included more than 2,000 volunteers over 18 years of age, and another study in children and adolescents, which confirmed that the CoronaVac vaccine was safe and effective. These results were key to the approval of the paediatric use of the vaccine in other countries in our region, including Brazil.
This evolution has made it possible to start building basic capacities that are unique in the country, such as a laboratory specialised in formulations with GMP (Good Manufacturing Practice) standards at UC to produce vaccines for scientific-clinical studies in phases I and/or II. This is an initial advance, which should be replicated for the development of medicines, and at a national level, in related fields.
As a country we have a knowledge platform of excellence, which must continue to strengthen academic-public-private interaction, in a network, in fields that add value, diversify the economy, with territorial and global relevance, and bring us closer to a knowledge society.