Here are some of the gaps in medical innovation that MSF teams face when trying to give quality care to patients:

Medicines and Diagnostics for Children
Across the board, paediatric treatments, vaccines and diagnostics are drastically under-researched. The gap between needs and available medicines is powerfully evident in the treatment of HIV/AIDS: because very few children are infected with HIV in rich countries (barely 100 children are newly infected in Europe or North America each year, compared with over 560,000 in Africa), pharmaceutical companies have no commercial incentive to develop drugs or tests that will work for children.  As a result, many antiretrovirals have simply never been tested for children. Diagnostic tests too are also woefully inadequate for children: there is still no simple way to find out whether an infant is infected with HIV/AIDS.

Children and HIV/AIDS

Tuberculosis
TB – long considered a poor man’s disease, but now mostly under control in wealth countries - is one of the biggest killers in the developing world. Yet the drugs today were developed almost 50 years ago, and are not up to the task of containing the disease effectively.   First-line drugs have to be taken for at least six months, so many patients stop taking the medications before they complete treatment.  This leads to the development of resistant strains of the bug, which are even harder to treat, as a patient has to take toxic drugs that bring on terrifying side effects, and often be isolated in a hospital ward for months at a time.

The tests to detect TB are also completely ill-suited.  The most widely used test for TB is one hundred and twenty five years old, only detects certain types of the disease, and even then in only 45-60% of cases.

Find out more on TB

TB-HIV/AIDS co-Infection
Tuberculosis and HIV/AIDS combine to devastating effect.  Tuberculosis has now become the biggest killer of people living with HIV/AIDS.  Yet because this mostly concerns developing countries, we still don’t have a TB test that is reliable and simple enough to be used on HIV positive patients.  In addition, some of the antiretrovirals used to treat HIV interact with the anti-tuberculosis drugs, and so doctors can’t treat both drugs at the same time.

HIV/TB Co-Infection

Other Sexually Transmitted Infections
340 million sexually transmitted infections occur every year. Simple, effective treatment exists but many are not getting it because of lack of simple, reliable tests.

Most Neglected Diseases
There are a number of other diseases beyond TB and HIV which receive so little attention from the pharmaceutical industry, that they have been dubbed the ‘most neglected diseases’.

Sleeping sickness: 60 million people are at risk of contracting sleeping sickness or human African trympanosomiasis. Diagnosing this fatal disease requires a lumbar puncture which is far too complex for regular health facilities in affected countries to perform. Often, treatment is woefully inadequate too, as the most commonly-used drug to treat sleeping sickness, based on a highly toxic arsenic derivate in use since 1940s, is so toxic that it kills 1 in 20 patients.  A better drug exists, but its use is too complex for it to be appropriate in resource-poor settings. As such there has been no significant improvement in sleeping sickness treatment for 50 years.

Kala-Azar or leishmaniasis kills 60,000 people each year, but antimony treatment developed in the 1930s has remained the mainstay of therapy despite considerable toxicity and side-effects.  The treatment is also unsuited because injections need to be given for four weeks which many patients either can’t or won’t complete the course.  Leishmaniasis becomes an even more deadly disease when it combines with HIV, as each infection gradually decreases the immunity of those infected and worsens the impact of the other. It is very difficult to diagnose and treat, and more than half of those treated experience relapse.

Chagas disease is found on the American continent and claims up to 50,000 lives a year. Tests to detect the disease exist, but they are too high tech, requiring expensive lab equipment and training.  This means they can only used to protect blood bank stocks to make sure contamination is prevented.  Due to lack of tests that can be used in remote settings, this chronic disease is usually diagnosed too late for current drugs to be effective. The only two available medicines, nifurtimox and benznidazol, were developed in the 1960 and 70s.