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MSF and Neglected Diseases
Diseases neglected by medical science
Neglected diseases mainly affect people in developing countries. They are the diseases which do not represent a commercially viable market for pharmaceutical companies, because those affected do not have the purchasing power to afford treatment. Companies therefore shirk away from investing into risky and expensive research and drug development for these conditions.
The most neglected diseases are the obscure afflictions which many of us have barely heard of – they include human African trypanosomiasis (or sleeping sickness), South American trypanosomiasis (also known as Chagas disease), Buruli ulcer, dengue fever and leishmaniasis, schistosomiasis, lymphatic filiriasis. These diseases fall outside the scope of the drug industry’s R&D efforts.
Other neglected diseases, more familiar because they also hit people in wealthier countries, are still neglected in that the overwhelming majority of those affected throughout the world do not have access to safe and affordable diagnostics, drugs or vaccines. This is true of the “big three” - HIV/AIDS, tuberculosis, and malaria. For these, a reasonably sized commercially viable market does exist – malaria is a health risk for tourists for example – but, crucially, not one for treatments that are adapted for remote or poor settings, where the majority of the patients live.
In the late 1990s the production of several drugs that did exist to treat these neglected diseases was halted altogether or put under threat. Concerted public and political pressure managed to salvage several important medicines such as eflornithine for African sleeping sickness and benznidazole and nifurtimox for Chagas disease.
However these successes have only brought limited improvements to treatment. For example eflornithine, used to treat sleeping sickness, although less toxic than the medicine most widely used, melarsoprol, requires multiple infusions on a daily basis. And the drugs used to treat Chagas disease, benznidazole and nifurtimox, are only useful for treating the disease in its early stages. There is an urgent need for better drugs, coupled with better diagnostic tools.
That these diseases remain neglected is a direct result of the inadequacies of the current profit-driven drug development system which steers R&D into areas of market profitability rather than health needs.
DNDi: Dedicated to developing medical tools for developing world diseases
In 2003, MSF co-founded the Drugs For Neglected Diseases Initiative or DNDi. The DNDi's mission is to develop new drugs for patients suffering from the most neglected diseases. The organisation initiates and coordinates drug R&D projects in collaboration with the international research community, the public sector, the pharmaceutical industry, and other relevant partners.
In March 2007, DNDi launched its first product, a combination malaria therapy, ASAQ.
Read more on malaria
Read more on Leishmaniasis (Kala-azar)
Read more on sleeping sickness
Read more on Chagas
The diseases medical science left behind
- 60 million people are at risk of contracting sleeping sickness ( human African Trypanosomiasis). Diagnosing this fatal disease requires a lumbar puncture which is beyond the capacity of regular health facilities in affected countries. Treatment is based on a highly toxic arsenic derivate
- Visceral Leischmaniasis ( Kala-azar as it is known in India) kills 60,000 people each year, but antimony treatment developed in the 1930s has remained the mainstay of therapy despite considerable toxicity and the need for injections during the four-week treatment.
Chagas disease is found on the American continent and claims up to 50,000 lives a year. Due to lack of adequate tests, 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 1960-70s. - Malaria kills an African child every thirty seconds. Resistance has rendered old treatments useless but the move to new drugs has been unforgiveably slow causing the needless loss of many more lives
What MSF is doing
MSF continues to work to raise awareness about the pitiful lack of medicines for most diseases that affect people in poor countries. We negotiate with drug companies to get hold of treatments and diagnostics at affordable rates where they exist. We are also active in exploring and supporting alternative models of drug development to help fill the gaps where medical tools are lacking.
In the longer term, MSF is supporting WHO-sponsored negotiations (Intergovernmental Working Group for Public Health, Innovation and Intellectual Property or IGWG) to transform the current market-driven Research and Development framework to one that better meets the health needs of millions in the developing world
Press releases
Key publications
Field news
30 April 2008
The Hospital on the Edge of Town: Treating MDR TB in Karakalpakstan
24 April 2008
07 February 2008
