Africa-led progress on neglected tropical diseases needs boost in Kigali
The Commonwealth summit provides an opportunity to take concrete action to develop more life-saving tools and build on recent successes.
Nearly 30 years ago, one of my patients, a young boy suffering from visceral leishmaniasis, died in my arms. Visceral leishmaniasis, also known as black fever, is a neglected parasitic disease endemic in eastern Africa that mainly affects children younger than 15. The boy was from an endemic area in Baringo, Kenya, 250km from Nairobi. At that time, the treatment that could have saved him was not easily available near his village.
This tragedy led me, then a young doctor, to dedicate my life to discovering and developing new, better drugs for neglected tropical diseases (NTDs). Visceral leishmaniasis is only one of these many infectious illnesses that kill, disable, and disfigure millions of people each year. They also disrupt employment, family income and education, effectively holding back the socio-economic development of affected countries and keeping communities in cycles of abject poverty.
Even though 1.7 billion people are at risk of NTDs, the only available treatments are often toxic, lengthy, ineffective, or impossible to administer in remote areas – if they exist at all. This is why all the eyes of the community of NTD researchers and advocates are now turned to Rwanda, where the Kigali Summit on Malaria and NTDs is about to start on 23 June on the sidelines of the Commonwealth Heads of Governments Meeting (CHOGM).
In Kigali, government officials, leading African and global medical research institutions, civil society, and the pharmaceutical industry will discuss concrete actions to tackle NTDs, including supporting medical research to develop more effective lifesaving tools – in line with the targets of the World Health Organisation (WHO) NTD Roadmap to eliminate 20 diseases as public health problem by 2030.
We cannot reach this goal without innovation for new health tools – in particular innovation driven by African nations and African scientists. We have shown what is possible: in the Democratic Republic of Congo (DRC) for example, researchers from national research institutes, working in close cooperation with the Ministry of Health and international partners, have already succeeded in developing breakthrough drugs for sleeping sickness, one of the world’s most neglected diseases.
We can replicate this success. The decades I spent in the field with my fellow researchers and communities affected by visceral leishmaniasis has taught me that medical innovation and partnerships, driven and supported by strong African leadership, are crucial to effectively combat NTDs. This approach has already brought spectacular results. Until recently, people with visceral leishmaniasis endured month-long hospital stays to receive painful daily injections. But thanks to new treatments, hospitalisation has been cut in half and we are now working to develop a first all-oral treatment for the disease.
Last week, the WHO recommended a shorter, more effective, easier-to-administer treatment for people co-infected with visceral leishmaniasis and HIV. This was made possible thanks to clinical studies conducted in Ethiopia and India by my organisation, the non-profit medical research organisation Drugs for Neglected Diseases initiative, and its Ethiopian, Indian, and international partners. Tens of thousands of patients will benefit from this innovation. Science works!
But for too many other diseases, adequate treatments are still missing. Take river blindness, a filarial disease caused by parasitic worms that migrate to the skin, eyes, and other organs, causing itching, disfiguring skin conditions, and ultimately blindness. About 240 million people are at risk, many just across the border from the meeting in Kigali, in neighbouring DRC. Current treatment for river blindness is based on regular mass drug administration (MDA) of ivermectin to everyone living in affected areas. The drug kills juvenile worms, but adult worms remain alive in the body, so MDA must be repeated for many, many years.
What we need is a safe, effective, affordable and field-adapted drug to kill the juvenile and the adult worms. We are working on it. In cooperation with national health authorities in the DRC and Ghana, and two pharmaceutical companies, we identified two promising drug candidates and hope to deliver them to patients in the coming years.
River blindness is not an isolated case. For many neglected diseases, the needs are immense. The Kigali Summit is therefore an historic opportunity to jumpstart innovation. Decision-makers, donors, and industry leaders must publicly commit to invest in research for better diagnostics and better treatments.
As communities across Africa face changing and growing burdens of neglected diseases linked to climate change – including leishmaniasis – African governments cannot afford to be complacent. Their commitment is essential. Eliminating and controlling NTDs will also be one of the most cost-effective ways to bolster their economies.
But above all, as a medical doctor, I think that hundreds of millions of people deserve a life without fear that NTDs will wreak havoc on their wellbeing, their families and their livelihoods. Children in Baringo and everywhere else deserve healthy and happy lives – knowing that when diseases strike, they will have safe, efficacious and easy-to-use drugs that will treat and cure them.