Africa needs to address neglected diseases

What you need to know:

  • It is estimated that about 4,000 cases occur annually in Kenya and five million people are at risk of infection, with the largest number coming from the arid and semi-arid regions of the country.
  • Research and development (R&D) for kala-azar and other neglected diseases worldwide is often fragmented — with different programmes and projects, but without global coordination or setting of priorities for the research itself and funding.
  • Property is an opportunity to put in place a mechanism that could be further extended to respond to the magnitude of global health challenges and crises.

The recent call by a group of global health experts for a research and development fund and mechanism to address emerging and infectious diseases as well as antibiotics resistance could not be more timely.

As countries in the region are still reeling from the effects of the recent Ebola outbreak, governments are beginning to wake up to the reality that neglected diseases are indisputably a cause for great public concern. These issues will be at the top of the agenda for most of the participating countries at the World Health Assembly meeting between May 19 and 26.

In Africa, neglected diseases continue to have a massive socio-economic impact on the poorest people. Take the example of kala-azar, or visceral leishmaniasis (VL). It is transmitted by female sandflies and affects the liver, spleen, and bone marrow.

It is estimated that about 4,000 cases occur annually in Kenya and five million people are at risk of infection, with the largest number coming from the arid and semi-arid regions of the country.

Research and development (R&D) for kala-azar and other neglected diseases worldwide is often fragmented — with different programmes and projects, but without global coordination or setting of priorities for the research itself and funding.

R&D for these diseases has not been considered a priority and the pharmaceutical industry fails to substantially invest in R&D where there is no profitable market.

As a result, treatments for these diseases are lacking. Treatment for kala-azar in Africa remains cumbersome, requiring prolonged hospital stays and multiple injections, and is not safe enough for certain patients. Although a successful study done in four countries in the region (Ethiopia, Kenya, Sudan, and Uganda) under the Leishmaniasis East Africa Platform (LEAP) that combined two drugs reduced the treatment period from 30 to 17 days, we are still far from the ideal treatment — a safe and simple oral pill.

An umbrella mechanism, such as the one being called for, will be able to incentivise innovation for neglected diseases, ensure that public health priorities remain in the hands of public health authorities, and meaningfully engage private sector actors in a sustainable manner.

Such a framework would enable countries such as Kenya to take important steps towards improved treatment for neglected patients. A global R&D fund and mechanism would help accelerate efforts for new technologies to be developed and introduced.

The 68th World Health Assembly and follow-up discussions of the Global Strategy and Plan of Action on Public Health, Innovation, and Intellectual Property is an opportunity to put in place a mechanism that could be further extended to respond to the magnitude of global health challenges and crises.

Kenya, and all African countries stand to benefit from such a framework, and many countries such as ours have developed R&D capacity and can contribute to innovation.

It is time for African countries to fully rally this call for global health coordination and funding for these diseases if we are to make strides towards addressing the health needs of our compatriots.

For more information about this call for action, go to https://www.plos.org/wp-content/uploads/2015/05/pmed-12-05-Pecoul.pdf

Prof Mpoke is director, Kenya Medical Research Institute. Dr Wasunna is Africa director, Drugs for Neglected Diseases initiative

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