A billion people around the world suffer from neglected tropical diseases, and the global health community is working to develop new drugs, vaccines and diagnostics. But experts note that success is uneven in part because of different rules and regulations in different countries for drug development and testing.
Dr. Shyam Sundar sees patients suffering from Kala azar in India's Bihar state. The disease, transmitted by sandflies, causes prolonged fever and can be fatal, if left untreated.
Dr. Sundar is developing a simpler approach to treatment, rather than the older protocol of several days of injections.
“Today, the future is much more bright for this disease than what it was 20 years ago," said Sundar.
Dr. Sundar works with Drugs for Neglected Diseases Initiative (DNDI). The international collaboration, committed to developing and delivering new drugs and therapies, has launched a four-year program for diagnosis and treatment of kala azar in India and Bangladesh. Experts say DNDI's findings may ultimately change the way the disease is treated in these two coutnries.
Dr. Peter Hotez, president of Sabin Vaccine Institute, says it is much easier to test new therapies in India than in other parts of the world.
“The good news is India is what we call IDC - Innovative Developing Country," said Hotez. "Yes, you have enormous pockets of poverty; yes, you have terrible problems with elephantiasis and hookworm, kala-azar, and leprosy. But at the same time, you have a very advanced and sophisticated biotechnology machine in India.”
Deadly and disabling infections are also severe in sub-Saharan Africa. But scientists working there say that people in the region do not benefit from new therapies because their governments lack standardized guidelines for testing new drugs. This is also a problem in south east Asia and parts of South America.
A new report from the Center for Global Development - a public policy research institute - says that scores of medicines for deadly infections are caught in a "regulatory labyrinth" [complex bureaucracy] that slows progress.
Amanda Glassman is the director for Global Health at the Institute .
“Very large number of really important and promising products that are in the clinical development pipeline nearing stage three clinical trials which is the last stage, yet the process to get through the clinical trials is very involved, very costly, very inefficient," said Glassman.
There are 90 potentially life-saving drugs in the pipeline waiting to be tested.
“If they can agree on rules of the game and they can empower a regional institution to make sure that the rules of the game are met then they are gonna get better quality of information," said Glassman. "They are gonna have clinical trial in their countries which also brings benefits.”
Experts say neglected infections take their biggest toll in the poorest countries of the world... nations that also lack the regulatory systems to test new therapies.
This is the 2nd article in the series.