The Research and Development Challenge
Current tests and treatments for most NTDs have serious limitations that hamper the provision of life-saving medical care and impede disease control and elimination efforts. To reach the global targets of the United Nations Sustainable Development Goals and 2030 NTD road map, sustained investment is needed in innovation and access to new health tools to prevent, diagnose, and treat NTDs. However, sustained R&D funding shortfalls for NTDs have consistently limited the pace and scale of scientific innovation to meet neglected patients’ needs.
The UK has a long history of contributing to the prevention and control of major epidemics, pandemics, and deadly infectious diseases. While the prevailing profit-oriented model for medical research and development leaves little incentive to develop drugs for the poorest and most vulnerable communities, UK investments in not-for-profit product development partnerships (PDPs) have helped fill critical innovation gaps. One beneficiary of UK support, the Drugs for Neglected Diseases initiative (DNDi), has developed nine new treatments against neglected diseases that have saved millions of lives.
In Focus – Treatment for Sleeping Sickness
Until 2009, treatments for sleeping sickness were toxic and difficult to administer. One treatment, the arsenic derivative melarsoprol, killed up to 5% of patients who received it but was commonly the only drug available for clinicians and patients. In 2009, DNDi and partners launched NECT, the first new treatment for sleeping sickness in 25 years. It was much safer for patients; however, it still required specialized hospital administration by trained staff, making it challenging to use in the remote and rural settings most affected by the disease.
At the end of 2018, the European Medicines Agency recommended fexinidazole, an all-oral 10-day treatment developed by DNDi and partners for the treatment of both stages of sleeping sickness. With significant advantages over previous treatments, fexinidazole comes in the form of simple tablets and eliminates the need for systematic hospitalization. WHO treatment guidelines now recommend fexinidazole as first-line treatment for sleeping sickness and NECT as second-line treatment.
Looking Ahead
The UK has long been a science superpower, driving progress in global health and medical R&D. From the NHS and the UK science and technology industry to research and academic institutions and PDPs, the UK has a strong health innovation sector with decades of experience ensuring impact and access to the fruits of scientific research. However, there is urgent unfinished business when it comes to equitable access to health tools and technologies for NTDs. The UK is well placed to lead in overcoming this gap.
Poverty-related diseases often carry the risk of becoming epidemic, and levels of resistance to many treatments are increasing. At the same time, climate change and migration are increasing the current and future burden of these diseases. With emerging health threats firmly in the public consciousness following the COVID-19 pandemic, it continues to be important to support efforts to end preventable death and disability from NTDs through UK-funded science.
Beyond drugs
NTDs have social, as well as biological causes. In recent years there have been calls for a need for research to understand the social and economic aspects of NTDs and devise contextually appropriate interventions. New social scientific studies of NTDs have offered insights into the lived experiences of those suffering from NTDs, bringing to the fore the voices and perspectives of those most affected.