On May 15, Research!America hosted a forum, “Neglected Tropical Disease Research in Louisiana: Saving Lives and Creating Jobs.” The forum, featuring leading NTD experts from the region, was held at Tulane University School of Public Health and Tropical Medicine in New Orleans.
Pierre Buekens, MD, PhD, dean of the Tulane University School of Public Health and Tropical Medicine, made opening remarks. He set the scene for the day, reminding us that there is a false divide between global and domestic health. Dr. Buekens pointed out that borders don’t matter when we share climates and that NTDs can affect people in all corners of world, including New Orleans. He argued that the US is not doing enough to address the threat of NTDs and said that it is “really time to wake up, we really can’t tell other countries what to do if we don’t address it at home.”
The first panel focused on NTDs and NTD research in the U.S. and Louisiana in particular. The panel was moderated by Dean Buekens and featured the following panelists: Patricia Dorn, PhD, Professor of Biological Sciences at Loyola University New Orleans; John B. Malone, DVM, PhD, Professor of Pathobiological Sciences at Louisiana State University; Raoult C. Ratard, MD, State Epidemiologist at the Louisiana Department of Health and Hospitals and Dawn Wesson, MS, PhD, Associate Professor of Tropical Medicine at Tulane University. Continue reading →
Based on their name, you might think that neglected “tropical” diseases (NTDs) aren’t something American physicians would encounter often. While that may have been true in the past, there is a growing threat of tropical illnesses spreading through the U.S. Many factors may contribute to the rise in incidence, but the bottom line is a very real health threat that the American medical community may not be prepared to face.
Take the story of Maira Gutierrez, for example. A resident of the U.S. for over 30 years, she found out she was infected with Chagas, a neglected tropical disease, after she donated blood. For years, no medical professional could provide more than cursory information about her disease, nor prescribe a treatment. Just like her diagnosis, she felt “neglected” by the medical community. Gutierrez and other patients will be featured in a video as part of our upcoming Neglected Tropical Diseases Forum at Tulane University in Louisiana on May 15. Continue reading →
END7 recently released the above video aimed at raising the profile of neglected tropical diseases. END7 is a Global Network campaign which raises money to increase access to NTD treatments and strives to end seven of the most common NTDs by 2020. NTDs affect millions each year, so it is extremely important to increase awareness of these diseases among the public and major political and philanthropic leaders.
In addition to the seven NTDs targeted by the campaign, it is critical that momentum continue to build around research and control efforts for other NTDs such as Chagas, dengue and leishmaniasis. Nature recently published results from a leishmaniasis study in Nepal, which indicated that leishmaniasis drugs are not effective in one-fifth of patients. Although the study doesn’t cite a particular reason for the drug failures, many suspect that the disease is becoming resistant to the most commonly used medication. With treatment failure rates up to an alarming 70% in areas of India and Brazil, drug resistant leishmaniasis is an increasing global concern. In addition, NTDs are on the rise here at home. Texas news outlets reported that 60-80% of animals in southern parts of the state are infected with Chagas, and experts warn that the overall risk of infection has increased. Florida officials have also confirmed that dengue has officially re-established itself in the state.
Despite these challenges, progress is being made in the fight against NTDs. Inviragen, a vaccine research organization based in Colorado, recently began Phase II clinical trials for its dengue vaccine candidate. The vaccine was well tolerated in the first phase of clinical trials and experts hope that Phase II will prove its efficacy and safety in young children.
Did you know that neglected tropical diseases such as dengue, Chagas and hookworm affect over 1.4 billion people worldwide, including individuals here in the U.S.? To discuss the global burden of NTDs and how federal funding and policy decisions impact the research and development of tools to combat these diseases around the world, Research!America will be hosting a panel at the Consortium of Universities for Global Health (CUGH) conference*. The panel, “Are NTDs a Growing Threat? Research, Access and Next Steps,” will be held on Thursday, March 14 at 1:30 p.m. at the Marriott Wardman Park Hotel.
The conversation will be moderated by Karen Goraleski, Executive Director of the American Society of Tropical Medicine and Hygiene (ASTMH) and will feature the following panelists: Rachel Cohen, Regional Executive Director of the Drugs for Neglected Diseases initiative (DNDi); Brian D’Cruz, Emergency Physician with Doctors Without Borders/Médecins Sans Frontières North America; LeAnne Fox, Medical Officer and Team Lead on NTDs at the Centers for Disease Control and Prevention (CDC); Kristy Murray, Associate Professor of Pediatrics at the National School of Tropical Medicine, Baylor College of Medicine and Mark Rosenberg, President and CEO of the Task Force for Global Health.
*Please note that attendance at the CUGH conference requires registration fees. For more information, please visit the conference website here.
You may be familiar with chocolate kisses and candy hearts on Valentine’s Day, but have you ever heard of “kissing bugs?” These insects, found throughout Latin America and parts of the United States, transmit Chagas disease, a parasitic infection that can lead to heart disease in both humans and animals. Chagas infects up to 10 million people worldwide and is a growing problem here in the U.S. It is estimated that 300,000 individuals here at home have Chagas and the disease costs the U.S. nearly $1 billion annually in lost productivity and health care costs. Some experts are also concerned about the growing number of animals with Chagas infections. A recent study showed that in Louisiana, up to 60% of dogs in some kennels have tested positive for Chagas. The Lackland Air Force Base in San Antonio has reported Chagas in military working dogs, and several dogs overseas have actually had to return home because of symptoms from the disease, leaving the units they supported without explosive detection dogs. Clearly this is just one small part of the global story of Chagas as the disease costs thousands of lives and imposes a significant economic burden on all affected countries, most notably in Latin America. More research is necessary to better understand the true impact of Chagas in both animals and people and to develop more effective tools to combat this potentially deadly disease worldwide.
–Morgan McCloskey, global health intern
On December 13 and 14, the global health community gathered at the Mount Sinai School of Medicine in New York for a conference called “Lives in the Balance: Delivering Medical Innovations for Neglected Patients and Populations.” Hosted by Mount Sinai Global Health, Doctors Without Borders (MSF), and Drugs for Neglected Diseases initiative (DNDi), the conference aimed to spur innovation for new tools to combat neglected diseases.
Several key themes emerged from the conference. First, there is a ‘fatal imbalance’ between the burden of neglected disease and medical innovations to combat these illnesses. Neglected diseases affect more than 1.4 billion people worldwide and account for nearly 11% of the global disease burden. In contrast, MSF’s Jean-Herve Bradol, MD, pointed out that of 850 new therapeutic products approved in the past decade, only 4.4% were for neglected diseases. Furthermore, only 1.4% of 148,445 clinical trials were for neglected diseases. To solve this problem, many presenters agreed that there must be a new global framework for global health R&D. A new framework would place an emphasis on public financing and some called for all countries to pledge 0.01% GDP to government-funded R&D.
In addition to reforming the global R&D system, several panelists mentioned the importance of improving access. This means not only improving access to medicines among neglected patients but improving information sharing and access to essential compounds among researchers. The idea of access must also be built into the beginning of the research process. For example, considering storage temperatures or dosage early on in the R&D process will help to ensure that the new tools being developed can be easily utilized in the field.
The conference has put a spotlight on the need for more research to combat neglected diseases. Diseases that once only existed in the developing world are becoming an increasingly large threat in Europe and in the U.S. Cases of multi-drug resistant TB are on the rise, and we need much better treatment options to cure patients. Only two drugs are currently available to treat Chagas disease; both were developed more than 35 years ago, have toxic side effects and are not effective in all patients. It is more important than ever before that governments, philanthropic groups and the private sector come together to help reform the global R&D system, improve access and find new tools to help neglected patients and populations around the world. Many have called this time, these partnerships and current innovations in modern science an unprecedented opportunity for neglected disease R&D. Others are frustrated by the seeming regression in global health due to non transformative “stopgap” efforts, citing drug resistant TB as an example. Both may be right. With unified advocacy to raise awareness and engage political and civic will for NTDs, we can successfully channel both the frustration and the opportunity ahead of us.
On September 29th, World Heart Day, the global health community will raise awareness about cardiovascular disease (CVD). Cardiovascular diseases range from heart failure, meaning the heart is not pumping enough blood, to a heart attack, which happens when blood vessels are damaged and blood flow to the heart is blocked. An estimated 17.3 million people died from CVD in 2008 and over 80% of all CVD deaths occur in low and middle income countries. This year, we are also raising awareness of one of CVD’s “hidden causes”: neglected tropical diseases (NTDs), and of the research necessary to combat these killers.
A group of parasitic and bacterial infections that disproportionately affect people in poverty, NTDs may be an important factor in the burden of CVD in the developing world. These diseases cause fever, disfiguring sores, visual impairment and organ failure. This includes heart damage that leads to CVD later in life. Chagas disease, a parasitic infection afflicting over 10 million individuals worldwide (including an estimated 300,000 people right here in the United States), can eventually cause heart failure if the parasite damages heart tissue. Up to 70% of individuals with African sleeping sickness will experience some degree of heart damage. Over 200 million individuals have schistosomiasis, another parasitic infection that can lead to lasting heart damage if the parasite invades the heart muscle. And dengue fever – another NTD emerging in the U.S. – has also been shown to reduce heart function in severe cases.
These risks highlight the importance of early detection and prevention of NTDs. U.S. researchers and federal agencies have made progress against many of these diseases and we must make sure to equip them with the diagnostic tools and drugs necessary to treat patients before they sustain heart damage. Similarly, improved surveillance and screening programs are needed to truly understand how many of the world’s CVD cases can be attributed to NTDs. In addition to prevention strategies like healthy eating and exercise, investment for NTD research is an important component in reducing the global burden of cardiovascular disease. To learn more about NTDs, please visit Research!America’s global health website.
-Morgan McCloskey, global health intern
As reported in the Washington Post, the number of West Nile virus cases in the U.S. is on the rise. Traditionally a disease that affects people in Africa, the Middle East and Asia, 48 states in the U.S. have reported cases in 2012 alone. Nearly 2,000 cases and 87 deaths, including one Wednesday in DC, have been reported overall. The West Nile virus, a neglected tropical disease or NTD, can cause flu-like symptoms or, in severe cases, even brain damage.
Peter Hotez, MD, PhD, director of the Texas-based product development partnership Sabin Vaccine Institute, recently wrote a New York Times op-ed addressing the increasing thread of West Nile right here in the U.S., “Tropical Disease: The New Plague of Poverty.” As Hotez points out, West Nile is just one of several NTDs that have a presence in the United States. Dengue fever, another virus transmitted through mosquitoes, has been reported in Texas, Florida and Hawaii. A recent estimate finds that 300,000 individuals in the U.S. have Chagas disease, an infection transmitted through insects that can cause heart failure and even sudden death. These NTDs pose an immediate threat to the health of Americans, particularly in impoverished areas of the South where poorer sanitation and drainage systems allow NTD “carriers” to thrive.
NTDs can go undocumented for long periods of time, can be extremely debilitating and have inflicted a large toll on peoples’ health and economic stability around the world. NTDs paint an increasingly troubling picture for American health. Toxic and ineffective, or in some cases no treatments, exist for many of these NTDs, and better surveillance and monitoring is desperately needed. With little financial incentive, private companies are reluctant to invest in this research. However, there is hope. Federally funded researchers at the National Institutes of Health have identified a new drug that has the potential to treat Chagas disease. Additional clinical trials will determine its safety and efficacy for widespread use. Bloomberg recently reported that another PDP, the Dengue Vaccine Initiative, has developed four dengue vaccines that are currently undergoing clinical trials. Continuing to fund this type of research and development is critical to ensuring that the promise of these vaccines becomes a reality.
In an effort to raise awareness about the importance of funding for NTD research, Research!America hosted a joint forum this summer entitled “Global Health Research and Development and the Hidden Burden of Neglected Tropical Diseases in Texas.” Additional support, including robust federal funding, will result in new prevention and treatment methods that are urgently needed not only to improve the health of individuals around the world, but right here in our own backyards. Please let your congressional representative know that even in today’s tough economic environment, funding for global health and NTD research must be a higher national priority.
A video of Research!America’s Texas forum on neglected tropical diseases is available here.