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 →
Research!America and Global Health Experts Focus on the Economic and Health Burden of Neglected Tropical Diseases in the U.S.
Leading researchers discuss emerging health threats at panel discussion
During a panel discussion today at Tulane University’s School of Public Health and Tropical Medicine, hosted by Research!America, several researchers and leading public health experts said the nation must increase public awareness and research to address the emergence of neglected tropical diseases (NTDs) in the U.S.
NTDs, commonly associated with the developing world, have recently been identified in many parts of the country including Louisiana. Factors such as increased globalization, trade, migration, urban sprawl or climate change have been cited as potential underlying causes for the emergence of NTDs in the U.S. Chagas disease, which can cause heart failure, affects more than 300,000 people across the nation and costs the U.S. an estimated $1 billion in health care and lost productivity each year. Researchers at Loyola University New Orleans identified the first locally acquired case of Chagas disease in Louisiana. 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.
On January 23, the NIH announced that a Phase I clinical trial for a dengue vaccine candidate has yielded promising results. Dengue is a potentially lethal virus which causes severe fever, headaches, and rashes. WHO estimates that 50 to 100 million cases of dengue occur worldwide each year, including here in the U.S., and has recently warned of the possibility of a global dengue epidemic.
The results of the trial, in which 90% of participants developed some immunity to the virus, represent a significant breakthrough in the development of a safe and effective dengue vaccine. The vaccine costs just $1 to produce, making it cost effective and ideal for future distribution to developing countries. The vaccine will enter Phase II clinical trials shortly and is yet another example of the importance of federal funding to advance global health research.
As we ring in the New Year, 2013 promises to be an exciting time to be involved in the fight to raise support and awareness for neglected tropical diseases. As the world becomes more interconnected and global warming changes disease patterns, NTDs are increasingly spreading across borders – including right here at home. For example, Slate recently published an article addressing the return of dengue in the United States. In the past few years, dengue has sickened hundreds in Florida and other southern states. Experts warn that the combination of the virus, a lack of immunity to dengue and widespread mosquitoes provide the perfect storm of conditions for larger dengue outbreaks in the U.S.
As the spread of NTDs adds urgency to the fight, scientists continue to work every day to develop innovative ideas to combat NTDs. In a trial experiment in Africa, researchers are testing the ability of prawns to combat schistosomiasis. A parasitic disease that can be fatal, schistosomiasis is spread through water snails. Prawns are the primary consumers of snails, so researchers hope that re-introducing prawns to rivers at the African test site will help decrease transmission of the disease. In addition to innovative experiments, every week there are reports of new scientific breakthroughs that will help save lives. Just last week, the FDA approved a drug to fight drug resistant tuberculosis, the first new drug for the disease in over four decades. Developed by Johnson & Johnson, the drug cures patients in less time than older treatment options. It is these kinds of innovations and breakthroughs that demonstrate the power of research investments and the importance of research for global efforts to eliminate neglected diseases. Be sure to check back soon for new NTD highlights!
–Morgan McCloskey, global health intern
The devastation caused by Hurricane Sandy has prompted a renewed discussion about climate change. Political leaders and climate scientists alike have raised concerns about the relationship between global warming and an increase in the number of extreme weather events. In addition to these concerns, climate change may also increase the threat of neglected tropical diseases (NTDs) here in the U.S. NTD transmission depends heavily on environmental conditions and warming temperatures may increase the severity or change the patterns of these diseases.
For example, funded by a grant from the Department of Defense, researchers at Texas Tech determined that climate change will allow dengue to thrive in the U.S. Historically found only in tropical regions, rising temperatures will allow the range of dengue-infected mosquitoes to shift north, increasing the risk of dengue within the continental U.S. We may already be seeing the first evidence of this shift – three cases of dengue fever have been reported in Florida in the past few weeks. Similarly, climate change is one suspected culprit in this year’s West Nile outbreak, as CDC officials note that unusually warm weather in 2012 may have played a role.
However, additional research is necessary to fully understand the impact of climate change on the range and transmission of NTDs. Even experts in the field have called for more research into the issue, arguing that “not enough attention is being paid to climate change in relation to NTD control.” They recommend improving NTD surveillance systems and increasing investment in field research, which will not only allow for the establishment of more effective NTD control programs worldwide, but will help the U.S. better understand and protect against these diseases here at home.
-Morgan McCloskey, global health intern
During the final presidential debate, research finally got some airtime. President Barack Obama noted that “… if we don’t continue to put money into research and technology that will allow us to create great businesses here in the United States, that’s how we lose to the competition.” Similarly, Mitt Romney emphasized his support for research, saying that “I want to invest in research, providing funding to universities … is great.”
It was great to hear both candidates acknowledge the importance of research for the future. As they explained, investment in research is crucial for supporting universities, creating jobs and maintaining America’s competitive edge (three of Research!America’s Top 10 Reasons Why the U.S. Should Invest in Global Health R&D). Research is also essential in protecting the health of the American people, as highlighted recently by a bipartisan group of Texas representatives.
On October 12, 21 Texas representatives sent a letter to the Department of Health and Human Services and the Centers for Disease Control and Prevention asking for more action to address the West Nile virus outbreak. Mentioning the significant burden of West Nile in Texas and throughout the country (4,725 cases and 219 fatalities this year alone), legislators requested that the agencies prioritize the development of a FDA-approved West Nile vaccine. Government-funded projects have made progress toward a West Nile vaccine in the past, and additional research investment could help to turn these vaccine candidates into a reality. Research to develop a vaccine is particularly important in light of new information on the long-term burden of West Nile. Recent studies have shown that 40% of West Nile patients still have severe, productivity-limiting symptoms several years after contracting the virus. Other researchers have discovered a link between the virus and chronic kidney disease, even among patients that did not show any West Nile symptoms originally.
In addition to the public health benefits of a West Nile vaccine, research investment into other neglected tropical diseases (NTDs) could also save American lives. NTDs like Chagas disease and dengue fever affect thousands of Americans every day, and political leaders must prioritize research for new prevention and treatment methods to fight these diseases around the globe and here at home.
-Morgan McCloskey, global health intern
On September 30, The Washington Post highlighted efforts in Haiti to eliminate lymphatic filariasis, commonly known as elephantiasis. A neglected tropical disease (NTD), elephantiasis is a parasitic infection spread by mosquitoes that can lead to swelling of the arms or legs — sometimes severely enough that individuals with the disease are stigmatized or unable to work. The good news is that elephantiasis can be prevented with anti-parasitic medicines. The Centers for Disease Control and Prevention and the U.S. Agency for International Development’s NTD program have taken a leadership role in administering these drugs in countries that are affected by elephantiasis. U.S. public health professionals have joined forces with local public health professionals and helped to organize programs, provide technical assistance and monitor progress. Through the collaborative efforts of these invaluable individuals, nine countries have already been declared free of elephantiasis. With support from the CDC and international charities, the Haitian health ministry is working hard to distribute this life-saving medication and join the list of countries free of elephantiasis.
This kind of outstanding work by public health professionals happens every day all around the world. Although there is no risk of elephantiasis in America, there are other NTDs emerging in the U.S. such as Chagas disease, West Nile virus and dengue fever. The CDC and other public health professionals play a crucial role in treating these diseases and organizing prevention and education campaigns here at home. These tireless individuals keep our drinking water safe, our air clean and our children healthy. Please join Research!America and other public health organizations in recognizing these public health heroes on November 19 for Public Health Thank You Day. For more information or to learn how you can get involved, please visit www.researchamerica.org/ph_thank_you or like our PHTD Facebook page at www.facebook.com/PHTD1.
-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.
A recent unsigned editorial by Bloomberg View restates what we’ve been saying for some time: Americans are not immune from global health problems.
The editorial focuses on West Nile virus and dengue, though there are certainly other diseases and conditions that were worthy of inclusion.
Worldwide travel means diseases are more transmissible than ever, and climate change gives disease-carrying mosquitoes more hospitable climates, the editorial notes. And a lack of treatments exacerbates the problem.
“Patients receive acetaminophen for fever and pain, fluids if they are dehydrated, and get-well wishes,” the editorial states. “No vaccines, no cures and no specific medicines exist to prevent or treat dengue or West Nile.”
The editorial lauds the National Institutes of Health for its focus on disease research that remains unattractive to industry and product development partnerships that have allowed new therapies to come to market.
“Although the U.S. is the largest funder of neglected-disease research, its spending declined 5.1 percent in 2010, according to an annual survey conducted by the research group Policy Cures,” the editorial concludes. “As the U.S. outbreaks of West Nile and dengue show, this spending is now a vital investment in the health of American citizens.”