New Drug for Visceral Leishmaniasis Is First Step In Tackling Neglected Diseases But Much More Must Be Done

Geneva, June 21, 2002 — The humanitarian medical aid organization Doctors Without Borders/Médecins Sans Frontières (MSF) welcomes this week's news from the World Health organization that miltefosine, a new drug to treat visceral leishmaniasis,¹ has been registered in India, and can now be used to treat patients infected with this killer disease. Visceral leishmaniasis affects around half a million people world-wide, almost all the poor in remote areas in the less-developed world. Without treatment, it is almost always lethal.

"This is excellent news for leishmaniasis patients. New, effective treatments are desperately needed. Although miltefosine has its limitations, it is the first oral drug to treat the disease, making it a much more practical drug compared to the current injectable treatments," said Dr Bernard Pécoul, Director of MSF's campaign for access to essential medicines. "Miltefosine must now be made available in other countries afflicted by this killer disease. The drug also needs to be affordable to patients who need it. We hope the price can come down to around 10$ per treatment." This is roughly equivalent of the price of the generic version of SSG, the most commonly used drug today.

Virtually no new treatments have become available for tropical diseases treatment in recent decades, even though these diseases kill millions of people each year in developing countries. An article published in the Lancet tomorrow² shows that out of the 1393 new drugs developed between 1975 and 1999, only 16 were targeted for tropical diseases and tuberculosis. Society has failed to allocate sufficient resources to battle the diseases that particularly affect the poor: market prospects and return on investment dictate today's pharmaceutical industry's investments, and the diseases of the poor are neglected.

The authors of the Lancet article conclude that the crisis of the most neglected diseases requires a combination of new strategies. An international pharmaceutical policy for all neglected diseases is required. More emphasis and investigation needs to go to mechanisms to oblige the private sector to invest in diseases of the poor; and not-for-profit drug development initiatives need to be explored.

Drug development cannot be left to the private industry alone. Without a shift to needs-driven R&D, the needs of millions in the developing world will continue to be largely ignored.

1. Visceral leishmaniasis, also known as "black fever," is a parasitic disease endemic in 62 countries. 200 million people are at risk of being bitten by infected sand flies that spread the parasite; 90% of all the cases occur in Sudan, Bangladesh, Nepal, India and Brazil.
2. Trouiller P; Olliaro P, Torreele E; Orbinski J; Laing R, Ford N. Drug development for neglected diseases: a deficient market and public health policy failure. Lancet 22 June 2002.