Loading
As the sunUNWHONTDNTDHIV/AIDSNTDNTDEND NTDDNDDNDDNDDNDWHOYour browser does not support the element. rises and the nurses enter the ward, the children whimper. When the trolley approaches their beds, they begin to wail. Each morning in Amudat, a town in eastern Uganda, those in the local hospital brace themselves for treatment. When the nurse administers the jabs—one in each buttock for 17 days straight—some try to resist. The drugs are so toxic that for several days it can be painful just to sit.The commonest treatment in Africa for visceral leishmaniasis, a parasitic disease (also known as kala-azar) that destroys the internal organs, is a harrowing ordeal, especially for children; one of the drugs involved, sodium stibogluconate, can be lethal. For decades it was used on its own, requiring 30 days in hospital and sometimes leaving debilitating side-effects. Many sufferers preferred traditional alternatives, which in Uganda includes drinking goat’s blood. Even today, nurses in Amudat say patients at the hospital find it so excruciating they sometimes try to escape.Kala-azar is one of what the ’s World Health Organisation () describes collectively as “neglected tropical diseases” (s). It is deadly if left untreated in most cases. Like other s, which include the biblical scourges of sleeping sickness, river blindness and elephantiasis, half of those infected are children. And because the populations blighted by kala-azar are overwhelmingly found in the poorest parts of east Africa, big pharmaceutical companies have tended to ignore it.Research and development funding for kala-azar remedies has been much stingier than for malaria, tuberculosis or , which affect more people globally and nowadays can be countered by effective treatments or vaccines. But now, thanks to a combination of non-profit researchers and African public-health workers, there are signs of progress against s. Promising new drugs for kala-azar and several other diseases are belatedly on the way.One reason is that philanthropic organisations have become more involved. A global campaign to wipe out s by 2030 has chalked up some big recent successes. Guinea worm has nearly been eliminated, thanks in part to funds from foundations like the Carter Centre in America. Today the “growing political consensus and evidence base” suggests that diseases such as kala-azar can be erased in Africa, says Sam Mayer of the Fund, which co-ordinates philanthropy for s with funds from governments and international outfits. This is prompting donors to give more.Another reason is a recent push to develop and test drugs in Africa, where just 4% of clinical trials are currently conducted. When the Drugs for Neglected Diseases initiative (i), a non-profit research-and-development organisation, first tested the treatments used for kala-azar in Asia on patients in east Africa, they found they were much less effective there; children in particular responded badly. i has called for a “new model of drug development”, says Simon Bolo, the group’s lead on kala-azar. This means, among other things, “carrying out clinical trials in the field, where the action is”.Today i runs such trials across Africa, including in Amudat. A single-dose cure for sleeping sickness, developed by i in partnership with Sanofi, a French drugs giant, recently completed clinical trials in Congo and Guinea. New drugs for river blindness and mycetoma, a gruesome flesh- and bone-eating infection, are also in the pipeline. As for kala-azar, a potentially ground-breaking oral drug being tested in Ethiopia “shows very promising results”, says Martina Penazzato of the . Researchers hope a pill could one day be taken at home, easing the disease’s immense burden on clinics and families.The goal of total elimination may still be a while off. Though a kala-azar jab is scientifically feasible, “there is still not really a business model out there for making a vaccine for people who can never hope to pay for it,” says Peter Hotez, a renowned vaccine expert in Houston, Texas. In the longer term, some researchers put their hopes in artificial intelligence, which could dramatically reduce the cost of medical innovation.
