A Prescription for Injustice: Part 3

A Hopeful Alternative: The threat of neglected diseases and the first not-for-profit pharmaceutical company

What would a pharmaceutical company actually look like if it were motivated by conscience rather than profit?

While the number of cosmetic procedures in America has increased by 444% over the past five years there has been a lack of focus on how deadly tropical diseases are being treated. Most of these diseases in fact, can be filed under N, for neglected.

A spokesperson for De Novo Pharmaceuticals, a drug design company based in the UK told Médecins sans Frontières (MSF), “The risk/benefit analysis, as far as shareholders are concerned, is not in favor of research into tropical diseases.” There just isn’t profit to be made in developing treatments for conditions like Chagas disease, leishmaniasis, Buruli and other, often fatal, sicknesses that affect only poor people in developing nations.


Glossary of Neglected Diseases

Buruli – Caused by the same bacteria that can lead to TB and leprosy, Buruli attacks the skin and soft tissue by creating large, open ulcers. It has been found in 30 tropical and subtropical countries. It is not yet known exactly how Buruli is transmitted. It is believed that infection may occur through the site of an injury, via aquatic insects, or through salt marsh mosquito bites.

Chagas disease – A parasitic infection transmitted by blood-eating insects. Found in Latin America, some infected people develop swelling at the site of the insect bite followed by swollen lymph nodes within a few days, but many experience no symptoms for months while the parasite invades their internal organs. Chagas disease is fatal 32% of the time, especially in young children.

Leishmaniasis – Another parasitic infection transmitted through sand fly bites. Found in 88 counties, leishmaniasis is thought to affect 350 million people. Different forms of the parasite leave different kinds of disfigurements. Facial scars, open ulcers, and tumor-like nodules can result. Some infections can destroy the spleen and the mucous membranes. People who bear the scars of leishmaniasis are often victims of prejudice and cast out of society.

Sleeping Sickness – After malaria, sleeping sickness – officially Human African trypanosomiasis — is the best-known neglected disease. Found only in rural and remote sub-Saharan Africa, this parasitic infection is transmitted by the Tsetse fly. If not treated, the disease is always fatal.

Source: The World Health Organization

New hope comes in the form of the world’s first conscience-driven, not-for-profit drug company. The aim of the Drugs for Neglected Diseases Initiative, or DNDI, is to develop medications for people who need treatment most. The foundation was started with an initial investment of just $250 million from MSF. Treatments developed by DNDI are owned by the not-for-profit organization and are to be made available to the public at cost whenever possible.

Tropical diseases—which also include malaria and sleeping sickness—and tuberculosis make up more than 12% of diseases suffered today. Only 1.3% of new medications released in the last 30 years were developed to treat them says an article published in the medical journal Lancet this past May. Just 21 new drugs were released to treat all the tropical diseases and TB combined. In contrast, the FDA approved 16 brand name drugs released to aid in weight loss alone over the same period (although 2 were later withdrawn due to side-effects).

Older treatments for tropical diseases are still in use, but are less effective due to the development of drug-resistant strains of the illness. Other problems include toxicity and harsh side-effects.


DNDI announced a new treatment protocol for malaria in January that is to be registered by the end of the year. The new, fast-acting medication is expected to cost $2 to 2.50 per adult treatment.

The initiative was founded in 2003 to take responsibility for neglected diseases out of the hands of the marketplace. The global coalition that created DNDI, which is based in Switzerland, includes health and medical research offices from India, Kenya and Malaysia, as well as the Oswaldo Cruz Foundation, and the Pasteur Institute in addition to the Nobel prize-winning MSF.

Seven New Treatments

DNDI has embarked on 20 projects to research and develop medications. There current, needs-based emphasis is on Chagas disease, sleeping sickness and leishmaniasis.

The company hopes to develop seven new treatments by 2014. To meet its goal, the foundation says it needs to raise another $250 million. $500 million for 7 treatments, in terms of drug economics, is a bargain.

Various sources from the for-profit pharmaceutical industry claim it takes an average of $800 million to bring a single drug to market. For new treatments of real diseases, not-for-profit pharmaceutical companies may be our best hope.

DNDI is currently asking its supporters to sign its research-action appeal located online at http://www.researchappeal.org

For more information see http://www.dndi.org