PS030 - Neglected Diseases: Improving Patient Access to New Diagnostics and Treatments

Mr. J. Alvar, in charge of the Control of Neglected Tropical Diseases (NTDs) at WHO, introduced his presentation by explaining how to recognize which tropical diseases are neglected. Examples of such diseases are Tripanosomiasis and Leishmaniasis. They are found specifically in poor countries, in the poorest populations and, most of the time, in the rural populations who don't have access to medication and health centres. Approximately one billion people are affected by more than one NTD. WHO has developed a Global Plan with nine strategies to combat NTDs, one of which is to ensure free and timely access to high-quality medicines and diagnostic and preventive tools. To achieve their objectives it is necessary to develop innovative and intensified disease management, increase preventive chemotherapy, transmission control and integrated Vector Management. It is crucial to decrease the cost of drugs (cost-effectiveness) and the most important of all is the availability and affordability of drugs.

The goals from this year to 2015 are to prevent, control, eliminate or eradicate neglected tropical diseases. The management of existing tools is very important in order to decrease treatment failures and resistant cases. A big gap remains between research and control. New strategies need to be identified. During, the last ten years, access to drugs for some of the most neglected diseases has been improved. (www.who.int/neglected_diseases/en/)

Mr. Miaka Mia Bilenge, the DRC National programme Advisor, presented a governmental approach to provision of medication, specifically Eflorithine, to people with sleeping sickness. The Republic of Congo is a huge country with a fragile political situation due to conflict and transportation difficulties. Health care components include: health education, preventive health care, environmental and family health. The organisation and control structure is divided into three levels: the National Level management in Kinshasa; the Provincial level which implements the strategic plans set by Kinshasa in their 515 health districts; and the Basic level of health centres, with around 5000 staff. In some areas the DRC Human Trypanosomiasis programme uses Eflornithine as a first line drug. This drug is taken for two weeks, four times a day, and needs to be administered with the support of excellent nursing care, well trained staff in the health centres and functioning logistics from WHO abroad and in the country. The improvement needed is a strong partnership and high level of commitment, mutual communication and close follow up. (http://www.minisanterdc.cd/pnltha.php)

Ms. M. Cayreyre, Marketing Director of Medication Access at Sanofi-Aventis, a socially responsible company, explained private sector activity. Sanofi-aventis is committed to an active role in access to medicines, fighting against some of the most neglected diseases of the developing world. Their strategy is threefold: a portfolio dedicated to diseases, the expertise of an international pharmaceutical company in terms of good quality manufacturing, and willingness to work in partnership with different partners (NGOs, national programmes, international organisations). The main areas covered are: preferential pricing (no profit-no loss), improvement of existing drugs, information, education and communication. They are present in seven priority areas: malaria, tuberculosis, sleeping sickness, leishmaniasis, epilepsy, mental health and vaccines. Between 2001 and 2006 more than one million vials were distributed, fourteen million tests performed and, according to WHO, 110,000 lives saved. Sanofi expect to consolidate these results and to contribute for the future with the hope of better products and continuous efforts of all the actors involved. (www.sanofi-aventis.com)

To conclude, M. B. Pecoul the Executive Director of DNDI presented the point of view of their NGO. Created in 2003, DNDI have seven founding partners: the Indian Council of Medical Research (ICMR), the Kenya Medical Research Institute (KEMRI), the Malaysian MOH, the Oswaldo Cruz Foundation, Brazil, Médecins Sans Frontières (MSF), the Institut Pasteur France, WHO/TDR (permanent observer). The vision is a collaborative, patients' needs-driven, virtual, non-profit drug research and development (R&D) organisation to develop new treatments against the most neglected communicable diseases. The primary objective is to deliver 6-8 new treatments by 2014 for leishmaniasis, sleeping sickness, Chagas diseas and malaria, to establish a strong portfolio that addresses patients' treatment needs. The secondary objective is to use and strengthen existing capacity in disease-endemic countries via project implementation. Two of the key issues are the development of new drugs for neglected diseases and to advocate for increased public responsibility. Even with current R&D, the need for new drugs is far from being addressed for the kinetoplastid diseases. It is important to seek pragmatic partnerships to deliver new field-adapted drugs for most NTD. M. Pecoul highlighted the need to deliver products to patients and to ensure that drugs are affordable and access is equitable.

After the presentations, the speakers were congratulated on the good results obtained in the past few years. One relevant question was about the partner chosen and medications under patent. Ms. Cayere observed that medication is chosen which is no longer subject to patent protection.