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Chronic underfunding afflicts Africa's fight against neglected diseases

Dr Wilfried Mutumbo Kalonji an officer with the HAT national control programme in DRC during the interview. Drugs against neglected diseases are not lucrative enough for manufacturers. PHOTO| SANDRA CHAO  NATION MEDIA GROUP

Africa Review
Sunday, July 07, 2013

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The African Union turned 50 in May, celebrating a number of milestones the region has made in terms of governance and development.

While there is much achieved including in increasing access to healthcare, there is need to do more to eradicate the neglected diseases-- a group of tropical infections-- that plague the continent.

More research is needed in order for the continent to develop shorter treatment regimes and which are less toxic.

Neglected tropical diseases continue to cause significant morbidity and mortality especially in the developing world. Yet, of the 1,556 new drugs approved between 1975 and 2004, only 21 (1.3 per cent) were specifically developed for tropical diseases and tuberculosis, even though these diseases account for 11.4 per cent of the global disease burden.

Human African Trypanosomiasis (HAT) is classified among the 17 neglected tropical diseases endemic in central Africa, with many of its cases being reported in the Democratic Republic of Congo.

Over the years patients were treated with a century-old regimen--- painful injections of an arsenic-based drug-- which itself killed one in 20 patients.

Improved treatment

An improved treatment was developed in 2009; a therapy combining an oral drug with intravenous injections and which has become the treatment of choice globally.

Trials of oral-only drugs are currently being carried out in selected areas within the central African states in order to provide a better treatment therapy for HAT.

The new 10 day oral treatment of the fexinidazole drug is currently at advanced stages of clinical trials in DRC and the Central African Republic.

According to Dr Wilfried Mutumbo Kalonji who works with the HAT national control programme in DRC, many of the patients are unable to access treatment in time.

“The war might have contributed to the lack of access but then again if you look at the peaceful areas there are no hospitals in which the sick can use let alone the roads to get there,” he lamented.

Dr Kalonji noted that the number of skilled medical practitioners in the country specialising in sleeping sickness is quite few and many of the doctors have to cover large distances using motorcycles in order to access patients.

“The medication for sleeping sickness is also not that available in the country; we mostly give both injectable and oral medication which require for the patients to be hospitalised and sometimes even as you try to reach those in remote areas you have to carry just enough for a few patients because of the weight,” he said.

More cash

Most of these challenges according to Dr John Amuasi can be adequately addressed with proper funding.

The head of research department at the Komfo Ankoye Teaching Hospital in Ghana notes that research in neglected diseases has failed to grow because of lack of funding.

“Many of the people who suffer from these diseases are not financially stable and as such cannot on their own afford these kinds of treatment. Most pharmaceutical companies unfortunately look for areas to invest in where they can eventually see profit,” he lamented.

The researcher said that because of this large portions of the rural African population, who are mainly at risk of these neglected diseases, are caught up in the vicious circle of poverty.

“They are affected in one way or another because treatment for the diseases eats up a large share of their finances which they could have used to improve their livelihoods,” added Dr Amuasi.

A pilot programme for affordable medication run in selected West African countries with the help of donors like the Bill and Melinda Gates Foundation he explains has proven what impact adequate funding can have on poor people.

Effective drugs

The affordable medicines facility for malaria was aimed at ensuring that people infected can be able to access effective drugs for just $1 instead of other available drugs that retailed at $10.

Dr Amuasi noted the programme increased the number of poor people who could now access malaria treatment and also helped to boost their livelihoods as they were able to buy food with the money that they saved.

“Even with such noble ideas there is need for proper government structures to eliminate corruption and to ensure that the members of the public get the increased access to medication at the set prices,” he reiterated.

Dr Ahmed Hassa Fahal of the Mycetoma research centre in Khartoum said that it was time that Africans invested in research in order to be able to treat the diseases endemic to the continent rather than wait for help from the west.

Political will

“There are several diseases like mycetoma that plagues the continent and which if left untreated can be fatal and which are yet to attract global attention or find their way to the list neglected tropical diseases,” he said.

Mycetoma is a fungal disease that affects the limbs and which in Africa is endemic in Sudan, Somalia and parts of Senegal. Though rare in occurrence the disease if left untreated can lead to amputation of the affected limbs and it is also fatal

“If as a continent we can own up to the diseases that plague us then we can collectively work towards getting better treatments and finding ways of permanently eradicating the diseases,” added Dr Fahal.

“If governments can provide the much needed political will,” acknowledges Professor Marcel Tanner, a director with the Swiss Tropical and Public Health Institute, “We would fast track the process of eradicating some neglected diseases by 2020 as set out by the World Health Organisation.”

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