Copyright © Françoise Herrmann
The theme for UN World Health Day 2014 is Preventing vector-borne disease. Vector-borne diseases are transmitted through a vector that is an organism such as insects, mosquitoes, tics and flies. These organisms transmit pathogens and parasites from one infected person (or animal) to another, causing serious diseases in human populations [WHO (1)].
The most deadly vector-born disease is malaria, transmitted through mosquitos carrying the plasmodium parasite, causing an estimated 627,000 deaths in 2012.
The fastest growing vector borne disease is dengue, also transmitted through mosquitos carrying one of four dengue virus serotypes. There is no vaccine or specific treatment for dengue. The most severe form of this disease is hemorrhagic dengue fever, which causes severe bleeding as a lethal complication. It is estimated that dengue puts about 40% of the world population at risk. [WHO (2)]
Other vector-borne diseases include, for example:
Most of the vector-borne diseases listed above are also considered Neglected Tropical Diseases (NTDs), that is, a group of diseases for which there are currently no available treatments, even though the figures associated with each of the diseases are staggering [NTDs, (1)].
It is “a conversation in progress”, bringing together many players and institutions (public, private, philanthropic and civil society), to endeavor to include unprofitable drug development for these diseases on the agenda of large pharmaceutical companies, whether for the discovery of new drugs, or the reformulation of orphan drugs (drugs that are patented, and often already tested, but that were abandoned and never marketed).
Indeed, for those confronted with these diseases, or their outbreaks, in the field, such as Doctors without borders/Médecins sans frontières and other NGOs, or civil society groups, there is a feeling of total helplessness without treatments, and indignation, by way of comparison, that cures and treatments for every possible complaint exist in the west (Balasegaram, 2014). Witnesses of the NTDs are well aware that pharmaceutical companies are business enterprises who claim they are compelled to recoup the cost of drug development. But these witnesses in the field, fighting NTDs, also deplore that some of the larger drug companies simply back out of drug development for NTDs, arguing that none of their clients in poverty-stricken or underdeveloped countries can afford the costs of treatment. (Balasagaram, 2014).
Consequently, this polarization of interests between the desperate need for NTD treatments, and the balance sheets of “Big Pharma” or large western pharmaceutical agendas, is increasingly seen as a fruitless dead-end. Smaller R&D agendas, such as those of OneWorldHealth, targeting NTD drug development, invoking partnerships between government agencies, philanthropic players and private enterprise, appear far more resourceful and successful in developing or retargeting drugs, and producing treatments at a fraction of the costs, thus engaging in purposeful and life-saving action (Hale, Woo & Lipton, 2005).
At the end of the day… various stakeholders also point out that the scales may eventually tip “more naturally”. On the one hand, the realization that in an interconnected world, the risk of these diseases looms in the west also will promote action in favor of prevention [WHO (3); Chneiwess, 2013]. And, on the other hand, the threat of drug resistance to common bacterial infections in the west will most certainly redirect pharmaceutical agendas towards the development of new types of antibiotics.
In the interim – and it is a sad irony that no such interim or waiting period exists for those impacted by the spread of parasites or vector-borne NTDs --, here are some of the staggering figures associated with 10 vector-borne NTDs:
· 4% of the drugs developed worldwide target NTDs, whereas these diseases account for 10% of the diseases worldwide
· 1 billion people worldwide are threatened by NTDS, and 30,000 people die each day from these diseases. (Touraine, M., 2014 - Institut Pasteur webcast)
Even though change is slow, it is also heartening to see that today, the world is celebrating the prevention of vector-borne diseases that include many NTDs, and thus that such diseases are no longer completely neglected, although much remains to be accomplished so that the statistics are no longer shameful. Consistent efforts by such multilateral groups as United to combat NTDs and what is referred to as the 2012 London Declaration, action has begun [NTDs,(2)].
Balasegaram, M. (Winter 2014). Drugs of the poor, drugs for the rich. Alert, vol. 15, No. 1.
Chneiweiss, H. (2013) Preface in Biotehcnologie: Quelle Limites? Quo vadis Homo sapiens ? by Bernard Fontaine. Paris : France : L’Harmattan.
Hale, V. Woo, K and H. Levens Lipton (July 2005.) Oxymoron no more: the potential for non-profit pharmaceutical companies to deliver on the promise of medicines for the developing world. Health Affairs, 24(4), pp. 1057-1063. http://content.healthaffairs.org/content/24/4/1057.full
Institut Pasteur webcast
NTDs (1) – Neglected Tropical Diseases
WHO (1) - World Health Day 2014
WHO (2) - About vector borne diseases
WHO (3) Europeans at risk of vector borne diseases too.