2024-11-20 11:00:00
A patient undergoes tests for human African trypanosomiasis, commonly known as sleeping sickness, in Chad, April 3, 2012. AFP PHOTO/HO/SANOFI
And World Health Organization (WHO) reportpublished on November 7, is alarmed by the shortcomings of research and development to treat neglected tropical diseases (NTDs) in children. “These diseases are generally neglected, and children are even more affected by this lack of investment”Martina Penazzato advances, co-author of the report and technical director of the Global Accelerator for Pediatric Formulations Network (GAP-f), a network of non-governmental organizations (NGOs) and research institutes, coordinated by WHO, which aims to accelerate the development of treatments for children. A scientific study already warned in 2019 : less than half of the drugs available for NTDs then had authorization and information for pediatric use.
NTDs affect poor populations, mainly in Africa, but also in Asia and Latin America. The WHO lists 21. Some particularly affect children. The latter represent, for example, half of the cases of visceral leishmaniasis, a parasitic disease transmitted by small insects, sandflies, which is fatal when untreated.
The WHO has identified, for the first time in 2023, seven pediatric drugs whose development is a priority for five NTDs: bilharzia, African trypanosomiasis, scabies, onchocerciasis or “river blindness”, and visceral leishmaniasis.
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For the pharmaceutical industry, the commercial interest in developing pediatric drugs for NTDs is low. The proportion of children affected is sometimes unknown, because they are less well diagnosed than adults. And the little sick people can find themselves scattered in different countries. “Clinical trials on children cost more because you often have to do several groups of different ages”adds Michelle Childs, advocacy officer for Drugs for Neglected Diseases Initiative (DNDi).
Bitterness must be reduced
NGOs like DNDi, based in Switzerland, or Medicines Development for Global Health, in Australia, are taking over. “They often conduct research that manufacturers do not do”observe Martina Penazzato. “Children are not little adults. The way their body metabolizes treatments is different”explains Michelle Childs.
“A medicine must not only be safe and effective. In the case of children, it must also be easy to administer”recalls Martina Penazzato. According to the report, 70% of those indicated for NTDs, included in the WHO list of essential medicines for children, are not available in suitable formulations. Tablets are easier to transport than syrups and tolerate tropical temperatures better. But the little ones can’t swallow them.
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What are the main challenges in developing pediatric treatments for neglected tropical diseases (NTDs)?
**Interview with Martina Penazzato, Co-Author of the WHO Report on Neglected Tropical Diseases**
*Editor: Thank you for joining us today, Martina. The recent WHO report highlights alarming gaps in the treatment of neglected tropical diseases (NTDs) in children. Can you summarize the key findings of the report?*
**Martina Penazzato:** Thank you for having me. The report emphasizes the dire need for more research and development focused on pediatric formulations for NTDs. These diseases are often overlooked, and children are disproportionately affected by this neglect. For instance, many existing treatments lack proper authorization for use in children, leaving them vulnerable to these often fatal diseases.
*Editor: Why are NTDs particularly concerning for children?*
**Martina Penazzato:** Children are at higher risk of severe complications and mortality from many NTDs, as their immune systems are not fully developed. Our report indicates that children make up about half of cases for several diseases, such as visceral leishmaniasis, which can be deadly if untreated. Unfortunately, the necessary treatments for these diseases are either unavailable or inadequately researched for pediatric use.
*Editor: What steps is the WHO taking to address these shortcomings?*
**Martina Penazzato:** We’ve identified seven pediatric drugs as priorities in our fight against five specific NTDs, including African trypanosomiasis and bilharzia. The goal is to fast-track the development of these medications to ensure they are accessible and effective for the children who need them most. Collaborating with NGOs, research institutions, and other stakeholders is critical in this effort.
*Editor: How can we improve awareness and investment in the R&D for treatments of NTDs?*
**Martina Penazzato:** Increasing awareness is key; we need a collective effort to highlight the urgency of addressing these diseases in vulnerable populations. Investment can come from governments, private sectors, and international organizations. Policymakers must recognize that treating NTDs not only saves lives but is also crucial for the overall health and economic stability of affected regions.
*Editor: Lastly, what message do you want to convey to our readers regarding this issue?*
**Martina Penazzato:** I urge everyone to recognize the importance of addressing neglected tropical diseases, particularly in children. Their health is a priority that deserves immediate attention and action. Together, we can advocate for better investment, awareness, and ultimately, the development of effective treatments that can save lives. Thank you.