Ms Wasunna, how has it been possible for many diseases to have been neglected by research for many years?
The poorest of the poor live in the places where these diseases are rampant, so it hasn't been worthwhile for the pharmaceutical industry to do anything. But governments, both in developing countries and in rich nations, have not done anything for a long time either.
You are the Africa Director of the Drugs for Neglected Diseases initiative, DNDi, an organisation that works to combat neglected diseases. Which diseases are they?
There are about 20 diseases that fall into this category: mainly tropical diseases like African sleeping sickness or Chagas disease, but also infectious diseases that lead to high child mortality. These are diseases for which there are often no effective drugs, research is virtually non-existent, and no one has really been interested in them for a long time. The staff of Doctors without Borders experienced the dramatic situation on the ground first-hand and drew attention to it shortly before the turn of the millennium. They appealed for urgent action to be taken to combat these diseases.
What happened in response?
Doctors without Borders was awarded the Nobel Peace Prize in 1999. Part of the prize money was used to form our organisation. DNDi brings together researchers from universities and industry to develop medicines for neglected and poverty-related diseases. We research new drugs and try to improve existing drugs or make them more affordable. Ongoing lobby work is also important: we ensure that the issue stays in people's consciousness.
Which diseases represent the greatest danger in developing countries and emerging economies?
Roughly three million people per year still die from malaria, AIDS and tuberculosis. But many of the neglected diseases can result in death if medical care is inadequate. Our work began with the fight against malaria. We worked with the company Sanofi to develop an effective drug that costs less than a dollar. The technology to manufacture this drug was passed on to Zenufa, a company in Tanzania. It is extremely important that the active ingredients are produced where they are needed.
Which diseases do you mainly focus on?
One of our top priorities is visceral leishmaniasis, an infectious disease that attacks the internal organs. It is transmitted by sand flies. It starts with headaches and fever and then attacks the immune system. If not treated correctly, visceral leishmaniasis can lead to death.
What have you been able to achieve so far in the fight against leishmaniasis?
We set up a research platform with various partners in Kenya, Sudan, Ethiopia and Uganda to conduct joint research on a drug: the Leishmaniasis East Africa Platform. We have been able to test the active ingredient, a combination of two existing preparations, in a study involving more than 1,000 patients. The outcome: the effect is significantly better, the duration of treatment cut almost in half. The World Health Organization has issued a recommendation for the product. This is an enormous success which has only been achieved because we share our knowledge and are willing to learn from one other. This is how good research works.
You yourself are a doctor, but today you work as Africa Director of DNDi. What is your role?
I run DNDi's regional office which has about 30 employees in Nairobi, the capital of Kenya. My job is to build and strengthen regional partnerships. We work together with health ministries, research institutes and universities. It is important that we can rely on our fellow advocates — because DNDi has neither its own laboratories nor clinics — and also that we have a regional office in Africa. This allows us to be in the places where these diseases occur. We can then provide guidance for the doctors, explain how our drugs are used and what they need to look out for.
DNDi is what is known as a PDP, a product development partnership. What are the advantages of this model?
PDPs pool the expertise of private and public institutions and industry for research and development of new products for which there is no commercial market. The model is ideal because it focuses on cooperation and sharing ideas and attaches importance to bridging specific research gaps. Every partner contributes their very best. There are now various PDPs— some working on drugs, others on vaccines or diagnostics for the various neglected and poverty-related diseases.
What drives you in your work?
That people are still dying because they don't have access to the right drugs or the right treatment. And as long as this is the case, we can't lower the pressure or the workload. The needs of patients are at the heart of our work: more affordable medicines, easier use, shorter treatment times. Many of the patients in the poor regions often spend hours on the road to find a clinic. However, the development of drugs that they can take orally instead of having to be injected by a doctor is an enormous improvement. Our vision is to significantly improve the lives and health of those affected. Health is a human right. The passion with which people are working to improve the situation is impressive. And I am proud to be part of this process.
What has happened since the turn of the millennium when it was recognised just how drastic the problem of neglected diseases is? Has progress been made?
Yes, absolutely. There has been a change in attitude at the pharmaceutical companies, and today we cooperate intensively with them. They have realised that financial success is not the only priority. The companies have also realised, for example, that it can be motivating for their employees to conduct research in such an important field.
In June 2015, the G7 countries agreed to strengthen the right to health and intensify research on neglected diseases. An important decision or more symbolic in nature?
The G7 countries have done an excellent job under the leadership of Germany. When the strongest industrial nations decide to join forces to tackle the problem, this is an important sign. Neglected diseases affect us all! We are linked by migration and mobility. No one can be sure that these diseases will not become a problem in his or her own country. We have to fight them together.