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World NTD Day: the fight to end Neglected Tropical Diseases

30 January 2020

EDCTP is a proud partner and supporter of this first World NTD Day, a call to action to end the burden of the neglected tropical diseases (NTDs). Pivotal in the renewed global focus on NTDs was the London Declaration of 2012, signed by a coalition of public and private partners. In 2014, EDCTP with the support of the European Union added the neglected tropical infectious diseases to the scope of its second programme to fight poverty-related infectious diseases. In 2015, ending the epidemic of the poverty-related NTDs was adopted by the United Nations as one of the targets under the Sustainable Development Goals. To date, EDCTP has invested more than €56 million in this fight.

The following video was made at the 11th European Congress on Tropical Medicine and International Health in Liverpool, United Kingdom, from 16-20 September 2019 and highlights the urgency of research for NTDs.

Progress achieved but work far from done

The last decade has seen substantial progress towards the targets set in the WHO NTD roadmap, with an estimated one billion people receiving treatment against at least one NTD. Progress for some diseases has been remarkable, such as the 97% reduction in the reported number of cases of African sleeping sickness, i.e. human African trypanosomiasis (HAT) between 1999 and 2018. For other diseases progress has been less impressive, for example, the elimination of schistosomiasis has been challenging in the African region.

For many diseases, new medicines, diagnostics and innovative technologies are needed to achieve the ambitious targets set. New product development requires increased, targeted and sustained investment. Neglected infectious diseases research, however, only receives a fraction of the total funding spent on R&D for infectious diseases, and less than justified by the considerable total NTD burden. *

The work, therefore, is far from done. Innovation and sustained efforts over time are needed. A major challenge ahead will be to ensure equitable access to treatments for NTDs. Including all populations in control programs will be vital to make progress towards elimination. Leaving no one behind also requires to address neglected conditions among patients afflicted by NIDs, such as female genital schistosomiasis. The necessary integration of NTD services into regular health care systems poses challenges which will differ by country and disease. In addition, as programmes shift towards elimination, surveillance, good data systems and adequate response are needed to sustain gains and avoid a resurgence of diseases, as has been seen in the past.

EDCTP investments in NTD projects

Since the launch of its second programme in 2014, which is supported by the European Union under Horizon 2020, EDCTP has invested €56.49 million in 27 NTD projects in sub-Saharan Africa. Almost all calls were open to proposals for NTD research and capacity building. Two 2017 calls invited proposals exclusively on NIDs, one for product-focused implementation research (RIA2017NIM), and a second one for clinical trials (RIA2017NCT).

Going forward, EDCTP will align its research priorities with the 2021-2030 WHO roadmap for NTDs, which will give updated targets for the control, elimination or eradication of each NID. Underpinning this roadmap will be a change of orientation from process to impact, a change in technical focus from diseases to delivery platforms and a change from an external-based agenda and funding to a more country-led and funded implementation within health systems. EDCTP has every intention to continue its role as a funding partner of research to end NTDs.

Portfolio of NTD projects

Since the start of EDCTP2, this Europe-Africa partnership has funded 27 projects for clinical research, research capacity development, and fellowships for African researchers. Details on all projects can be found in the EDCTP public project portal. They are also highlighted in the online EDCTP project portfolio presentation.

Projects and partnerships

EDCTP aims to fund projects that are aligned with global research priorities for poverty-related infectious diseases and that work with key partners and stakeholders to achieve maximum impact. An example of alignment is the DiTECT-HAT project which addresses the need for developing diagnostic algorithms for the detection of human African trypanosomiasis (HAT) for passive case detection and post-elimination monitoring.

DiTECT-HAT - Guinea

One good example of funding in partnership is EDCTP’s support for the urgently needed development of a paediatric formulation of praziquantel to treat schistosomiasis in preschool-aged children. In 2017, EDCTP and the Global Health Innovative Technology (GHIT) Fund agreed to a partnership against parasitic infections and to jointly fund the development of a paediatric formulation for schistosomiasis through the PZQ4PSAC phase III safety and efficacy trial in Kenya and Ivory Coast. The aim of the study to provide clinical data and support for registration of a new praziquantel tablet which easily dissolves in the mouth, to treat schistosomiasis in preschool-aged children. EDCTP is proud to co-fund this study with a contribution of €1.99 million alongside a contribution of €3.22 million from the GHIT Fund. The total project value is €12.10 million comprising in-kind and cash contributions from Pediatric Praziquantel Consortium partners.

Projects for product-focused implementation research are also supported, including two projects on leprosy that are co-funded with the Leprosy Research Initiative (LRI). In 2017, LRI and EDCTP created a partnership to encourage leprosy research that are co-funded with the LRI contributing €400,000 through two EDCTP calls for proposals towards two leprosy projects – PEP4LEP and PEOPLE. These studies are generating evidence on the most effective and feasible ways to integrate post-exposure prophylaxis (PEP) – recommended by WHO in 2018 to prevent leprosy in contacts of leprosy patients – into leprosy programmes in sub-Saharan Africa.

EDCTP also invest in the next generation of African scientists through its extensive fellowship programme, including for NIDs. Among the 26 NID projects awarded, 12 are fellowships and include projects such as the BuruliNox project by Senior Fellow Dr Richard Philips at the Kwame Nkrumah University of Science and Technology (KNUST) in Ghana, which aims to develop a nitric oxide generating dressing to improve management of Buruli ulcer. Another example is the study conducted by Senior Fellow Dr Dawit Wolday from Makelle University in Ethiopia, which evaluates simple diagnostic methods for diagnosis and test of cure in patients with visceral leishmaniasis.

Projects by EDCTP member countries: more than €250 million committed to NIDs

The EDCTP2 programme encompasses projects that are initiated and funded by its member countries independently. These so-called Participating States’ Initiated Activities (PSIAs) are considered a contribution to the programme if these are within the scope of the EDCTP programme and contribute to its objectives.

Between 2014-2019, African and European EDCTP member countries have supported 42 PSIAs on NTDs, with a combined indicative commitment of €250.8 million. These PSIAs cover diseases such as human African trypanosomiasis, dengue, hookworm, lymphatic filariasis and leprosy, amongst others. They also include support to NID-related activities conducted by product development partnerships such as the Drugs for Neglected Diseases initiative, the European Vaccine Initiative, the Dengue Vaccine Initiative, the Sabin Vaccine Institute and the Foundation for Innovative New Diagnostics.

Spain, for example, through its institutional support to the National Centre for Epidemic Control in Equatorial Guinea, has funded the development and implementation of the national plan to combat HAT, onchocerciasis and other filariasis control programmes in Equatorial Guinea.

Finland is supporting sampling and epidemiological work in Tanzania, Ethiopia and Kenya to develop innovative, non-invasive sampling methods to detect dengue virus infections in order to establish the disease burden in Africa and consider threats of other arboviruses. This research is helping to increase awareness and understanding of the emerging epidemiology and burden of dengue in Africa and to provide capacity-building for dengue surveillance.

Zambia supports work to increase clinical awareness of leprosy and improve detection rates of new leprosy cases in Zambia, to evaluate new leprosy diagnostic tests, and to apply next-generation sequencing for rapid diagnosis of leprosy and defining M.leprae strains and susceptibility to anti-leprosy drugs.

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* Background information in this message is based on WHO publications and the G-finder report.