Transcript Lecture Slides1

Sustaining Priority Research for
Neglected Tropical Diseases
Rob Ridley
Director, TDR
Global Forum for Health Research
Mumbai, September 12 to 16 2005
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TDR 'twin' Mission
• To undertake research, development and evaluation of
new and improved tools and interventions to fight major
tropical diseases
• To strengthen research capabilities in countries where
these diseases are endemic
– enhanced stakeholdership / ownership of research
Global Forum for Health Research
Mumbai, September 12 to 16 2005
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A vicious cycle
Global Forum for Health Research
Mumbai, September 12 to 16 2005
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Many 'Neglected Diseases'
Mortality Estimates for 2002 (World Health Report 2004)
•Infectious and Parasitic diseases 10 904 (000)
•HIV/AIDS
•Diarrhoeal diseases
•Tuberculosis
•Malaria
•Childhood diseases
•STI (excluding HIV)
•Meningitis
•(Other) Tropical Diseases
•Hepatitis B
•Hepatitis C
•Dengue
•Japanese encephalitis
•Intestinal nematode
•Leprosy
2 777
1 798
1 566
1 272
1 124
180
173
129
103
54
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14
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Global Forum for Health Research
Mumbai, September 12 to 16 2005
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'Neglected' Diseases affect 'Neglected' Populations
Global Forum for Health Research
Mumbai, September 12 to 16 2005
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Priority Setting
Global Forum for Health Research
Mumbai, September 12 to 16 2005
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Tropical
Disease
Burden
Poverty
Poverty
Control/
Elimination
Of Tropical
Research
Diseases
Global Forum for Health
Mumbai, September 12 to 16 2005
reduction
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Innovation to Impact
Grand Challenges
NIH, Trust,
Research councils
etc.
Global Forum for Health Research
Mumbai, September 12 to 16 2005
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Need to sustain and increase
basic science funding
NIAID Funding in Infectious & Parasitic Diseases
(1998-2003) as Defined by
WHO World Health Report 2004-Changing History
4
3.5
$ (Billions)
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Infectious &
Parasitic Diseases
Funding
Total NIAID
Funding
NIAID BioD
Funding
2.5
2
1.5
1
0.5
62%
60%
60%
60%
55%
43%
0
1998
1999
2000
2001
2002
2003
FISCAL YEAR
The World Health Report 2004-Changing History (http://www.who.int/whr/en/; Statistical Annex, Table 3 Burden of Disease in DALYS by cause,
sex and mortality stratum in WHO Regions, estimates for 2002 (http://www.who.int/whr/2004/annex/en)
Global Forum for Health Research
Mumbai, September 12 to 16 2005
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Product Development
Global Forum for Health Research
Mumbai, September 12 to 16 2005
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Examples of public private partnerships
that have delivered new tools
Drug
Reg
Indication
Partners
Nifurtimox
1972
Chagas disease
Bayer
Oxamniquine
1973
Schistosomiasis
Pfizer
Praziquantel
1976
Schistosomiasis
Bayer / TDR
Benznidazole
1978
Chagas disease
Hoffman La Roche
Multi-drug therapy
1980
Leprosy
Ciba-Geigy / TDR
Albendazole
1981
Intest parasites, LF
Smith Kline Beecham
Mefloquine
1984
Malaria
Hoffman La Roche, WRAIR
Ivermectin
1987
Onchocerciasis
Merck / TDR
Halofantrine
1988
Malaria
Smith Kline Beecham, WRAIR
Eflornithine
1991 African Trypanosomiasis
Marion Merrel Dow / TDR
Liposomal amphotericin B 1994 Leishmaniasis (Kala azar)
NeXstar / TDR
Artemether
1997
Malaria
Rhone Poulenc Rorer, Kunmig /TDR
Artemether-lumefantrine
1999
Malaria
Novartis
Atovaquone+proguanil
2000
Malaria
Glaxo Wellcome
Artemotil (beta-arteether) 2000
Malaria
Artecef, WRAIR / TDR
Miltefosine
2002 Leishmaniasis (Kala azar)
Zentaris, Indian CMR / TDR
Chlorproguanil-dapsone
2003
Malaria
Glaxo Smith Kline / TDR
Global Forum for Health Research
Mumbai, September 12 to 16 2005
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Innovation to Impact – product development
EDCTP
MMV
Microbicides
DNDi
GATB
IAVI
FIND
MVI
Global Forum for Health Research
Mumbai, September 12 to 16 2005
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Product Development Activities Need Sustaining
• 8 new drugs anticipated by
2010
• Proposed fund of $200M
per year to complement
PPP's
Global Forum for Health Research
Mumbai, September 12 to 16 2005
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Much variation by disease (e.g. Gates)
Global Forum for Health Research
Mumbai, September 12 to 16 2005
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Evaluation and Implementation Research
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Mumbai, September 12 to 16 2005
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Examples of TDR – mediated
evaluation and implementation research
• Onchocerciasis
– Ivermectin and Community Directed
Treatment
• Malaria
– Home management of malaria strategies
• Visceral Leishmaniasis
– Tools in place for 'elimination'
programmes
A critical area for future funding
given increase of tools in pipeline
Global Forum for Health Research
Mumbai, September 12 to 16 2005
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Example in progress
Visceral Leishmaniasis
New tools stimulate India / Nepal /
Bangladesh to sign MoU for
elimination of VL by 2015
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Local ownership of research critical
Recognition of significance of social,
economic and behavioural research
Research must be embedded in and
owned by countries and integrated into
health systems
Inter-country coordination facilitated by
WHO / SEARO / TDR
Requires a co-ordinated approach by
partners for maximal impact
Global Forum for Health Research
Mumbai, September 12 to 16 2005
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Innovation to Impact
Global Forum for Health Research
Mumbai, September 12 to 16 2005
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Innovation to Impact
Global Forum for Health Research
Mumbai, September 12 to 16 2005
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Look beyond single issues
Managing Interfaces
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Challenges No. 1
• Maintained funding for basic science, continued
innovation and PPP product development
– Better balance for more neglected diseases
– Better management of translation research
• Enhanced Evaluation and Implementation
Research for all diseases
• Enhanced coordination and interaction between
initiatives, funding agencies, governments and
regional bodies
– Role for international agencies
Global Forum for Health Research
Mumbai, September 12 to 16 2005
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Look beyond single issues
Cross-cutting issues
Global Forum for Health Research
Mumbai, September 12 to 16 2005
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Challenges No. 2
• Need capacity building coupled to capacity utilisation
• Need to enhance country participation, 'stakeholdership' and
ownership of research
• Need to 'embed' the output of research activities within the
institutions of developing countries
• Need to enhance capabilities of developing countries to
engage in 'innovation' as well as implementation
Global Forum for Health Research
Mumbai, September 12 to 16 2005
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Use-inspired
Research
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Mumbai, September 12 to 16 2005
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