Neglected no longer?

GENEVA—Looking to put a serious dent into the half million new infections that emerge each year around the world, the Drugs for Neglected Diseases initiative (DNDi) announced it was tackling the problem of visceral leishmaniasis (VL or kala azar) by partnering with Advinus Therapeutics, based in Bangalore, India. As DNDi Senior Project Manager and project lead Dr. Denis Martin explains, having a partner from one of the many countries where VL is endemic has its advantages.

"Central and East Asian collaborators bring a solid and unique commitment to being active in the field of neglected diseases, where their countrymen are often affected," he says. "And, as in the case with India, there is a range of expertise, from parasitology to preclinical and clinical development, available in single country."

Under the five-year collaborative agreement, Martin explains, Advinus will provide scientific expertise in medicinal chemistry, PK, ADME and toxicology, while DNDi will bring expertise in project management and drug development, and will establish ties to other potential partners on an ad-hoc basis.

According to Dr. Rashmi Barbhaiya, Advinus CEO and managing director, the collaboration is first-and-foremost an opportunity for his company to make a contribution to a global problem that primarily affects the poorest countries. It is also, he says, a matter of a "shared vision and commitment to serve unmet clinical needs of neglected diseases."

"At Advinus, we want to devote a percent of our resources to serve unmet clinical needs of neglected diseases. We know that this is not a big commercial opportunity for us. However, we believe that it is our responsibility to give something back to the society and to the country."

VL is typical of the expanding list of neglected diseases that generally get little attention from Western pharmaceutical firms because of the small monetary rewards associated with the disease, whether the result of low disease populations or poverty of the endemic region.

"VL—a disease that is fatal if left untreated—persists today in poor, remote, and sometimes politically unstable areas, where there is limited healthcare and patients have little access to preventive measures and affordable drugs," Martin says. "A significant proportion of clinical cases occur in children, who are highly vulnerable to its effects. Current treatments have significant drawbacks, either in terms of route of administration, length of treatment (21 to 28 days), or emerging parasitic resistance."

For this reason, these diseases have largely become the domain of public-private partnerships like the one between Advinus and DNDi. And of course, DNDi would like to see more of this type of effort.

"We would like to see greater networking and activity of North and South partners, in all aspects of drug R&D, so as to bridge the gaps left by previous market and public policy failures of the last millennium," Martin says. "Such partnerships can be part of the solution to sustainably address the needs of those who have been neglected for far too long."

The partnership is also indicative of a change in the way drug companies in Central and East Asia work with Western partners—more as scientific equals than as technical servants (see "From service to innovation").

"We believe that a country such as India is poised to satisfy not only the needs for neglected [diseases] but it can provide a solution for the biggest problem pharma and biotech companies from the established countries are facing—spiraling increase in the R&D spending and flat productivity," Barbhaiya says. "Through the cost-effectiveness advantage that India offers, there are options to have more shots at the goal and thereby create opportunities for productivity improvement with speed."

For its part, DNDi will benefit from the added expertise of Dr. Shing Chang, newly appointed director of R&D, and Dr. Jean-Pierre Paccaud, newly appointed director of business development. These appointments, Martin suggests, are in line with DNDi's strategy to become an active player in both the discovery and development of new therapies for neglected diseases.