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Building on the generous contributions of CECP members, the ‘neglected diseases’ community is embracing novel efforts to integrate drug treatments of some of the world’s most debilitating diseases. Recent estimates of integrated treatment show that for less than a dollar, a person living in sub-Saharan Africa could be protected for an entire year from five devastating diseases that cause blindness, skin disease, severe kidney and bladder disease, genital damage, and serious disability. |
CECP members GlaxoSmithKline, Merck & Co., Inc. and Pfizer are supporting burgeoning efforts to look at ways to integrate the treatment of five ‘neglected’ diseases which could lead to cost efficiencies and improved health outcomes for the affected communities. Though malaria, tuberculosis and AIDS capture most of the global health headlines these days, these other diseases—lymphatic filariasis (elephantiasis), onchocerciasis (river blindness), schistosomiasis, soil-transmitted helminths, and trachoma—relentlessly inflict severe economic, psychosocial and physical damage, exacerbating conditions in communities that already are impoverished. The World Health Organization has identified these diseases as “targets of opportunity” since the technical solutions for their control are already available and affordable, due in no small part to the generous donations of essential medicines by CECP members. |
Since 1997, GSK and Merck & Co., Inc. have been key partners in the global effort to eliminate lymphatic filariasis (LF) as a public health problem by the year 2020. More than one billion people are at risk of contracting LF, which is one of the leading causes of permanent and long-term disability in the world, causing billions of dollars of economic losses each year. GSK has committed to providing an unlimited supply of its antiparasitic medicine albendazole to the more than 80 countries where LF exists. When taken once a year in combination with one other drug (Merck has made a commitment to donate Mectizan for all 28 LF endemic countries in Africa and an inexpensive generic drug is used in other parts of the world), it is possible to stop transmission of LF within four to six years. Already about 80 million people are being treated annually through LF elimination programs run by the endemic countries. GSK’s and Merck’s support also extends to critical financial assistance for coalition-building, communications, and training.
Merck & Co., Inc. and Pfizer have made similar drug contributions to eliminate or control other neglected diseases. Over 17 years ago, Merck established the Mectizan Donation Program, a vehicle for distributing Mectizan®, the primary drug used to control onchocerciasis. In 2004, Merck donated more than 45 million treatments for onchocerciasis and more than 25 million for lymphatic filariasis.
Pfizer helped establish the International Trachoma Initiative in 1998 to fight the world’s leading cause of preventable blindness. A single annual dose of its donated antibiotic Zithromax© stops the severe inflammation caused by C. trachomatis infection, thus preventing the scarring and corneal damage that leads to blindness. Using a strategy of mass distribution of Zithromax©, as well as improved hygiene and environmental control, Morocco is on track to eliminate trachoma within the year. |
An African health worker provides instructions to villagers on a drug distribution day. |
In the last several years, these global health programs and their pharmaceutical partners, along with the global programs working to end schistosomiasis and soil-transmitted helminths, began to realize that certain factors facilitate program integration, including geographic overlap, drug distribution similarities, safe co-administration of needed drugs, and the extensive use of community volunteers to deliver drugs. In collaboration with the World Health Organization, the various ‘neglected disease’ programs estimate that if each program were to reach its targeted 2006 level of implementation in sub-Saharan Africa while working independently, the cost of all five programs would be $97 million. However, in theory, the cost that could be achieved through integrated efforts is estimated at only $58 million, a 40 percent savings over stand-alone treatment. Treating someone for all five diseases through an integrated program is estimated to cost only $0.92 (excluding the value of the donated medicines). The proof of concept for such a comprehensive integration strategy is worth pursuing. |
On the ground in endemic countries, there are already strong examples of the impact of integration, particularly between LF and onchocerciasis but increasingly with other diseases as well. An excellent example of the impact of integration is the success of the onchocerciasis program in Nigeria. Schistosomiasis and lymphatic filariasis programs were combined with existing onchocerciasis programs in two states; subsequently, treatments for all three programs have exceeded goals and have markedly reduced infection. Integration efforts are also underway in Togo, Uganda, and Mali, and many other countries recognize the possibilities inherent in this type of cooperation.
An important contribution to these efforts was recently made by the U.S. Congress, which appropriated $15 million to the integrated treatment of the aforementioned five diseases as well as leprosy. This allocation will further encourage coordination and integration among the various disease programs, and also encourage other international donors to contribute to this integrated strategy. Such funds support the training and social mobilization that is necessary to deliver the drugs, most of which are donated, to the billions of people at risk in developing countries.
“GSK and all of its employees are proud of the contributions made to end lymphatic filariasis,” said JP Garnier, CEO of GSK. “Given the tangible benefits to people living in areas affected by multiple diseases, integrating treatment is an exciting and innovative solution to controlling these ancient diseases once and for all.”
These thoughts are echoed by Dick Clark, CEO of Merck & Co., Inc., “At Merck, we already have seen the benefits of the integrated treatment of onchocerciasis and lymphatic filariasis. Further collaboration to integrate additional disease programs is an exciting prospect which can have a profound impact on many lives throughout the world.” |
This young African girl is representative of the beneficiaries of integrated treatment efforts being supported by CECP members GSK, Merck & Co., Inc., and Pfizer. |
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To learn more about what these pharmaceutical companies are doing to improve lives around the world, please visit their web sites.
GlaxoSmithKline's partnership with the Global Alliance to Eliminate Lymphatic Filariasis:
www.gsk.com/filariasis/index.htm
Merck & Co., Inc.'s Mectizan® Donation Program:
www.mectizan.com
Pfizer's work with the International Trachoma Initiative:
www.pfizer.com/responsibility
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