The drug and vaccine landscape for neglected diseases (2000–11): a systematic assessment

Background In 1975–99, only 1·1% of new therapeutic products had been developed for neglected diseases. Since then, several public and private initiatives have attempted to mitigate this imbalance. We analysed the research and development pipeline of drugs and vaccines for neglected diseases from 2000 to 2011. Methods We searched databases of drug regulatory authorities, WHO, and clinical trial registries for entries made between Jan 1, 2000, and Dec 31, 2011. We defi ned neglected diseases as malaria, tuberculosis, diarrhoeal diseases, neglected tropical diseases (NTDs; WHO defi nition), and other diseases of poverty according to common defi nitions. Findings Of the 850 new therapeutic products registered in 2000–11, 37 (4%) were indicated for neglected diseases, comprising 25 products with a new indication or formulation and eight vaccines or biological products. Only four new chemical entities were approved for neglected diseases (three for malaria, one for diarrhoeal disease), accounting for 1% of the 336 new chemical entities approved during the study period. Of 148 445 clinical trials registered in Dec 31, 2011, only 2016 (1%) were for neglected diseases. Interpretation Our fi ndings show a persistent insuffi ciency in drug and vaccine development for neglected diseases. Nevertheless, these and other data show a slight improvement during the past 12 years in new therapeutics development and registration. However, for many neglected diseases, new therapeutic products urgently need to be developed and delivered to improve control and potentially achieve elimination

A Large-Scale Distribution of Milk-Based Fortified Spreads: Evidence for a New Approach in Regions with High Burden of Acute Malnutrition

BACKGROUND: There are 146 million underweight children in the developing world, which contribute to up to half of the world's child deaths. In high burden regions for malnutrition, the treatment of individual children is limited by available resources. Here, we evaluate a large-scale distribution of a nutritional supplement on the prevention of wasting. METHODS AND FINDINGS: A new ready-to-use food (RUF) was developed as a diet supplement for children under three. The intervention consisted of six monthly distributions of RUF during the 2007 hunger gap in a district of Maradi region, Niger, for approximately 60,000 children (length: 60-85 cm). At each distribution, all children over 65 cm had their Mid-Upper Arm Circumference (MUAC) recorded. Admission trends for severe wasting (WFH<70% NCHS) in Maradi, 2002-2005 show an increase every year during the hunger gap. In contrast, in 2007, throughout the period of the distribution, the incidence of severe acute malnutrition (MUAC<110 mm) remained at extremely low levels. Comparison of year-over-year admissions to the therapeutic feeding program shows that the 2007 blanket distribution had essentially the same flattening effect on the seasonal rise in admissions as the 2006 individualized treatment of almost 60,000 children moderately wasted. CONCLUSIONS: These results demonstrate the potential for distribution of fortified spreads to reduce the incidence of severe wasting in large population of children 6-36 months of age. Although further information is needed on the cost-effectiveness of such distributions, these results highlight the importance of re-evaluating current nutritional strategies and international recommendations for high burden areas of childhood malnutrition

Type of care and treatment response of children 6–36 months from Guidam Roumdji, by beneficiaries of RUF distribution, Maradi, Niger 2007

<p>Type of care and treatment response of children 6–36 months from Guidam Roumdji, by beneficiaries of RUF distribution, Maradi, Niger 2007</p

Recommended Daily Intakes for infants and nutritional composition of RUF (Plumpy'Doz®)

*<p>Vitamin and Mineral requirements in human nutrition, WHO & FAO, 2^nd edition 2004</p

Monthly percent of annual admissions from Guidam Roumdji (<70% NCHS) to MSF therapeutic feeding programs in Maradi, Niger, 2002–2005.

<p>Monthly percent of annual admissions from Guidam Roumdji (<70% NCHS) to MSF therapeutic feeding programs in Maradi, Niger, 2002–2005.</p

The drug and vaccine landscape for neglected diseases (2000–11): a systematic assessment

Background: In 1975–99, only 1·1% of new therapeutic products had been developed for neglected diseases. Since then, several public and private initiatives have attempted to mitigate this imbalance. We analysed the research and development pipeline of drugs and vaccines for neglected diseases from 2000 to 2011. Methods: We searched databases of drug regulatory authorities, WHO, and clinical trial registries for entries made between Jan 1, 2000, and Dec 31, 2011. We defined neglected diseases as malaria, tuberculosis, diarrhoeal diseases, neglected tropical diseases (NTDs; WHO definition), and other diseases of poverty according to common definitions. Findings: Of the 850 new therapeutic products registered in 2000–11, 37 (4%) were indicated for neglected diseases, comprising 25 products with a new indication or formulation and eight vaccines or biological products. Only four new chemical entities were approved for neglected diseases (three for malaria, one for diarrhoeal disease), accounting for 1% of the 336 new chemical entities approved during the study period. Of 148 445 clinical trials registered in Dec 31, 2011, only 2016 (1%) were for neglected diseases. Interpretation: Our findings show a persistent insufficiency in drug and vaccine development for neglected diseases. Nevertheless, these and other data show a slight improvement during the past 12 years in new therapeutics development and registration. However, for many neglected diseases, new therapeutic products urgently need to be developed and delivered to improve control and potentially achieve elimination. Funding: None

Map of Niger with Maradi region (brown) and Guidam Roumdji district (red).

<p>Map of Niger with Maradi region (brown) and Guidam Roumdji district (red).</p

Prevalence of severe wasting (by MUAC<110 mm) in Guidam Roumdji, Maradi, Niger, 2007.

<p>Prevalence of severe wasting (by MUAC<110 mm) in Guidam Roumdji, Maradi, Niger, 2007.</p

Total number of severely malnourished children (<70% NCHS or MUAC or oedema) from Guidam Roumdji admitted to the MSF treatment program in Maradi, Niger 2003–2007 (in red: treatment of moderate malnutrition with RUTF; in dark green: 6-months RUF distribution).

<p>Total number of severely malnourished children (<70% NCHS or MUAC or oedema) from Guidam Roumdji admitted to the MSF treatment program in Maradi, Niger 2003–2007 (in red: treatment of moderate malnutrition with RUTF; in dark green: 6-months RUF distribution).</p

The marriage of science and optimized HIV care in resource-limited settings

SCOPUS: no.jinfo:eu-repo/semantics/publishe