Diseases know no borders, neglected ailments do not always affect people thousands of miles away, and calling them “neglected” should not mean they disappear from the agenda of those with the money and power to change society’s priorities. global health. Indian scientist Kavita Singh, Director for South Asia of the Drugs for Neglected Diseases Initiative (DNDi), arrived in Oviedo with this news, receiving the Princess of Asturias Prize for International Cooperation this Friday. The entity was honored for its work in research and development of new “affordable and easy-to-use” treatments for those suffering from any of these 20 diseases, a total of 1,000 million people worldwide, according to the World Health Organization (WHO).
On the list of these diseases, most registered in poor places in the tropics, are visceral leishmaniasis, a parasitic disease, and dengue transmitted by mosquitoes, which take up part of the work of this 54-year-old woman. Singh celebrates small victories in these 20 years of DNDi’s journey, but prefers to focus on what remains to be done. “Our work will only be complete when a patient from a city lost in a tropical country has a diagnosis and access to the best medicine that exists for his disease without having to travel long distances,” he emphasizes in this interview he conducted. by phone..
Ask. Neglected disease is not synonymous with distant disease.
Reply. Of course it’s not. I personally believe that they are not where they should be on the global health agenda. Funding organizations also do not give them the importance they should. I hope this award serves to bring attention to these ailments. Many of these are diseases that are greatly affected by climate change and we know that they will change in the coming years. Treating neglected diseases benefits everyone, not just the region that suffers from them today.
P. Can you give an example of the effect of climate change on the development of these diseases?
R. For example, the course of dengue fever and other diseases is changing with climate change. We didn’t have so many cases or so many deaths in our South Asian region before. More than 1,000 people have died of dengue fever in Bangladesh this year. Those are numbers we haven’t seen in decades. The same is happening in Sri Lanka or Pakistan, where thousands are infected. Healthcare systems are collapsing due to high patient numbers and we inevitably lose patients.
Treating neglected diseases benefits everyone, not just the region that suffers from them today.
Kavita Singh, DNDI
P. DNDi has just formed a Global Dengue Alliance with institutions from several countries such as India, Thailand, Malaysia and Brazil to precisely accelerate research and implementation of treatments for the disease over the next five years. Is this also an example of the effectiveness of South-South cooperation?
R. The knowledge, experience and years of work in the fight against dengue fever are in the southern countries because that is where most of the patients are, so the trials must take place in those countries. It’s not that we want to leave out the northern countries, but it’s an initiative to work together, to progress faster and to get a real cure for this disease because it doesn’t exist yet. We limit ourselves only to alleviating the pain and symptoms of the sick. We must not forget that today dengue occurs mainly in tropical countries, but with climate change, the vector may change and the presence of the disease may also change.
Most of these neglected diseases attack already impoverished communities and make them even poorer. It’s a hell of a cycle
P. Has the treatment of these diseases and their availability improved in South Asia in the 20 years of DNDi?
R. Every disease is different. Some are now being reviewed and removed from the list of public health concerns. Others have a treatment but it does not reach the population, and there are others for which the best treatment does not yet exist, as is the case with Chagas disease. In the case of sleeping sickness, DNDi has done an incredible job with a drug that cannot yet be applied to all forms of the disease. Most of these 20 neglected diseases attack already impoverished communities and make them even poorer. It’s a hell of a cycle. Therefore, our work will only be complete when a patient from a remote city in a tropical country has a diagnosis and access to the best medicine that exists for their disease without having to travel a long way.
Women are at a disadvantage in accessing medicines and in many cases do not have it as easy as men.
P. What are India’s biggest challenges right now in fighting these neglected diseases?
R. We always talk about the region because diseases and vectors know no borders. In the last 20 years, we have made great progress in the treatment of visceral leishmaniasis, also known as kala random. Before we had the three treatments, we did a study to compare their effectiveness, and we saw that a single dose of the drug, liposomal amphotericin B, showed very high efficacy and should be the first option. This recommendation was included in national programs and changed the landscape and above all reduced the number of deaths. For example, in India there were 18,000 deaths per year in 1990 and now there are around 800. The disease has complications and years later patients develop another variant, called Postkala-azar Dermal Leishmaniasis (PKDL, abbreviated in ), which causes severe skin lesions . At the moment, the clinical trial is over and we are closer to introducing a simpler treatment without side effects. Reducing this disease and its early treatment also means stopping the social marginalization of the affected, especially children and women.
P. Do these neglected diseases affect more women?
R. Not from a strictly medical point of view, but women are restricted in their access to medication and in many cases do not have it as easy as men. Moreover, they are more afraid to disclose their illness because of the weight of the society in which they live. For example, if a girl or woman has skin lesions, it is not so easy for them to leave their home and seek treatment. That’s why education is almost as important to us as receiving effective treatment.
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