Glaxo, Merck developing drugs for 'kala azar'

Heard of kala azar or leishmaniasis? Chances are you haven’t.  Amid cancer, diabetes, strokes, flu, arthritis, etc, this life threatening disease, which affects millions of poor people in the world, finds negligible public attention or favour with drugmakers.

Data from the World Health Organisation (WHO) shows that about 350 million people are at risk of kala azar, which is transmitted by sandflies, and about 51,000 people estimated to be dying of it.

But with only very drugmakers investing time and money into research for kala azar, the WHO has classified it as a neglected tropical disease.  However, British major GlaxoSmithKline (GSK) and US behemoth Merck & Co are some of the few companies that have entered into agreements with a not-for-profit organisation for discovery and development of improved treatments for kala azar.

The two players, as also the Tata group promoted Advinus Therapeutics, have collaborations with Geneva-based not-for-profit organisation Drugs for Neglected Diseases initiative (DNDi) for compounds for this disease.

Says a GSK spokesperson, “There is a need for more basic research into neglected tropical diseases.” Rashmi H Barbhaiya, CEO and MD of Advinus, says that in partnership with DNDi, the company is looking for an oral drug for kala azar that does not require hospitalisation and is cost effective for patients.

According to Sujay Shetty, associate director, PricewaterhouseCoopers (PwC), in future, diseases such as kala azar cannot be ignored as they are a huge burden.  “If companies are looking at expanding their footprints in markets such as India, they have to have a focus on neglected diseases though they are not very profitable.”

Muhammad Shaffi, deputy medical coordinator at international humanitarian organisation Medecins Sans Frontieres-Spain, says, “The disease affects the poorest of the poor, which represents an unattractive market because most of the people cannot afford to pay for the drugs.”

India, along with Bangladesh, Brazil, Ethiopia, Kenya, Nepal and Sudan, is amongst the worst affected, with 90% of new cases being reported in these seven countries, according to DNDi.

Says C P Thakur, former union minister of health and family welfare, “31 districts in Bihar, 4 in Jharkhand, 5 in Uttar Pradesh, and 10 districts in West Bengal are worst affected, apart from a few cases in Assam and Gujarat.” The current treatments, which have problems such as toxicity, are difficult to administer, apart from being expensive, says Shaffi.

Moreover, drugs like amphotericin B are given through the intravenous route, while miltefosine can’t be given to pregnant women, says Thakur.