global forum for health research mumbai, september 12 to 16 2005 1 rob ridley director, tdr...

Global Forum for Health ResearchMumbai, September 12 to 16 2005

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Rob Ridley

Director, TDR

Sustaining Priority Research for Neglected Tropical Diseases


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• To undertake research, development and evaluation of new and improved tools and interventions to fight major tropical diseases

• To strengthen research capabilities in countries where these diseases are endemic– enhanced stakeholdership / ownership of research

TDR 'twin' Mission


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A vicious cycle


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Many 'Neglected Diseases'

•Infectious and Parasitic diseases 10 904 (000)•HIV/AIDS 2 777 ¨•Diarrhoeal diseases 1 798 ¨•Tuberculosis 1 566 ¨•Malaria 1 272 ¨•Childhood diseases 1 124 ¨•STI (excluding HIV) 180 ¨•Meningitis 173 ¨•(Other) Tropical Diseases 129 ¨•Hepatitis B 103 ¨•Hepatitis C 54 ¨•Dengue 19 ¨•Japanese encephalitis 14 ¨•Intestinal nematode 12 ¨•Leprosy 6 ¨

Mortality Estimates for 2002 (World Health Report 2004)


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'Neglected' Diseases affect 'Neglected' Populations


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Priority Setting


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Strategy ??

Tropical DiseaseBurden

Poverty

Control/EliminationOf TropicalDiseases

Poverty

reduction


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NIH, Trust, Research councils

etc.

Grand Challenges

Innovation to Impact


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NIAID Funding in Infectious & Parasitic Diseases (1998-2003) as Defined by

WHO World Health Report 2004-Changing History

0

0.5

1

1.5

2

2.5

3

3.5

4

1998 1999 2000 2001 2002 2003

FISCAL YEAR

$ (B

illi

on

s)

The World Health Report 2004-Changing History (http://www.who.int/whr/en/; Statistical Annex, Table 3 Burden of Disease in DALYS by cause, sex and mortality stratum in WHO Regions, estimates for 2002 (http://www.who.int/whr/2004/annex/en)

62% 60% 60% 60% 55% 43%

Infectious & Parasitic Diseases Funding

Total NIAID Funding

NIAID BioD Funding

Need to sustain and increase basic science funding


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Product Development


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Drug Reg Indication PartnersNifurtimox 1972 Chagas disease BayerOxamniquine 1973 Schistosomiasis PfizerPraziquantel 1976 Schistosomiasis Bayer / TDRBenznidazole 1978 Chagas disease Hoffman La RocheMulti-drug therapy 1980 Leprosy Ciba-Geigy / TDRAlbendazole 1981 Intest parasites, LF Smith Kline BeechamMefloquine 1984 Malaria Hoffman La Roche, WRAIRIvermectin 1987 Onchocerciasis Merck / TDRHalofantrine 1988 Malaria Smith Kline Beecham, WRAIREflornithine 1991 African Trypanosomiasis Marion Merrel Dow / TDRLiposomal amphotericin B 1994 Leishmaniasis (Kala azar) NeXstar / TDRArtemether 1997 MalariaRhone Poulenc Rorer, Kunmig /TDRArtemether-lumefantrine 1999 Malaria NovartisAtovaquone+proguanil 2000 Malaria Glaxo WellcomeArtemotil (beta-arteether) 2000 Malaria Artecef, WRAIR / TDRMiltefosine 2002 Leishmaniasis (Kala azar) Zentaris, Indian CMR / TDRChlorproguanil-dapsone 2003 Malaria Glaxo Smith Kline / TDR

Examples of public private partnerships that have delivered new tools


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MicrobicidesMMV

IAVIFIND

GATB

MVI

EDCTP

DNDi

Innovation to Impact – product development


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• 8 new drugs anticipated by 2010

• Proposed fund of $200M per year to complement PPP's

Product Development Activities Need Sustaining


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Much variation by disease (e.g. Gates)


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Evaluation and Implementation Research


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• Onchocerciasis– Ivermectin and Community Directed

Treatment

• Malaria – Home management of malaria strategies

• Visceral Leishmaniasis– Tools in place for 'elimination'

programmes

Examples of TDR – mediated evaluation and implementation research

A critical area for future funding given increase of tools in pipeline


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New tools stimulate India / Nepal / Bangladesh to sign MoU for elimination of VL by 2015

• Local ownership of research critical• Recognition of significance of social,

economic and behavioural research• Research must be embedded in and

owned by countries and integrated into health systems

• Inter-country coordination facilitated by WHO / SEARO / TDR

• Requires a co-ordinated approach by partners for maximal impact

Example in progressVisceral Leishmaniasis


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Look beyond single issuesManaging Interfaces


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• Maintained funding for basic science, continued innovation and PPP product development– Better balance for more neglected diseases– Better management of translation research

• Enhanced Evaluation and Implementation Research for all diseases

• Enhanced coordination and interaction between initiatives, funding agencies, governments and regional bodies – Role for international agencies

Challenges No. 1


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Look beyond single issuesCross-cutting issues


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• Need capacity building coupled to capacity utilisation

• Need to enhance country participation, 'stakeholdership' and ownership of research

• Need to 'embed' the output of research activities within the institutions of developing countries

• Need to enhance capabilities of developing countries to engage in 'innovation' as well as implementation

Challenges No. 2


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Use-inspiredResearch

global forum for health research mumbai, september 12 to 16 2005 1 rob ridley director, tdr...

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