In addition to a vaccine, IDRI is in the process of creating a blood test that would be able determine whether or not a patient is infected within 10 minutes.

The Seattle Times report includes an interview with Scottish researcher Malcolm Duthie who heads the IDRI leprosy vaccine-development programme. He says, “Our belief is that a vaccine will give an active protection. If we can vaccinate people, we could potentially break the transmission cycle”.

The newspaper has also recently published an article on the activities of the Harborview Medical Center, one of 15 federal clinics in the US focused on patients with leprosy.

The Colombian Institute of Tropical Medicine “Antonio Roldan Betancourt” ICMT-CES is a center of excellence in research, nonprofit, described by COLCIENCIAS full exaltation granted by that organization: Group A1 “Institution of Excellence in research.”

It was founded in 1989 as a Joint Participation Corporation for purposes of public and social interest. Currently the Institute has an operating headquarters in the CES University facilities in the town of Sabaneta and another office located in Apartado - Antioquia.

The ICMT is managed by the University of Medellín CES, an institution renowned for the quality of its academic programs and unconditional support to the development of research and science, as well as the provision of services, consulting and advisory services in the Colombian health sector and Latin America.

ICMT-CES Mission Working continuously for the development of science, through research and academic training of health professionals, with the aim to contribute actively in improving the health of the citizens.

Our Institute has international recognition, thanks to the work associated with other research institutions and the many publications of scientific contribution.

ICMT-CES focuses its research activities in all areas of Tropical Medicine, based on epidemiology and immunology of infectious diseases, supported by the most advanced techniques of molecular biology for diagnosis. They stand out for their development research in progress: leishmaniasis, Chagas disease, intestinal parasites, salmonellosis, leprosy, tuberculosis, malaria, cysticercosis, dengue, leptospirosis, diagnostic methods, medical entomology and brucellosis.

The focus is generally upon Africa. For example, in the best-selling book The Bottom Billion, it was argued that the countries in which the poorest one billion people live are almost all in Africa. New research suggests, however, that a large proportion of the world’s ultra-poor are in India. The Guardian (UK) reports that specialists at Oxford University have devised a new “multidimensional poverty index”, according to which there are more poor people in eight of India’s states than in the 26 countries of sub-Saharan Africa combined.

The index uses 10 major variables including education, nutrition and sanitation. According to the index, more than 410 million people live in poverty in the eight Indian states, and the intensity of the poverty is equal or worse than what is found in Africa. For example, the Democratic Republic of the Congo (population 62 million) is perhaps the poorest nation in Africa, but India’s vast central Indian Madhya Pradesh state (70 million) has a near-identical level of poverty.

Many laudable efforts have been made in recent years to address poverty and disease in Africa. India’s poor, in comparison, have been neglected. This is all the more tragic, given the impressive growth of India’s national economy.

From the research perspective, India’s needs must help shape the agenda. Vivax malaria, dengue, visceral leishmaniasis and leprosy are amongst the infections which threaten the poor in many parts of India.

Writing in PLoS Neglected Tropical Diseases, Peter Hotez, President of the Sabin Vaccine Institute and Distinguished Research Professor of The George Washington University Medical Center, and Bernard Pecoul, Executive Director of Drugs for Neglected Diseases initiative (DNDi), outline in eight points why the global community should increase financial support for NTD control and elimination efforts and research and development.

The manifesto states that:

·      All NTDs are “tool ready” with cost-efficient and effective interventions that could be implemented now, even if for some diseases such tools are far from being perfect or complete.

·      At the same time that NTDs are tool ready they are also tool deficient, signifying that the tools are incomplete, or inadequate, to sustain elimination efforts.

·      NTDs have received little attention from the international community during the past ten years despite their large disease burden.

·      Increasing evidence indicates an association between NTD prevalence and conflict and violation of human rights.

·      NTDs can be particularly destabilizing and disrupt agricultural productivity and food security. Many poor societies with high NTD burdens have been recently engaged in a civil or international conflict or are currently at war.

·      Sustained involvement by the WHO and other international health agencies is crucial for current and future NTD control and elimination efforts.

·      Nothing is more important to the success of global NTD control than the involvement of communities themselves and disease-endemic countries’ health ministries.

·      Achievement of Millennium Development Goal 8 (”develop a global partnership for development”) will rest with stakeholders — health ministries, affected communities, public–private partnerships, large and small non-governmental organizations, etc. — establishing a well-functioning international strategy for NTD control.

While acknowledging that policymakers are “slowly beginning to appreciate the importance of NTDs” — evidenced by the creation of a new department of Neglected Tropical Diseases at the World Health Organization; TDR’s 10-year strategic plan; and the identification, by NIH’s Francis Collins, of neglected diseases as a research priority, among other developments — Hotez and Pecoul argue that the challenge of NTDs calls for a manifesto — “a public declaration of motives by a government or by a person or group regarded as having some public importance.”

Moreover, they add, by doing more to tackle NTDs, the global health community can make progress toward Millennium Development Goals.

“[NTD control] activities have facilitated the delivery of additional interventions such as insecticide-treated bed nets, antimalarial drugs, micronutrients, and childhood immunizations,” they write.

The authors urge scientists working on NTDs to increase collaboration and identify funding opportunities and cost-efficient interventions.

“By highlighting important challenges in the fight against NTDs, this ‘manifesto’ calls on the global community for urgent, renewed, and innovative efforts.”

Reference
1. Spiegel JM, Dharamsi S, Wasan KM, Yassi A, Singer B, et al. (2010) Which New Approaches to Tackling Neglected Tropical Diseases Show Promise? PLoS Med 7(5): e1000255. Available from: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000255

The World Health Organization defines leprosy elimination as reducing the level of prevalence to below one in 10,000 of the population. Most of the countries that were formerly highly endemic for leprosy have now achieved elimination by this definition, but many of those same countries (most notably India) still have many cases of leprosy. According to the article, many countries stepped down their efforts against leprosy once the elimination target had been reached. In consequence progress against the disease, of which there are still around a quarter of a million new cases every year, has thus suffered.

The article also refers to a new report from WHO’s Southeast Asian Regional Office (SEARO) which puts forward a new strategy for further reducing the disease burden due to leprosy. Most notably, under this strategy, the rate of new cases with grade-2 disabilities among new cases per 100,000 population would be used as a key indicator to monitor progress.

TropIKA.net’s own coverage of World Leprosy Day 2010, which emphasized the role of research, may be accessed here.

Saint Damien won recognition for his ministry to people with leprosy (also known as Hansen’s disease), who had been placed under a government-sanctioned medical quarantine on the island of Molokai in the Kingdom of Hawaii. He eventually contracted and died of the disease in 1889.

Since Saint Damien’s time, much progress has been made against leprosy but many barriers still need to be overcome before the disease is eradicated. Over 200,000 people worldwide are registered with leprosy and some two to three million people are estimated to be permanently disabled as the result of the disease. India has the greatest number of cases, with Brazil second and Burma third. Stigma, even against people who no longer have leprosy, holds back control efforts.

Highlighting the work of Saint Damien may help renew global efforts to fight the disease.

Commenting on the canonisation, President Barrack Obama said Father Damien’s life should stand as an example for how to deal with modern-day diseases - see ABC News report.

Obama’s comments are of interest given that the President, who of course was born in Hawaii, has chosen to increase the funding that the US provides for the control of neglected tropical diseases - see TropIKA.net News.

The announcement was made at the annual meeting of the Clinton Global Initiative in New York - see press release.

The meeting heard that soil transmitted helminths and Chagas disease cause the greatest NTD burden in the Americas, followed by dengue, schistosomiasis, leishmaniasis, trachoma, leprosy, and lymphatic filariasis. More than 230 million people in the region are currently living with these devastating diseases.

Partners involved in the new initiative range from the Brazilian soccer team to pharmaceutical giant GlaxoSmithKline (GSK) and Partners for Philanthropic Change.

GSK has also recently announced that it will provide Brazil with some of its vaccine technology and also fund research in Brazil for a vaccine for dengue fever - see Wall Street Journal.

According to the laws of some Indian states they cannot hold a driving licence, travel by train or stand in local elections. Having leprosy is also grounds for divorce. The employment that people affected by leprosy are allowed to perform is restricted, and the restrictions remain even years after a person has been cured.

An article in the Hindu newspaper calls for the antiquated laws to be changed.

Leif Kirsebom and colleagues say they have now shown that, not M. tb. but a ‘close relative’, can form spores. Apparently their discovery was initially an accidental finding. The research has not yet been published but is expected to appear shortly in the Proceedings of the National Academy of Sciences. It is to be hoped that this new knowledge of the Mycobacteria might ultimately lead to new ways to control TB and other mycobacterial diseases in humans and animals. These include leprosy and Buruli ulcer.