The Nobel Prize 2015: A Resurgence of Neglected Tropical Diseases Research

By Siwei Zhang

In the early hours of October the 5th, Professor Urban Lendahl, secretary of the Nobel committee for physiology or medicine, continued with the century long tradition of announcing the winners of the first category of the Nobel Prizes 2015: The prize in physiology or medicine. This year, the prize will be jointly awarded to William C. Campbell and Satoshi Ōmura for their discoveries “concerning a novel therapy against infections caused by roundworm parasites” and to Youyou Tu for her discoveries “concerning a novel therapy against Malaria”. In other words, anti-parasite drugs, which are members of a broader category of medicines aimed at the prevention and treatment of neglected tropical diseases (NTDs), have swept all three medals for this year.

By the definition of WHO, NTDs are “a diverse group of diseases with distinct characteristics that thrive mainly among the poorest populations”. Such NTDs are currently endemic in 149 countries affecting more than 1.4 billion people and, needless to say, are imposing another heavy burden to the already crippling economies of developing countries. Their causes include mainly three categories: parasites (protozoa/helminth) such as Schistosomiasis, bacteria such as leprosy and yaws, and viruses such as Dengue and rabies. Whilst researches dedicated to the understanding, prevention, and treatment of these diseases can be traced back to more than 100 years ago, as marked by the establishment of the London School of Tropical Medicine (later London School of Hygiene and Tropical Medicine), the most intensive efforts were taken between the 1960s-1980s. The avermectins, a class of compounds discovered by William C. Campbell and Satoshi Ōmura that kill parasitic roundworms were developed during the 1970s. It is almost the same time that the Lasker Prize winner Youyou Tu extracted artemisinin from the plant Artemisia annua and developed the artemisinin-combination therapies (ACTs) targeting malaria.

However, despite an extensive stimulation plan to make continued incentives for NTD research from the beginning of 1980s as marked by the Orphan Drug Act 1983 and the Rare Disease Orphan Product Development Act 2002, the R&D investment of NTDs dramatically recessed after the 80s. One study indicated that out of 325 approved orphan drug products approved by the FDA between 1983 and 2008, only 2 of them were for NTDs. Generally, health analysts agree that there is a lack of incentives for major pharmaceutical companies to invest and develop NTD products mainly due to the very low profit margins of such products and significant threats from generic drugs.

However, it should be noticed that, the situation has changed significantly since 2010 as resurgent interests have been focused on NTD research. Such changes are partly due to an influx of smaller biopharmaceutical companies that took the vacuum left by giants. More importantly, there was an increasing concern that North America and Europe – continents that have been long-considered free of plagues from such NTDs, are facing another rising wave of infectious diseases. More worrying is that unlike the common assumptions that such infectious diseases, such as river blindness and leishmaniosis, were brought into the countries by careless travellers, many patients were found to have never left their home countries for years. For example, The Smith Clinic, a clinic specialized in the treatment of NTDs, operating in Houston, has admitted countless NTD patients from the neighboring areas. In other words, such NTDs are now becoming “home-brew”, and any endemic outbreak would catch millions of ordinary people completely out of darkness. This is especially problematic for people born after the 1990s, as immunizations against such “extinct” diseases have ceased since their birth. Such concerns brought in dramatic changes in the field, from the publication of the PLoS Neglected Tropical Diseases, an open-access, peer-viewed journal dedicated to NTDs research and to the establishment of USAID’s NTD program jointly supported by a group of concerned entities including the CDC, the Carter Center, Merck, Pfizer, and Johnson & Johnson. Moreover, the main theme of the Nobel Prize for Physiology or Medicine this year is expected to further consolidate such concerns and raise the awareness of the government and public. Any keen investors or biotechnology/biopharmacology-related entrepreneurs should keep close observation on the current situation and seek for potential opportunities at this transitional era.


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