Leishmaniasis is a parasitic disease spread by sand flies that causes large, painful skin lesions. Other, more serious forms of the disease are mucocutaneous and the generally fatal visceral. It overwhelmingly impacts poor communities in tropical regions of Asia, Africa and Latin America.
Current treatments are antiquated, toxic, and difficult to administer over the long course required, often 20-30 painful injections. Many patients fail to complete treatment, allowing the parasite to become resistant and spread in their communities.
After over a century of stagnation, there is finally progress towards better cures. Researchers at a small Colombian institute — the Program for the Study and Control of Tropical Diseases, or PECET, based at the University of Antioquia in Medellín — have partnered with an international nonprofit — the Drugs for Neglected Diseases Initiative, or DNDi, based in Geneva — to develop experimental oral medications.
One of these treatments cured patients in days with minimal side effects during small trials. DNDi has five drugs for leishmaniasis in phase 1 trials, and one in phase 2. However, the lack of commercial viability has blocked the global medical establishment from conducting larger studies required for regulatory approval.
The system created to incentivize development of profitable drugs for wealthy markets has neglected diseases like leishmaniasis that primarily impact the poor. But growing research capacity in middle income countries promises more relevant and accessible treatments if political will can fund later phase trials. Climate change also threatens to spread the sand fly habitat to new regions, increasing the urgency for an updated medical arsenal against this plaguing parasite.