Neglected Tropical Diseases

Lord Patel Excerpts

Monday 1st February 2016 Lords Chamber

[Lord Patel (CB)]

My Lords, I am going to concentrate mainly on strategies to develop treatment for neglected tropical diseases. I am a doctor by background, as everyone knows. I was born in Tanzania and I visit there often in relation to charity. Last year, I was bitten extensively by the flies that carry sleeping sickness and every time I doze off I wonder if I caught it, so I am concerned about finding treatments.

Effective control against NTDs can be achieved if several public health approaches are combined, guided by local epidemiology and the availability of appropriate detection, prevention and control measures. Due to the nature of many of the parasites that cause NTDs, it has proved very difficult or impossible to develop vaccines that are suitable for mass administration. Other approaches are therefore required, and we are familiar with them, including: vector control, such as spraying to kill insects; strategies to reduce contact with insect vectors, such as bed nets; improved hygiene, housing and new drugs; and, more recently, as the House of Lords Science and Technology Committee report suggests, the genetic modification of insects, and today’s news about gene editing, which can also apply to insects.

To reduce the burden of NTDs using drugs, we must address three main urgent issues. First, many current drugs to treat NTDs are extremely toxic and difficult to administer. Secondly, many drugs now simply do not work because parasites have become resistant, for a variety of reasons. Thirdly, disease diagnosis remains challenging. Additionally, the development of new treatments for NTDs is hampered by a historic lack of systemic drug discovery, due to the lack of a commercially viable market for drugs and insufficient understanding of parasite biology, resulting in a lack of validated drug targets—that is, good approaches to develop drugs.

Three years ago my university, the University of Dundee, made a commitment that by 2020 it would try to find cures for some of these diseases. To tackle those issues, the university has combined renowned scientists with expertise in NTDs with professional drug discovery within its drug discovery unit, mainly recruited from pharmaceutical industry and led by Professor Paul Wyatt. I declare an interest: not only have I been an associate of the university since I went there as a medical student, but I am now chancellor of the university. With support from organisations like the Wellcome Trust and the Gates Foundation, Dundee has been making good progress across the areas. A new and exciting antimalarial compound has recently been developed, with the potential not only to cure but to prevent and block the transmission of malaria with a single dose, and it is now going to clinical trials.

These are some examples, but the main thing is that, with support from the Gates Foundation, the university has made available a set of 70,000 compounds to initiate new drug discovery programmes for multiple NTDs. The new team is using cutting-edge technologies to determine the mechanisms by which drugs kill parasites. I hope that such strategies will lead to finding cures for many of the NTDs. To quote Richard Horton, editor-in-chief of the Lancet, in praising Dundee University’s effort:

“Something very special is taking place in Dundee … a drug discovery unit for parasitology … has torn down disciplinary walls to put chemists next to biologists, industry scientists beside academics. The result is a portfolio of promising new medicines for malaria”.

I hope that the Ross Fund will be used to fund clinical trials when the time comes, because there will be no other way of doing so.