Thursday, June 28, 2018

Funding for new drugs endemic to Africa available

New funding that will be given through a call for proposals for the discovery of new drugs for diseases endemic to Africa over the next two years is now available.

The Drug Discovery funds is up to $100,000 per project to researchers in Africa to identify new drug candidates, particularly for malaria, tuberculosis and neglected tropical diseases.

The funding will also be used to create a network of drug discovery as well for development scientists that will initiate, develop, share, evaluate and disseminate best approaches and practices within the research community in Africa.

The African Academy of Sciences (AAS), University of Cape Town (UCT) Drug Discovery and Development Centre (H3D), Medicines for Malaria Venture (MMV) and the Bill & Melinda Gates Foundation have committed funding for the discovery of new drugs for diseases endemic to Africa over the next two years.

This is the third call for proposals administered by the AAS’ Grand Challenges Africa (GC Africa), a scheme implemented through the AAS and the NEPAD Agency’s Alliance for Accelerating Excellence in Science in Africa (AESA).

"This partnership will benefit Africa by developing the capacity and augmenting efforts to discover and develop drugs for diseases that are prevalent on the continent and are otherwise being affected by a market bias that has seen drug discovery efforts on the continent hampered," said the AESA / Director of Programmes Prof Tom Kariuki.

Africa represents 17% of the world’s population but bears a disproportionate 25% of the global disease burden with sub-Saharan Africa carrying 90% of the global cases of malaria while 2.5 million who fell ill with TB in Africa in 2016 represented a quarter of new TB cases in the world.
Drug resistance is also compounding the disease burden requiring for Africa to build capacity and step up drug discovery activities.

The new funding will be given to projects that identify new chemical entities with potential for drug development in diseases of local relevance for Africa and to expand institutions' drug discovery research capacity. 

Selected applicants will also benefit from a network of drug discovery scientists in Africa and across the globe, linking them to peers, mentors and providing them with access to resources and technologies

Prof Kelly Chibale - Founder and Director of Drug Discovery and Development Centre, H3D at the University of Cape Town, said: “The attractive aspect of this programme is that it focusses on highlighting and investing in those who are present on the continent. The partners involved are proactively seeking to identify and fund talented African-based scientists to succeed and not to merely survive.

This will result in an effective increase in the numbers of productive and contributing African drug discovery scientists as well as an increase in the quality and impact of drug discovery science generated in Africa by Africans.”

“Medicines for Malaria Venture (MMV) is proud to support the effort to identify new drug candidates for the big three diseases of malaria, tuberculosis and Neglected Tropical Diseases via this call for proposals,” said Dr. Timothy Wells, MMV’s Chief Scientific Officer.

“At MMV, our focus is on bringing forward the next-generation of medicines to help defeat malaria. Through these grants, together with our partners, we aim to support the next-generation of African scientists to get involved in this endeavor for malaria as well as other diseases.”

Tuesday, June 26, 2018

Uganda introduces rotavirus into routine vaccination

Uganda has today launched a new rotavirus vaccine to protect under five-year-old children from diarrhea.

An estimated 10,637 children under five years of age die in Uganda each year due to rotavirus diarrhea. Diarrhea is among the top ten causes of morbidity in Uganda, with rotavirus being responsible for about 40% of all diarrheal cases.

The vaccine, which will be available for free in health facilities throughout the country, is the 11th vaccine to be added into the national schedule of the expanded programme on immunization in Uganda.

Rotavirus vaccine is safe and can be administered simultaneously with other routine infant vaccines. It is given orally and requires two doses at 6 and 10 weeks of age, with an interval of at least 4 weeks between doses.

“This vaccine will help save the lives of thousands of children in Uganda by combating severe diarrhea,” said Gavi Deputy CEO Anuradha Gupta.

“The introduction of rotavirus vaccine marks a key milestone in the country’s commitment to improving the health of all children and I’d like to commend the Government for its efforts to provide a bright future for Uganda’s next generation.”

Speaking at the launch of the vaccine in Buikwe, the Minister of Health, Honorable Dr. Jane Ruth Aceng, announced that Rotavirus vaccine is now available in Uganda. She appealed to Ugandans to take their children at 6 weeks and 10 weeks of age for rotavirus immunization to the nearest health facility.

“WHO emphasizes the use of Rotavirus vaccines to be part of a comprehensive strategy to control diarrhea diseases with the scaling up of both prevention and treatment packages,” said WHO Representative Dr. Yonas Tegegn Woldermariam.

The UNICEF Representative in Uganda, Dr. Doreen Mulenga, congratulated the Ministry of Health for making further progress in securing children’s health by introducing a rotavirus vaccine into its national immunization programme and said that vaccination is one of the best ways to protect children from serious childhood diseases.

The introduction of the rotavirus vaccine into the routine immunization schedule has been financed by Gavi, the Vaccine Alliance, with technical support from WHO and UNICEF.

Rotavirus infection is the leading cause of diarrhea in children under five and it is highly contagious. It poses an exception to typical diarrheal disease management rules.

While improved access to clean water and better sanitation and hygiene practices are vital to preventing most diarrheal diseases, they have done little to disrupt rotavirus infection. The virus may cause severe, dehydrating diarrhea in young children and, in untreated cases, lead to death.

Globally, according to the World Health Organization, an estimated 450,000 children under five years of age die each year from vaccine-preventable rotavirus infections.

Tuesday, June 19, 2018

Another sickle cell treatment option now available to Ugandans

By Esther Nakkazi

Today, 19th June is world sickle cell day and from this year hydroxyurea, arguably the most significant breakthrough in sickle cell treatment ever is now on the list of essential drugs in Uganda.

That means it is now more available in drug shops and that brings the price down to a third of the original price, to Ushs 3,000 per tablet from Ushs 10,000 although this does not necessarily mean its affordable and it is not yet available in public health facilities.

As well it does not mean that it will be prescribed to everybody who’s eligible as Ugandan doctors like elsewhere in the world may not necessarily want to prescribe hydroxyurea because it is given in the most maximum tolerated doses and requires continuous blood tests.

Hydroxyurea was approved for sickle cell treatment in 1998 by the FDA and was originally and it still is a cancer drug which increases healthy forms of oxygen-carrying hemoglobin, resulting in less organ damage and fewer pain crises, transfusions, and emergencies for sickle cell patients.

Specialists doctors who are supposed to treat sickle cell disease, hematologists, are hard to come by so most patients are seen by clinicians except for a few dedicated doctors like Prof. Christopher Ndugwa, a paediatrician now known to many as the ‘Uganda grandfather of sickle cell disease’. He has trained about 80 percent of the doctors who treat sickle cell disease in Uganda.

Sickle cell is a multi-organ disease. When patients get an attack they go through a vaso-occlusive crisis in which sickle-shaped red blood cells clog the vessels and cut off oxygen to joints and organs. The inadequate blood supply triggers excruciating pain, damages vital organs and causes a stroke.

Sickle cell disease has been declared a major public health problem for sub-Saharan Africa by the World Health Organization.

The intensity of the disease was unknown until a study was done which prompted action and institution of policy. Now after 20 years since its approval, the now called wonder drug to Ugandans is no longer scarce and here are some efforts that led to policy, treatment changes and action.

In 2014, the Ministry of Health carried out a survey to profile the sickle cell trait and sickle cell disease across Uganda. To date, Uganda is the only African country with current national prevalence data, which was also been published in a leading medical journal, the Lancet.

The survey found scary statistics; at 15,000 to 20,000 babies are born with sickle cell disease every year in Uganda and 80 percent of them die before their 5th birthday. It further documented a high sickle cell burden with a national trait average of 13.3 percent and a disease burden of 0.73 percent.

The research earned Uganda a reward. It was nominated to host the 6th International Symposium on Sickle Cell Disease (REDAC 2016). Mass screening, patient management, early testing, pre-marital counseling and sensitization campaigns were created.

On 16th March 2017, the Minister of Health, Dr. Jane Aceng presented a Ministerial Statement to parliament about the situation of sickle cell in Uganda. The shocked parliamentarians pledged to support it in terms of allocations of funds to the budget, creating awareness and policy.

They requested that equipment be available to screen at birth for sickle cells in all regional hospitals and a budget be allocated so that funding for sickle cell treatment is not left to donors as was the practice.

Aceng informed them that the Ministry of Health had in fact already set up a national programme to screen newborn babies and children below two years in high prevalence districts and a National Sickle Cell reference laboratory with the capacity to run 8,000 samples at ago was operational.

Aceng also appealed to the Buganda kingdom to collaborate with the Ministry and create awareness. The study showed that Buganda was one of the high burden regions with a prevalence of 20 percent and disease burden above 1.5 percent.

The Kingdom of Buganda agreed to provide support to which they accepted to use Sickle Cell Anaemia treatment drives as a theme in the Kabaka Birthday Run for the next three years.

As such the 2017 edition of the Kabaka’s birthday run launched by the Katikkiro of Buganda Charles Peter Mayiga, he equated the lack of awareness to the early HIV days. He said people referred to sicklers as 'offsprings of parents with bad blood or those that are cursed'. That year the funds from the birthday run went to support sickle cell.

More efforts continued like lobbying from civil society organizations like HEPS Uganda and now finally hydroxyurea is on the table in Uganda. However, elsewhere more treatment options are becoming available.

Endari, a nutritional supplement which has been shown to relax the stiff, sickle-shaped red blood cells of people with the disease is now the newest drug on the market. Another treatment option that still needs to go through clinical trials is CRISPR or gene editing therapy. This can be used to edit the sickle mutation in blood stem cells so they produce more fetal hemoglobin, which can reduce the severity of the disease.

It would be interesting to know if Ugandans would participate in the CRISPR sickle cell clinical trials if they got here. But all we know there is hope after all more treatment options are on the way.