Results and milestones

In 2011, just under 2 billion people (1.9 billion) required interventions against NTDs. This figure dropped to 1.5 billion in 2016, representing a decrease of over 400 million who no longer require preventive chemotherapy.

The R&D-based biopharmaceutical industry pledged 14 billion donated treatments to control or eliminate the ten NTDs responsible for more than 90% of the global NTD burden. Year on year, biopharmaceutical companies have met their commitments; 1.8 billion treatments were donated in 2016 alone. 17 billion USD worth of medicine donated by the R&D-based biopharmaceutical industry, making this partnership one of the most cost-effective programmes in public health.

With the record-breaking drug donation programmes that are a cornerstone of the London Declaration partnership, countries are eliminating these diseases, thereby reducing the overall public health burden. The drug donation programme was recently recognized in the Guinness Book of Records as the largest of its kind in history, with the most medicines donated in a 24-hour period. Through these combined efforts, the following milestones have been achieved;

In 2016, 1 billion people received treatment for at least one NTD.

In 2016, only 2,184 cases of sleeping sickness (Human African trypanosomiasis) were reported worldwide, down from 6,747 in 2011.

In 2017, there was a 98% reduction in Guinea worm cases, from 1,060 in 2011 to 26 cases

In 2017, four countries – the Marshall Islands, Thailand, Togo and Tonga – eliminated Lymphatic filariasis, as a public health problem, bringing the total to ten countries (including; Cambodia, the Cook Islands, Maldives, Niue, Sri Lanka and Vanuatu).

Ten countries have eliminated lymphatic filariasis as a public health problem.
Five countries have been validated by WHO as having eliminated Trachoma as a public health problem:

Cambodia, Lao People’s Democratic Republic, Mexico (2017), Morocco (2016) and Oman (2012).

Guinea worm disease, which 30 years ago afflicted more than 3 million people in 20 countries, is on the brink of eradication, with just 26 cases in two countries in 2017.

Onchocerciasis has been eliminated in nearly all of the Americas. Colombia (2013), Ecuador (2014), Guatemala (2016) and Mexico (2015) have been validated as ‘onchocerciasis-free’.

For more than 30 years, Novartis and the Novartis Foundation have been working with partners around the world to eliminate leprosy. Multidrug therapy (MDT) has been a major breakthrough in the treatment of leprosy and its free availability has reduced the global disease burden by 95% in the past three decades. Since 2000, Novartis has been providing MDT free of charge to all leprosy patients through the World Health Organization, helping to treat more than 7.5 million patients. Further, this has made it possible to interrupt the transmission of leprosy and prevent disabilities. In 2015, as part of its commitment to the London Declaration on NTDs, Novartis announced the extension of its MDT donation through to 2020. In 2020, the company renewed its pledge to extend its donation with the WHO through a new five-year agreement. The agreement also covers the continuing donation of triclabendazole for the treatment of fascioliasis. More commonly known as liver fluke infestation, this NTD infects at least 2.4 million people worldwide. The Novartis donation has helped to treat around two million fascioliasis patients in more than 30 countries since 2005.

Eisai began donating DEC tablets to endemic countries through WHO in 2013 to eliminate LF. Over the six years, Eisai donated over 1.6 billion DEC tablets to 28 countries and will continue its provision until LF is eliminated.

Merck doubled its donation from 100 million tablets in 2015 to 200 million in 2016. To date, more than 100 million patients have been treated, consisting primarily of children. Merck and Astellas are part of a public-private partnership to help develop an effective pediatric formulation of praziquantel to treat children under six years old, an age group which accounts for around 10% of the global population infected or at risk for schistosomiasis.

Through participation in the London Declaration Bristol-Myers Squibb extended the reach of its R&D efforts into NTDs, providing access to proprietary compound libraries to third parties, including Drugs for Neglected Diseases initiative (DNDi), to help develop potential new medicines for targeted NTDs. BMS further extended its collaboration with DNDi on Chagas and Leishmaniasis and to identify potential clinical stage compounds with activity against helminthes. Furthermore, at the Institut Pasteur Korea, thousands of compounds from the Bristol-Myers Squibb library were screened and over 100 compounds were identified with potential activity against Chagas Disease and Visceral Leishmaniasis. Initial screening at the University of Dundee identified 119 compounds with potential activity against Visceral Leishmaniasis.

Sanofi contributes to the fight against neglected tropical diseases, particularly within the scope of a long-term partnership with the WHO. Launched in 2001 with a program focused on sleeping sickness, their partnership was extended to include Leishmaniasis, Buruli ulcer, yaws and Chagas disease. Since then, over 27 million people living in endemic areas in sub-Saharna Africa have been screened for sleeping sickness, and more than 175,000 people have received free treatment.  In partnership with the Drugs for Neglected Diseases initiative (DNDi), Sanofi is working to develop a new oral treatment that could support disease elimination efforts.

Bayer develops a new formulation of nifurtimox to allow weight-adjusted doses in children of all age groups suffering from Chagas disease. The study in pediatric patients including newborn babies also aims to provide evidence for shorter treatment duration.

Working with the Liverpool School of Tropical Medicine, AbbVie has discovered a new compound to potentially treat river blindness and elephantiasis. The compound depletes a symbiotic bacteria inside the parasitic worms causing these diseases, sterilizing the adult female worms in order to interrupt transmission. In collaboration with DNDi, AbbVie has advanced this compound through Phase 1 clinical trials. In addition, AbbVie collaborates with various partners to provide in-kind support for the preclinical advancement of drug candidates targeted to treat tuberculosis, malaria, leishmaniasis, Chagas disease and cryptosporidiosis.

In 2000, GSK began donating albendazole tablets to the global effort to defeat LF. A decade later, GSK scaled up its efforts by dedicating a new production facility in India to making albendazole. In 2011, GSK pledged to expand its donation to WHO with an additional 400 million albendazole tablets each year for deworming of school-age children until 2020. Over the past 18 years, GSK has donated 8.5 billion albendazole tablets to help eliminate LF and control intestinal worms.

GlaxoSmithKline and Johnson & Johnson founded the NTD Supply Chain Forum (NTDSCF) in October 2012 with the goal of identifying and addressing impediments to NTD drug delivery. The Forum’s over-arching purpose is to streamline and coordinate the provision of donated drugs/supplies for country NTD programs. It is an excellent example of collaboration between companies, the WHO and the Gates Foundation in support of commitments made as part of the London Declaration.

The NTDSCF was initiated by a coalition of NTD drug supply chain partners led by GSK, and currently includes Eisai, Janssen Pharmaceutical Companies of Johnson & Johnson, Pfizer, MSD*, Merck, Sanofi, WHO, the Bill & Melinda Gates Foundation, as well as freight forwarder DHL and supporting NGOs (Children Without Worms, International Trachoma Initiative, Mectizan Donation Program and RTI International).

The Forum initially focused on delivery of NTD drugs from the manufacturer to the endemic countries (the ‘First Mile’) primarily focused on the preventative chemotherapy diseases that rely on MDA where drugs are frequently co-administered. More recently, it expanded its remit to assess possible in-country supply chain management and distribution areas where further support may be required (the ‘Last Mile’).

*MSD is known as Merck & Co. within the US and Canada