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The London Declaration on NTDs

Active Since: 2012

Multi-Company Partnership

Contributing to SDGs…

On 30 January 2012, pharmaceutical companies, donors, endemic countries and non-government organisations came together to sign the London Declaration on Neglected Tropical Diseases. Together, they committed to control, eliminate or eradicate 10 diseases by 2020 and improve the lives of over a billion people.

Objectives

  • To eradicate, eliminate, or control 10 NTDs by 2020
  • Eradicating Guinea worm disease by 2020
  • Eliminating lymphatic filariasis, leprosy, sleeping sickness (human African trypanosomiasis) and blinding trachoma by 2020
  • Controling schistosomiasis, soil-transmitted helminthes, Chagas disease, visceral leishmaniasis and river blindness (onchocerciasis) by 2020

Neglected Tropical Diseases (NTDs) are a group of 17 diseases that disproportionally impact those living in poverty. More than 1.6 billion people worldwide are affected by NTDs, including more than 500 million children. The opportunity exists to help millions of people avoid significant debilitation and disability, including malnutrition, disfigurement and social discrimination.

Many NTDs can be controlled through existing, affordable interventions and tremendous progress has been made in recent years.

Partnership activities and how they address needs and challenges

Original endorsers of the London Declaration, including twelve pharmaceutical companies, the World Health Organization (WHO), governments of the United States and United Kingdom, Drugs for Neglected Diseases Initiative (DNDi), the Bill and Melinda Gates Foundation and the World Bank, among others, work cooperatively to sustain or expand existing drug donation programs to meet demand through 2020.

These partners share their expertise and compounds to accelerate research and development of new drugs and provide more than USD 785 million to support R&D efforts and strengthen drug distribution and implementation programs.

The partners also seek to advance R&D for many of these diseases through partnerships and by providing funding to find next-generation treatments and interventions for NTDs.

These are the five big commitments made in the London Declaration:

Sustain, expand and extend programs that ensure the necessary supply of drugs and other interventions to help eradicate some diseases and to help control others by 2020.

Advance R&D through partnerships and provision of funding to find next-generation treatments and interventions for neglected diseases.

Enhance collaboration and coordination on NTDs at national and international levels through public and private multilateral organizations.

Enable adequate funding with endemic countries to implement NTD programs necessary to achieve these goals, supported by strong and committed health systems at the national level.
Provide technical support, tools and resources to support NTD-endemic countries to evaluate and monitor programs.

NTDs mire communities in a cycle of poverty, and hinder progress towards the sustainable development agenda. By providing access to existing drugs and accelerating development of new treatments, millions of people can have a better opportunity to succeed in school and lead a more socially and economically productive lives.

The partners provide regular updates about their progress in reaching the 2020 goals and identify remaining gaps.

Quote
"Taking steps to reduce the toll of NTDs takes long-term and wide-ranging commitment many actors. Our industry has stepped up to the plate, not only with historic levels of donations, but also with long-term commitment to R&D."
Thomas Cueni
Director General, IFPMA

SDGs THE PARTNERSHIP CONTRIBUTES TO

SDG 3: Good Health and Wellbeing

  1. 3.2: Reduce Under-5 Mortality 
  2. 3.3: Communicable Diseases & NTDs

SDG 10: Reduced Inequalities

SDG 17: Partnerships for the Goals 

RESULTS & 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’.

Since 2000, Novartis has been providing MDT free of charge to all leprosy patients through the WHO, donating more than 56 million MDT blister packs valued at over USD 90 million, helping to treat over 6 million leprosy patients worldwide. In 2015, as part of its commitment to the London Declaration on NTDs, Novartis announced the extension of this MDT donation through to 2020. This five-year agreement includes treatments worth more than USD 40 million and up to USD 2.5 million to support the WHO in handling the donation and logistics. Overall it is expected that the program will reach an estimated 1.3 million patients during the five-year period.

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.

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 University of Dundee, thousands of compounds from the Bristol-Myers Squibb library were screened for potential activity against Chagas Disease and 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 and Novartis is engaged in drug discovery to identify improved 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