Lack of drugs in development for post-tsunami diseases

Pharmaprojects, a leading source of worldwide intelligence on pharmaceutical r&d, has reported only 87 drugs in active development for some of the diseases most likely to be threaten survivors of the Asian tsunami.

The tsunami has now claimed an estimated 280,000 lives but David Nabarro, a doctor for the World Health Organisation (WHO), predicted that post-tsunami disease could kill as many people as were killed in the floods, with the most likely outbreaks being in malaria; dengue haemorrhagic fever; Japanese encephalitis virus; measles; respiratory diseases and cholera.

Dengue haemorrhagic fever (DHF), a potentially fatal communicable disease, has no vaccines or drugs available for prevention or treatment. Difficulty in developing a vaccine arises because there are four types of virus that may cause DHF, and protection against only one or two of these could increase the risk of more serious disease. Although no vaccines have been launched, Pharmaprojects reports nine drugs in active development, including GlaxoSmithKline's tetravalent vaccine, which is in Phase II trials.

For the disease Japanese encephalitis (JE) virus, which is an infection of membranes around the brain, there is a prophylactic vaccine available, but it is expensive and requires two boosts after the initial vaccination. Yet despite a need for cheaper and better products, only four drugs are being actively developed, the most advanced of which are Acambis' and Intercell's prophylactic vaccines, both in Phase II trials.

Diseases that can be easily treated, such as cholera, still pose a threat to South-East Asia. Up to 90% of cholera cases can be treated with oral rehydration, but in communities unprepared for the disease, fatality rates can be as high as 50%.

The disease in which most research is being car-ried out is malaria, where Pharmaprojects reports 36 drugs in active development. Although many scientists doubt that a single cure for malaria will ever exist, treatments such as arteminisin-based combination therapies are being used effectively.

With so few drugs in development, and even fewer close to launch, the situation for improving treatment options is not ideal. However, with several campaigns currently giving money to fund drug development programmes, such as the Bill and Melinda Gates Foundation $750 million donation to the Global Alliance for Vaccines and Immunization (GAVI), there are signs of improvement on the horizon Pharmaprojects said.