Interview of Alice Dautry

Managing Director of the Institut Pasteur, member of the Sanofi Espoir Foundation board of Directors


Alice Dautry

Alice Dautry

Why do people say that some tropical diseases are "neglected"? Who is most affected by them?

Neglected tropical diseases affect the world’s poorest people living in parts of sub-Saharan Africa, Asia and the Americas, where incomes are low. These diseases bring suffering, irreversible disability, disfigurement and social exclusion to approximately a billion people, and they are rampant in areas where there are high rates of precarious water supply and sanitation, where nutrition is poor, and where there are low literacy rates and rudimentary health systems. Today, there is little or no treatment, almost no vaccines, and very little research activity into healing or protecting these populations, because these countries do not have the means to fund them. They are ‘neglected’ diseases because of the general lack of interest until recently among researchers and pharmaceutical companies. Very few resources are devoted to these diseases, which are nourished by poverty.

 

What are the main challenges?

Although these diseases are considered as “forgotten” by research into medical treatment, most of them can be prevented and even eliminated by ensuring that affected communities have timely access to effective remedies. The majority of these diseases have gradually disappeared from many regions of the world as living conditions and hygiene improved. Yet we need international support to sustain and build on the successes in fighting and preventing these diseases. It is worth noting in this regard the unprecedented mobilization of developed countries in recent years: they have become aware that the world we live in will never reach an equitable balance when one out of every six people continues to be severely affected by avoidable diseases. The growth of public-private partnerships (PPP) between NGOs, government laboratories, pharmaceutical companies, corporate foundations and other sources of public and private funding has brought together the financial resources needed to accelerate the development of new vaccines, organize prevention, and distribute medication free of charge. This in turn has led to considerable progress, notably through enhanced surveillance programs, better care for patients, and new, simpler, cheaper drugs that are easier to distribute. However, many sufferers do not get treatment in time, and because they are too poor or live too far away from health centers they only find help when the disease is relatively advanced.

 

How can we provide better support for developing countries to boost their policies for fighting neglected diseases?

We must above all help them beef up simultaneously their health systems and the level of general disease awareness of their populations, so as to create a virtuous circle. We can also improve training for people in the field, because fighting these diseases uses simple treatments that can be given by non-specialists such as teachers, village leaders, and local volunteers as part of community prevention programs. For example, we must make people understand that they can protect themselves by not allowing stagnant water to collect near their houses, or that it is dangerous to regularly administer antimalarial drugs to children because they have a fever! These errors can lead to serious consequences, so we crucially need to run awareness campaigns and train people in basic health care! It is absolutely vital to develop contacts in the community and rely on field technicians who can meet needs and act fairly and efficiently to achieve the best outcomes possible under local circumstances, using the means at their disposal. By making it easier to gain access to safe, cost-efficient tools, we can prevent, eliminate or eradicate many neglected tropical diseases. If I had to say just one thing, it would be this: we don’t always need extraordinary resources. People must collectively take responsibility for themselves over the long term, otherwise we’ll never get there!

 

What changes have you seen in the efforts to fight these diseases?

There has been spectacular progress in recent decades. 116 of the 122 endemic countries have eliminated leprosy as a public health problem in the past twenty years. Since 1985, the prevalence of this disease has dropped by more than 90%. The number of people infected with guinea worm has fallen from 3.5 million to only 10,000. Over 25 million hectares previously infested by flies that cause river blindness are now habitable and being farmed, and millions of people are now protected from lymphatic filariasis. In Africa, the coordinated efforts of Sanofi and the DNDi (Drugs for Neglected Diseases) foundation together with campaigns to distribute ITNs have helped reduce deaths due to malaria by a third in ten years. In the case of sleeping sickness, academic research institutes have been working with pharmaceutical companies to develop new drugs. These successes demonstrate that it is possible to eliminate or control these diseases. Another example is AIDS. Admittedly, this is not a neglected disease, but by strengthening local health systems, the fight against this global affliction has also helped drive treatments for malaria and other parasitic diseases. But we still need to do more in the case of other diseases such as rabies, leishmaniasis, leptospirosis and Buruli ulcer. This is a huge task that has been addressed by the “London Declaration on neglected tropical diseases”, whose signatories (13 pharmaceutical companies including Sanofi, the governments of the United States and Britain, the Bill and Melinda Gates Foundation, the World Bank and other organizations) committed in January 2012 to increase their cooperation to reduce the global impact of these diseases.