Stiefel supports fight against one of the world’s most neglected tropical diseases
Putting patients at the heart of everything we do and ensuring their true needs are met, is fundamental to our business. So when Stiefel was approached by experts from the International Society of Dermatology (ISD), to assist their Regional Leishmaniasis Control Centre (RLCC) programme in Yemen, we were delighted to provide a charitable donation of Pentostam treatment to support the management of the disease during the next three years.
Leishmaniasis: the scale of the problem
Leishmaniasis is one of the world’s most neglected tropical diseases, typically spread by sandflies, via theLeishmania parasite1,2. It is estimated to affect about 12 million people across more than 80 countries and results in 20,000-50,000 deaths each year3,4,. In Yemen, leishmaniasis is widespread, with recent prevalence estimates being 180,0005.
The impact of the disease is huge. It can mutilate and disfigure, causing life-long aesthetic, social and psychological problems. Those infected can become socially marginalised; a situation that affects quality of life and results in significant socio-economic burden3.
Diagnosis and effective treatment of leishmaniasis pose a considerable challenge. Lack of funding, diagnostic capabilities and limited access to affordable treatment, coupled with governmental and environmental barriers all make it difficult to control the disease6,.
RLCC programme: first steps towards eradication of the diseaseThe RLCC in Yemen was established in April 2013, by Dr. M. Al-Kamel (American Academy Dermatology and ISD), supported by dermatologist Dr. Luitgard Wiest (ISD member, Munich). This collaboration saw the beginning of the biggest and most effective movement against leishmaniasis in the history of the disease, through a range of community programmes.
Since launch, the RLCC has conducted educational campaigns across more than fifty remote, disadvantaged rural villages and settlements in Yemen. Hundreds of patients have been given free examinations, with some of the poorest receiving free treatment through partnerships with pharmacies across the regions. Two main control centres have been established, supported by a large network of volunteers, helping manage up to twenty cases of leishmaniasis every week and conducting a range of awareness-raising campaigns across the region.
The RLCC recently hosted an educational launch event for its Medicine for All programme, at which Stiefel’s donation of Pentostam treatment was announced to an audience of more than 150 local and international dermatologists, pharmacists, distributors and media. Commenting on the Pentostam donation and the difference it will make to the people of Yemen, Dr Al-Kamel said: “This donation will help poor patients who are the main victims of the disease in Yemen, to get what was considered unavailable and unaffordable medicine. It will help in our work to eradicate the disease in Yemen and will improve the lives of many patients.”
Ali Al-Ahdal, GSK Yemen said: “The work of Dr Al-Kamel and the RLCC team here in Yemen is truly inspiring. We hope that our collaboration and support for this initiative will help make a real difference to patients, their communities and the longer-term fight against leishmaniasis.”
How will Pentostam help?
The first order of Pentostam arrived at the RLCC in Yemen’s capital city of Sana’a on 9 November. Pentostam (sodium stibogluconate) is an injected, 30-day treatment that can help cure leishmaniasis7. It was developed by GSK in the 1940s and belongs to a class of medicines called pentavalent antimonials. These drugs remain the cornerstone of therapy for leishmaniasis, with no significant new treatment advances anticipated within the next decade8.
The majority of people in rural and poor communities, where the disease is most prevalent, are unable to afford treatment, often making Pentostam inaccessible to the patients who need it6. Governments in affected areas tend to only buy treatment when there is an outbreak, therefore stock-outs are common and patients often go without, or have suboptimal treatment6.
Simon Jose, Stiefel President, said: “We’re delighted to be able to support such a worthwhile initiative. Everything we do must start with the patient or consumer in mind; through our Pentostam donation, we are helping make healthcare accessible to the communities who urgently need it and address the high unmet medical need that exists in the treatment of leishmaniasis in Yemen.”
What is leishmaniasis?
There are 3 main forms of leishmaniasis9,10, with symptoms varying depending on where the lesion is located:
Cutaneous – sores, or lesions, on the skin that heal very slowly leaving a permanent ugly scar. It usually develops on an exposed part of the body such as face, neck and distal limbs.
Mucocutaneous - symptoms may include ulcers, erosions or destruction in the nose, lips, tongue and gums. It also may manifest with breathing and swallowing difficulties, and a stuffy and runny nose. Symptoms are difficult to treat spontaneously without urgent medical care.
Visceral – this manifests with cough, diarrhoea, vomiting, high intermittent fever, loss of appetite and fever. Patients with systemic infection then develop abdominal distension, weight loss, hair loss and scaly, gray, dark, ashen skin. This form of leishmaniasis often ends with the death unless the patient is early diagnosed and managed.
References
1. World Health Organization. Leishmaniasis. http://www.who.int/leishmaniasis/en/ (last accessed 17 November 2014)
2. McDowell MA, Rafati S, Ramalho-Ortigao M, Ben Salah A (2011) Leishmaniasis: Middle East and North Africa Research and Development Priorities. PLoS Negl Trop Dis 5(7): e1219. doi:10.1371/journal.pntd.0001219 (last accessed 17 November 2014)
3. World Health Organization. Leishmaniasis. Magnitude of the problemhttp://www.who.int/leishmaniasis/burden/magnitude/burden_magnitude/en/ (last accessed 17 November 2014)
4. J. Kavouris. N-Myristoyltransferase inhibition as a tool for antileishmanial drug discovery: use in high throughput, de novo, and piggback strategies for drug development. University of Pittsburgh 2014 http://d-scholarship.pitt.edu/22670/
5. RLCC field study data on file
6. World Health Organization. Leishmaniasis. Access to essential antileishmanial medicines and treatmenthttp://www.who.int/leishmaniasis/research/en/ (last accessed 17 November 2014)
7. Pentostam Injection SPC. Last updated March 2014.http://www.medicines.org.uk/emc/medicine/2182/SPC/Pentostam%20Injection/ (last accessed 17 November 2014)
8. R. Kumar Jha et al. The treatment of visceral leishmaniasis: safety and efficacy. J Nepal Med Assoc 2013;52(192):645-51
9. World Health Organization Factsheet 375 http://www.who.int/mediacentre/factsheets/fs375/en/ (last accessed 17 November 2014)
10. Leishmaniasis. Medline Plus http://www.nlm.nih.gov/medlineplus/ency/article/001386.htm (last accessed 17 November 2014)
