:strip_icc()/i.s3.glbimg.com/v1/AUTH_59edd422c0c84a879bd37670ae4f538a/internal_photos/bs/2019/5/a/PwweA3R9AuGB7oT2ndfw/20190128-172049.jpg)
[ad_1]
The reason? "They are linked to poverty, they do not have much interest for the market because they do not report a lucrative return," says Sinval Brandão, researcher at Fiocruz and president of the Brazilian Society of Tropical Medicine (MTFS).
The WHO clbadifies 17 pathologies among neglected tropical diseases. They are different from each other, but they share the fact that they mainly affect low-income or poor people living in poor and developing regions.
Some of the pathologies have been known for centuries, says Ethel Maciel, an epidemiologist at the Federal University of Espírito Santo (UFES).
Several of them that you have already studied at school: taeniasis, leprosy, Chagas disease, schistosomiasis, sleeping sickness, trachoma, onchocerciasis, lymphatic filariasis, among others.
For many people living in the major urban centers of the first world, one has the (erroneous) impression that it is about past diseases that have been eradicated. After all, in vast areas of the world where living and hygiene conditions have improved, they are no longer a problem.
But they are still very much present, concentrated in poor areas of the world, isolated rural areas, favelas and urban areas without sanitation – including (and in large quantities) in Brazil.
"Brazil accounted for 70% of Chagas deaths globally in 2017, accounting for 93% of new leprosy cases and 96% of visceral leishmaniasis cases in the continent, to name just a few. some examples, "says Brazil. Jardel Katz, Head of Research and Development, DNDI (Drug Initiative for Neglected Diseases).
If so many people are affected, why not talk about these diseases? According to the WHO, they are silent "because those affected or at risk have little political voice."
"Sometimes they get their attention when they leave the circuit of poor, low-income countries where they are normally endemic and reach the middle clbad, wealthy neighborhoods," said Ethel Maciel. "That's the case with dengue, for example."
Some entities consider a broader group of diseases as neglected diseases. The G-Finder project cites 33 diseases in its annual report on neglected diseases, including tuberculosis and malaria. The project is organized by Policy Cures Research, a research center dedicated to finding solutions to improve the health of the poorest in the world, and sponsored by the Bill & Melinda Gates Foundation.
According to Jardel Katz of the DNDI, the 33 diseases examined by the G-Finder are present in Brazil, to a greater or lesser extent depending on the region.
In 2008, the Ministry of Health defined seven neglected diseases as priorities in the country, based on data on its impact in Brazil: dengue, Chagas disease, leishmaniasis, leprosy, malaria , schistosomiasis and tuberculosis.
The problem is that in an area so dependent on public investment, public spending on research and development has declined. According to a report recently released by G-Finder, the government has cut 42% of funding for research on neglected diseases between 2016 and 2017.
One of the main treatments for leishmaniasis, for example, consists of a substance called antimoniate, which kills the protozoan , which kills the protozoan that causes the infection. Unsplash
Jadel Katz explains that, in the pharmaceutical sector, the treatment of these diseases is very old, with limitations, low efficiency and adverse reactions.
One of the main treatments for leishmaniasis, for example, is used with a substance called antimonyate, which kills the protozoan that causes the infection.
"It is a treatment that is over 100 years old and very toxic, the person goes into treatment and may have a heart or kidney problem," says epidemiologist Guilherme Werneck, Harvard Doctor of Public Health and professor at the State University of Rio de Janeiro (UERJ).
"There is another remedy, Amphotericin B"
Ethel Maciel explains that the difficulty is not only related to treatment, but also to prevention and diagnosis.
"In the fight against dengue, the disease is very expensive and very toxic, the way of fighting the vector (the mosquito that transmits the virus) is the same since the 1980s in most of the country", she says. In the case of dengue, there is still no specific cure and only one vaccine, not very effective "
Research and Development
" For these diseases, the public sector finances more research, which generates important discoveries. But for innovation and treatment issues, partnering with private enterprise is essential, "says Werneck.
Indeed, says Jadel Katz, universities and public institutions often speak of progress in the field of health. most so-called basic science research (studying causative agents and how to combat them).
The study on the creation and application of remedies as such results in private initiative, which has more money and structure – in addition "They take more care of this step where there are regulatory issues, clinical trials, that require patient involvement, money, "says Katz.
In addition, there is a third manufacturing step that requires infrastructure.
However, in the case of neglected diseases, virtually all research and development is conducted by the public sector or non-profit institutions. mainly foreign.
"This is an area extremely dependent on public investment," says Sinval Brandão.
But even though the public sector and the academic world invest in research, progress is much more difficult without the infrastructure of the sector, particularly in the creation of treatments and the manufacture of drugs.
have a level of production comparable to that of private enterprise.
"Since it's not pure business, you need development alternatives," Katz says. "Get partners to talk, both in government and in basic science, and think about having an industrial partner, you have different partners, who dominate the different stages of production."
In Brazil, the fall in public investment in these diseases is a matter of serious concern.
According to the G-Finder report on investments in research and development (R & D) on neglected diseases, investments in Brazil have decreased significantly in recent years – despite growth in the world, where they have reached their highest level in 2017.
According to the survey released last week, the total investment in the area in Brazil rose to R $ 29 million in 2017, or 42% of less than in 2016, which has made Brazil one of the world's top twelve financial.
"We feel directly this reduction in budget cuts," said Sinval Brandão, SBMT. "The reduction in investment, which had already been felt in recent years, was much stronger in 2017 and 2018, interrupting projects and closing laboratories."
According to the report, between 2016 and 2017, the decrease in public funding was attributable to the spending ceiling set by the government, which had reduced the spending of two funding agencies: the National Development Bank (BNDES), who had suffered a reduction. $ 15 million investment; and the Foundation for Research Support of the State of São Paulo (FAPESP), which has reduced R $ 14 million.
"This overall reduction is extremely important in an area that is attracting so little interest in the private sector," Brandão said.
This concerned virtually all neglected diseases considered a priority by the Brazilian Ministry of Health.
Investments in malaria research decreased by 15%. For leishmaniasis, the reduction in funds was 63%. For tuberculosis, the reduction was 45%.
Regarding Chagas disease – a problem for which Brazil was the second largest funder of research for five years – the reduction was 74%.
Only two diseases led to increased investment. One of them was dengue fever, which increased by 41%.
The other was schistosomiasis, which had increased significantly from 500 000 rand in 2016 to 2.8 million rand in 2017, an increase of 460%. According to the Ministry of Health, about 1.5 million people live in areas at risk of contracting the disease.
When it approved the spending ceilings in 2016, the government repeatedly reiterated that the budget ceiling would not affect health and education – several advocates pointed to the point, including the Henrique Meirelles (who was at the Department of National Defense). Fazenda) and Dyogo Oliveira (planning).
When asked by BBC News Brazil, the Ministry of Planning said that it should act of the Ministry of Health. "The money that comes out of the agency's budget, it decides where and how to spend". folder, in note.
The Department of Health says its Department of Science and Technology (Decit) has not reduced neglected diseases and has continued its research through partnerships with government agencies such as CNPq and Finep but does not react to the reductions made by the agencies. donors.
The Ministry also states that Brazil is "heavily affected by noncommunicable diseases, in addition to communicable and neglected diseases".
"This means that resources for research are intended for several areas of knowledge." More specifically, with regard to neglected diseases, the resources allocated to certain diseases for specific needs may be more or less important. In 2017, with the emergency in Zika, investments in research on the mosquito Aedes aegypti were more important. "
The record highlights data from the G-Finder report that Decit is one of the largest funders of mosquito vector control research in 2017. He believes that Department of Health and the federal government are not covered by the report ", but do not specify which diseases and how much were invested.
However, the Ministry has identified a list of measures to control neglected diseases that do not involve research and development (and therefore do not appear in the G-Finder report), such as "retentions." more than 10 million rand for the intensification of "malaria control actions in the states with the highest number of cases".
"In the case of leprosy, the Ministry of Every year, Health conducts a campaign to alert people to the signs of disease, stimulate demand for health services and mobilize health professionals in active case finding, thereby promoting early diagnosis, treatment and prevention of cancer. disabilities ", said the ministry in a statement.
The body also highlighted the National Plan for the End of Tuberculosis as a Public Health Issue, launched the year of last, as well as "joint action with public and municipal health secretaries to combat leishmaniasis", in addition to diagnosis and treatment. offered in the SUS for diseases.
Source link
