Laura Kurtzman, UC San Francisco
Researchers at UC San Francisco, UC Berkeley and partner institutions are receiving $6 million to speed development of new tools and technologies that will address three neglected tropical diseases that place a huge health and economic burden on people in Central and South America: Chagas’ disease, dengue and onchocerciasis.
Led by scientists at UCSF Global Health Sciences and funded jointly by the Bill & Melinda Gates Foundation and the Instituto Carlos Slim de la Salud (the Carlos Slim Health Institute), the two-year project is titled FIRST (Fighting Infections through Research, Science, and Technology). The research, which is already underway, will focus on Mesoamerica, which comprises the Southern states of Mexico and Central America from Guatemala to Panama. A significant number of people, mainly of indigenous descent, live in poverty in these countries, making them vulnerable to illness and death.
Diseases affect billions worldwide
FIRST promises to address three diseases that collectively affect billions of people worldwide, and have significant health and economic effects, by helping to find better treatments, more effective vaccines and other ways to prevent them.
“We are selecting projects that will give us quick wins, allowing us to make a huge impact immediately, as well as game-changing, high-risk research that will make a significant impact in the long term,” said Jaime Sepulveda, M.D., MPH, MSc, DrSc, the executive director of UCSF Global Health Sciences.
“Although transmission of onchocerciasis has been interrupted in Mesoamerica, many indigenous communities are still at high-risk because current treatments do not kill the adult worms,” said Jim McKerrow, the principal investigator on the onchocerciasis project and a UCSF professor of pathology. “We will carry out a clinical trial with collaborators in Cameroon and the UK to determine whether Auranofin, an FDA approved drug, can be repurposed as a macrofilaricide to kill adult worms.”
The aims of the other projects in the FIRST portfolio include developing:
- Low-cost diagnostic tools for early detection of dengue
- Information systems that will provide early warnings of dengue outbreaks
- New tests to guide dengue vaccine development
- A cell phone app for crowdsourcing mosquito control
- New, less toxic drugs for Chagas’ disease
- Better biomarkers to monitor treatment of Chagas’ disease
In addition to UCSF, researchers whose work will be funded by this project are affiliated with Blood Systems Research Institute, Liverpool School of Tropical Medicine, Sustainable Sciences Institute in San Francisco and Nicaragua, UC Berkeley, UC San Diego, UC Santa Cruz, University of North Carolina, and University of Sao Paulo.
McKerrow is also working on a project to address Chagas’ disease, which is a leading cause of heart failure throughout Mesoamerica.
“Current therapy requires 60 or more days of treatment and is often ineffective or produces unacceptable side effects,” he said. “We will explore untapped chemical space for new drugs to treat Chagas’ disease including supporting acquisition of marine natural products from Mesoamerican sources. This will provide new avenues for therapy as well as training for Mesoamerican scientists and an incentive to preserve sites of biodiversity in the region.”
Eva Harris, professor of infectious diseases at UC Berkeley, is leading projects aimed at generating tools for faster diagnosis of dengue, which is a major cause of illness and death in tropical regions, as well as developing new tests for monitoring natural dengue infections and for improving development of vaccines.
“Our laboratory-based and informatics projects on dengue are being conducted in close collaboration with our long-term partners in Nicaragua, including training of Nicaraguan scientists in Managua and at UC Berkeley,” said Harris.
A key strength of the FIRST initiative is stakeholder engagement with partners in Mesoamerica, which prepares the ground for implementation of the tools being developed in this initial phase of the program.
“In addition to developing tools, our goal is to strengthen local capacity in immunology, diagnostics, epidemiology, and informatics applied to infectious disease control and public health,” said Harris.
FIRST is the newest of several joint ventures between the Gates and Slim Foundations. In 2010 they launched the “Salud Mesoamérica 2015” Initiative, whose goal is to reduce health inequities affecting the poorest 20 percent of the population in Central America and Southern Mexico. They’ve also collaborated on CIMMYT, an agricultural research center in Mexico, and on programs to support the eradication of polio.
About the diseases
Dengue is the most rapidly spreading mosquito-borne viral disease in the world, and it infects an estimated 100 million people in the world every year, inflicting a significant health, economic and social burden. Some 2.5 billion people live in the 100 countries worldwide where dengue is endemic, placing them at risk of the disease. There are no specific treatments for dengue and no effective vaccines to prevent its spread.
Chagas’ disease (American Trypanosomiasis) is caused by a parasite that’s spread by reduvid bugs and is a major health problem in Mexico, Central America and South America. It affects an estimated 8 million to 11 million people in Latin America and some 300,000 in the United States. People living in poor housing conditions are at greatest risk for acquiring infections. Most Chagas’ cases are asymptomatic, making it difficult to diagnose and treat, and untreated Chagas’ can develop into a chronic, life-threatening disease for which there is no current treatment.
Onchocerciasis, also known as “river blindness,” is the second leading cause of infectious blindness worldwide. It is caused by a parasitic disease caused by the filarial worm Onchocerca volvulus, which is transmitted through the repeated bites of infected blackflies. There are approximately 37 million people worldwide infected with onchocerciasis — mostly concentrated in 30 African countries but also in Yemen, Mexico, Guatemala, Ecuador, Colombia, Venezuela and Brazil.
