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Interview with

Bernard Pe" coul

MD, MPH, Executive Director
Drugs for Neglected Diseases initiative (DNDi)

A committed medical doctor, Bernard Pécoul has dedicated his life to fi-
ghting for the less fortunate. After having worked as a doctor in the field for
more than twenty years, and then as the Head of MSF's Campaign for Ac-
cess to Essential Medicines, he played a major role in setting up the not-
for-profit organization Drugs for Neglected Diseases initiative (DNDi).

Dr Pécoul gave us some of his precious time to explain to us what DNDi is all
about and what they are doing. Their list of merits is impressive; after eight years
of existence they have five new treatments available; they have set up research
platforms in Africa and elsewhere. And don't worry, with the pragmatic and dy-
namic Dr Pécoul at the helm, there is more to come

Q: Could you tell us how it all 90 gap, meaning that only io% of by the tsetse fly to human beings,
started? the expenditure on health research there are two stages to the disease.
reaches health problems that affect The first phase has few symptoms,
The initiative was set up in 2003, 90% of the world's population. This but afterwards the parasite reaches
based upon observations that had is bad news because we are dealing the brain and the patients start to
been made by myself and other with lethal diseases in some cases. present neurological symptoms.
field staff within Doctors without An additional issue is drug resis- Without treatment all patients will
Borders (Médecins Sans Frontières tance, and this is another factor that die within a few months. It's a very
-- MSF). I had spent twenty years adds to the dire need for research serious disease.
on field missions for MSF. The last and development in the field of ne-
position I held for them was as Head glected disease treatments. Q: Do these diseases mainly af-
of the Campaign for Access to Es- fect rural dwellers, or can they
sential Medicines. DNDi's mission is to develop new affect people anywhere?
treatments for neglected diseases,
Based on my own and others' field with the aid of partners. We do not Sleeping sickness affects mainly the
experiences, we drew attention to possess any laboratories. We are a rural populations of Central Africa,
two sorts of problems. One was that co-ordination body working with notably the Democratic Republic
many treatments were too expensive private and public institutions all of Congo (2/3 of the cases), fol-
to be used in low-income countries. over the world with the objective of lowed by Angola, Chad, and Sudan.
The second observation was that delivering new treatments. We do a A total of thirty-six countries are at
research and development for new job that many pharmaceutical firms risk in Africa, but the most affected
treatments for tropical diseases had were not doing, because of their countries are found in the central
been abandoned for many years. need to gain return on investment. region.
During the last three decades, very We are doing a job that is driven by
few new treatments and vaccines the patients' needs in the poorest, We are also dealing with leishma-
have been developed for neglected most remote areas of the world. niasis, one form of which is visceral
diseases. MSF's Access Campaign leishmaniasis, also known as kala-
and the Drugs for Neglected Di- Q: What are these diseases you azar, which is much more frequent
seases Working Group undertook are working on? and affects a larger geographical
research and a document entitled area in Asia, Africa, Latin America
Fatal Imbalance was published. This DNDi focuses the core of its work and even in the south of Europe. It's
report said that even for tropical di- on the kinetoplastid diseases, which also a parasitic disease transmitted
seases affecting a large number of includes sleeping sickness, leishma- by an insect, the sandfly. It is also
people, there is very limited invest- niasis and Chagas disease, and more 100% fatal if left untreated.
ment in the development of new recently we added specific helminth
drugs, new diagnostic tools and new infections and paediatric HIV to Q: What kind of disease is this?
vaccines. It also described, as others our portfolio. So take, for example,
had done before, the so-called io- sleeping sickness. Transmitted It starts with a fever, but quickly af-

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