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fects the liver and the whole system. agreements with them, and we have but many children miss the treat-
It's another very severe disease. been able to do so successfully. We ment and enter a chronic stage.
For both of these diseases [sleeping now have agreements with Novar- This is the reason why we are trying
sickness and visceral leishmaniasis] tis, GlaxoSmithKline, Merck, and to develop treatment for the early
the existing treatments are not sui- Sanofi to name a few. We combine chronic stage. We are taking advan-
table and have serious limitations, these partnerships with academic tage of the work carried out by a Ja-
because of their cost, complexity of partners, universities, as well as panese company called Eisai. They
administration, or their toxicity. with partners in endemic countries. developed a drug for a fungal di-
We have developed serious par- sease, but it has been well-docu-
I will illustrate the latter with the tnerships to undertake these studies mented by scientists that it works
case of sleeping sickness. For many and to translate them into action. very well against Chagas. So we have
years we used a drug called Melar- negotiated with Eisai to have access
soprol. You can forget the name, Q: How do you find the right to their drug. We are currently doing
but basically it is arsenic. For this combination of drugs -- for clinical studies in Bolivia. That is not
reason, when you inject the drug, sleeping sickness, for instance? the end of the story, but if this cli-
you kill one out of twenty of your pa- nical study is successful, Eisai will
tients due to the toxicity of the drug. Our basis is scientific and this is the make this drug available for Chagas
You do not have any choice, because reason why the academic groups at an affordable price.
without treatment the disease is are so important for us. Parasitic
100% fatal. Arsenic is a drug that diseases are very complex but, for Q: Does everything come down
was used in Europe and the United this very reason, very attractive to to poverty alleviation?
States in the nineteenth century -- the scientific community. In ma-
and it's a poison! king progress in our understanding Well, I agree. If you could eradicate
of the way these parasites func- poverty, these diseases would be
During the last eight years we have tion, you can also make progress less prevalent. They would definitely
developed a portfolio of projects, on science in general and develop not disappear, because parasites
starting from the early stages of dis- some new concepts. So the scientific are very intelligent creatures. But I
covery and going through to the im- background was there -- we were agree that the reduction of poverty is
plementation process, or rolling out not obliged to invent it -- and we a solution. Inversely, the control of
of the treatments to the patients. We were able to tap into it from day one. disease forms part of the reduction
have short-term projects to improve of poverty -- it's a vicious circle.
existing treatments, for example by Sometimes there are bridges from
combining them in order to shorten one disease to another. Take Cha- In Congo for instance, if you have
treatment length or to reduce resis- gas disease for example. Prevalent one person infected with sleeping
tance. In some cases, these drugs in Latin America, this parasitic di- sickness, it's very difficult to get re-
were developed to treat other di- sease affects a lot of children. They sources to the family because the
seases. You can: (a) use one drug on will eventually die from heart pro- sick person is already a heavy bur-
one disease and then test to see if it blems later on in life as a result of den on them. Thus, if you do not
works on other ones; (b) adapt drugs the disease. The disease comes treat people for sleeping sickness,
that were not properly formulated; from a bug -- widely known as the you are putting the whole family in
or (c) complete the development of 'kissing bug'. Chagas disease is danger. Once the disease reaches
drugs that have been abandoned poverty-driven as the vector is main- a village, you will have many more
through lack of interest, lack of pro- ly found in mud habitations. Bolivia cases. Poverty will strike the vil-
fit, etc. Some of these drugs have is the most affected country. An es- lage because of the presence of the
been abandoned by pharmaceutical timated 8 million is infected, but not disease. Therefore, we cannot dis-
companies for such reasons, so we all of them will develop the disease. connect the reduction of poverty
take them up and develop new treat- Many people are not declared to be from the control of disease, and
ments by means of partnerships. suffering from Chagas disease when control will require research and de-
they die - because of a lack of dia- velopment. We consider our project
Q: Do pharmaceutical compa- gnostics - but nevertheless this might as a small part of the big picture --
nies give you access to their re- well be the cause of their death. Im- the reduction of poverty.
search without any problems? migration has made the disease glo-
bal, in other words people infected Q: Which universities do you
Indeed, one of the major issues is to with the disease twenty years ago in work with?
have access to the expertise, to the Bolivia may now be living in the Uni-
drugs that have been abandoned, ted States and elsewhere. And it's We have, for example, a lot of agree-
or to their libraries of compounds. transmitted from mother to child, ments with the Swiss Tropical and
Companies develop a great diversi- which means that there are children Public Health Institute in Basel, the
ty of chemical compounds, seeking being born with Chagas disease. It Geneva University Hospitals, the
drugs for a profitable market. An is very difficult to diagnose at the London School of Hygiene and Tro-
abandoned compound could be ex- outset. There is now a test available pical Medicine, the Institute of Tro-
tremely useful for the diseases that that is being used more and more. pical Medicine-Antwerp, the Liver-
we are trying to tackle. We negotiate Ideally, one should treat children, pool School of Tropical Medicine,

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