What to include?

1. What to include? Should EDCTP-2 be expanded to other fields? Marja Esveld, 29 September 2010

2. Current mandate of EDCTP EDCTP aims to accelerate the development of new or improved • drugs, vaccines and microbicides • against HIV/AIDS, malaria and tuberculosis, • with a focus on phase II and III clinical trials • in sub-Saharan Africa.

3. % Ischaemic heart disease 12.2 Cerebrovascular disease 9.7 Lower respiratory infections 7.1 COPD 5.1 Diarrhoeal diseases 3.7 HIV/AIDS 3.5 Tuberculosis 2.5 Trachea, bronchus, lung cancers 2.3 Road traffic accidents 2.2 Prematurity, low birth weight 2.0 % Lower respiratory infections 6.2 Diarrhoeal diseases 4.8 Depression 4.3 Ischaemic heart disease 4.1 HIV/AIDS 3.8 Cerebrovascular disease 3.1 Prematurity, low birth weight 2.9 Birth asphyxia, birth trauma 2.7 Road traffic accidents 2.7 Neonatal infections and other 2.7 Leading Causes of Mortality andBurden of DiseaseWorld, 2004 Mortality DALYs* * Disabilty adjusted life years

4. Burden of disease by broad cause group and region, 2004

5. Burden of disease in low income countries, 2004 DALYs (millions) Per cent of total DALYs Lower respiratory infections 76.9 9.3 Diarrhoeal diseases 59.2 7.2 HIV/AIDS 42.9 5.2 Malaria 32.8 4.0 Prematurity and low birth weight 32.1 3.9 Neonatal infections and other 31.4 3.8 Birth asphyxia and birth trauma 29.8 3.6 Unipolar depressive disorders 26.5 3.2 Ischaemic heart disease 26.0 3.1 Tuberculosis 22.4 2.7

6. Need for new or improved products for prevention and control DALYs (millions) Per cent of total DALYs Lower respiratory infections 76.9 9.3 Diarrhoeal diseases 59.2 7.2 HIV/AIDS 42.9 5.2 Malaria 32.8 4.0 Prematurity and low birth weight 32.1 3.9 Neonatal infections and other 31.4 3.8 Birth asphyxia and birth trauma 29.8 3.6 Unipolar depressive disorders 26.5 3.2 Ischaemic heart disease 26.0 3.1 Tuberculosis 22.4 2.7

7. Global funding for Neglected Disease ResearchSource: G-Finder 2008 Funding US$ (*1000) 2007 2008 2008 %

8. Reasons to expand • Diseases • ‘Double neglected diseases’ cause high morbidity • Clear funding gap • Low hanging fruits • Efficiencies: some interventions could serve more diseases • Geographical area • Capacity building needs in almost all other regions • Aids/HIV and TB epidemics outside Sub Sahara Africa (including Eastern Europe!) • Some NTDs have focus outside Africa (Chagas, Dengue) • Efficiencies: some interventions could serve more regions or there may be a small commercial market

9. Reasons to expand • Type of products • Diagnostics key to effective (and efficient) treatment • Potential impact of non-medical products (ie insecticides) • Position in pipeline • Phase I studies needed to ensure innovation • Phase IV and access studies needed to enhance uptake and optimal use • Expanded pipeline allows for more strategic planning

10. Reasons NOT to expand • Challenge to define scope / set priorities • WHO definition for NTDs include 10 diseases • Do we include vector control? • Need for ‘products’ vs other preventive interventions (ie sanitation) • Need for additional funding • Need to expand expertise in SAC and other EDCTP governance bodies • Additional programmes (FP7/8, global programmes) may cover research

11. Thank you!