>> Innovating Together to Beat Neglected Tropical Diseases

 #InnovatingTogether, #beatNTDs, and #EndTheNeglect: these are some of the hashtags we use on our social media channels while talking about neglected tropical diseases. The hashtags beautifully encapsulate our vision of cultivating global nonprofit partnerships to deliver treatments for the world’s most neglected populations – and helping countries eliminate these diseases. 

The #InnovatingTogether hashtag, in particular, captures the spirit of the work we did last year. 2023 was about strengthening partnerships with our existing partners and stakeholders as well as forging new partnerships while staying focused on our efforts of finding solutions for neglected populations, health system strengthening and capacity building of frontline health workers to support the government in the last mile elimination efforts of kala-azar. 

We will continue to work with the government to sustainably eliminate kala-azar. Finding a specific drug for dengue treatment -- along with our partners -- will continue to remain a top priority. We also hope to continue encouraging open science collaborations for drug discovery with Indian universities through our Open Synthesis Network project.  

I wanted to share last year's highlights of our continued efforts to build partnerships that will help eliminate neglected tropical diseases for good.

  
Dr Kavita Singh 
Director, DNDi South Asia

>> Efforts towards the sustainable elimination of kala-azar

World NTD Day
Thanks to the Indian government's consistent efforts over the years to spread awareness about kala-azar and integrate safe and effective drugs into the national elimination program, the country is now on the verge of eliminating the deadly disease. When celebrating such public health successes, our society often overlooks the contributions of people who relentlessly work on the ground to implement the government's strategic interventions. On last year's World Neglected Tropical Diseases Day, we highlight the contribution of frontline workers who've played a crucial role in India's fight against kala-azar. We felicitated and honoured several healthcare workers (ASHAs and ANMs), fumigation staff, lab technicians, as well as the additional Director cum State Programme Officer, Bihar, and District Malaria Officer, Chapra, at an event in Baniyapur Referral Hospital in Chapra district, Bihar.

Centres of Excellence 
We continue to support the government’s efforts towards sustainable elimination. In partnership with the National Center for Vector Borne Disease Control, the Bihar Health Department, and the Rajendra Memorial Research Institute of Medical Sciences, (RMRIMS), Patna, DNDi established two Centres of Excellence (CoE) for Leishmaniasis in Bihar’s Saran (Chapra) and Purnea districts by refurbishing labs and kala-azar wards in public hospitals. The Centres provide diagnosis, treatment, and act as focal points for managing complicated kala-azar cases.

Skill enhancement of health workers
Moreover, the Centres help preserve and advance knowledge and skills in the diagnosis and treatment of leishmaniasis.  As cases dwindle, we stand the risk of losing this knowledge. To prevent that, we regularly organized trainings for doctors and para medic staff and equipped them with the latest science in diagnosis and treatment of kala-azar and its complications as well as briefed them on the updated national treatment guidelines. Trainings were also conducted for ASHA and ANMs in identifying kala-azar and PKDL patients. DNDi is committed to providing refresher trainings to these women healthcare workers as they form a crucial bridge between the patient community and the healthcare system. In 2023, we trained over 2,000 ASHAs and ANMs across the Saran and Purnea districts of Bihar. Last year, we also introduced a photo album on PKDL into the training.

>> United Against Dengue -- to find urgently needed treatments

Dengue Alliance Meeting
The ferocious combination of climate change and rapid urbanization is causing an alarming rise in dengue cases: The number of dengue cases reported to World Health Organization increased over 8-fold over the last two decades, from 505,430 cases in 2000, to over 2.4 million in 2010, and 5.2 million in 2019. Dengue is being touted as one of the top five threats to global health. Bangladesh is just emerging out of a record-breaking dengue outbreak that has killed over 1500 people. In 2022, DNDi facilitated the formation of Dengue Alliance, a global partnership led by five institutions from four countries – India, Brazil, Malaysia and Thailand – that have borne the brunt of this diseases for decades.  The Dengue Alliance is committed to finding affordable and accessible treatments for dengue. In February last year, Alliance members met for the first time in-person at the Translational Health Science and Technology Institute (THSTI) in Faridabad and took stock of the Alliance’s progress on the R&D front. The Alliance prioritizes resource mobilization, open research sharing, and cooperation. It completed pre-clinical profiling of 23 compounds, narrowing down to three for further studies.  

National Dengue Day
Later, on National Dengue Day, we co-organized a symposium with the Indian Council of Medical Research on May 16 where ICMR announced that vector borne diseases will be a major research priority for the institution. The experts at the meeting emphasized the need for point-of-care diagnostics for dengue as early detection is key to preventing patients from progressing to severe disease state. Experts also shed light on behaviour communication strategies that can help spread awareness about dengue.

>> Media Engagement and Advocacy

MSF-DNDi Media Fellowship
Over the last few years, we’ve solidified our collaboration with the media to highlight the plight of neglected populations. Last year, we partnered with MSF South Asia, to fund the Neglected Tropical Diseasese category of the Without Borders Media Fellowship. The four grantees are traveling across South Asia to report on dengue, cutaneous leishmaniasis, post-kala-azar dermal leishmaniasis & lymphatic filariasis. 

SJAI Conference
We were also one of the proud sponsors of the first conference of the newly formed Science Journalists Association of India on Nov 24/25. In a panel discussion titled, “Triumphs and Trials: Health Journalism in India, DNDi emphasized the need for journalists to forge cross-border collaborations with counterparts in neighbouring countries, such as Bangladesh, and investigate why some of them are ahead of our country in addressing neglected tropical diseases.  

Interactive session with media
At Neglected Tropical Diseases in India – An interactive session with health journalists, an event we organized at Press Club of India in November, we took a back seat and heard out journalists who shared their challenges of covering NTDs: lack of funding for travel to affected areas, editors’ reluctance on assigning stories on these “depressing” conditions, as well as lack of data. We brainstormed ways to address these challenges and it turned out to be a fruitful discussion. The session will inform our decision making as we strategize support for the media. 

>> DNDi at G20

>> Strenghtening ties with partners and stakeholders

MSF Scientific Days
Partnerships are a central part of DNDi’s work model. In 2023, we continued to engage with stakeholders in various capacities. Once again, we had a presence at MSF Scientific Days, a forum that invites researchers around the world to present research from humanitarian and global health sectors. Last year’s MSF Scientific Days was held in Dhaka, Bangladesh, which was in the middle of a record-breaking dengue outbreak. There, DNDi experts -- Byron Arana, Neelika Malavige, Kavita Singh -- along with Dr Md. Khalequzzaman, Associate Professor at BSMMU, were part of an important panel discussion that explored how South Asian countries can address the impact of climate change on neglected tropical diseases.

Open Synthesis Network
India has one of the largest student pools in the global higher education system and ranks among the top 15 countries globally in high-quality chemistry research output. However, India has contributed very few new drug molecules to the world. To remedy that, DNDi has been collaborating with leading Indian institutes through a project called Open Synthesis Network (OSN):  Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, Mumbai; Shiv Nadar University, Noida; National Institute of Pharmaceutical Education and Research Hajipur; Indian Institute of Technology, Gandhinagar; and University of Lucknow. OSN’s goal is to engage and expose organic chemistry/medicinal chemistry students in real life early-stage drug discovery and enhance their critical thinking and collaboration skills. Last year, we brought on Punjabi University into the fold as well.

>> Championing equity and integrity in research

International Clinical Trials Day
Even as we work to find new treatments for neglected tropical diseases, we remain equally committed to enabling equity and ethical integrity in R&D. On the eve of International Clinical Trials Day, which is celebrated every year on May 20, we joined forces with CSIR-Central Drug Research Institute (CDRI), the country’s leading drug discovery institute, to conduct a symposium titled, “Patient Engagement: Benchmark in Clinical Trials.” The symposium brought together experts from the field of clinical research and patient engagement groups to explore ways to include more patient voices in the design of clinical trials because as a nonprofit R&D organization we believe in outcomes that matter most to patients. We’re also committed to having inclusive clinical trials that are adequately representative of populations that we’re trying to serve. 

Good Clinical Practices Training
On similar lines, we organized a Good Clinical Practices training at RMRIMS, Patna, in August. Led by Prof YK Gupta, President AIIMS Jammu and Bhopal, the training delved into the essentials of maintaining high clinical standards in trials, such as handling data appropriately and ensuring patient safety. The training was attended by DNDi staff that are involved in clinical trials in RMRIMS, Patna, members of the hospital’s ethics committee, as well as hospital staff. 

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