A Fruitful Idea
City Hospital,Birmingham B18 7QH, United Kingdom
R E Ferner
City Hospital,Birmingham B18 7QH
|How to cite this article:|
Ferner R E. A Fruitful Idea.J Postgrad Med 2005;51:4-4
|How to cite this URL:|
Ferner R E. A Fruitful Idea. J Postgrad Med [serial online] 2005 [cited 2023 Jan 29 ];51:4-4
Available from: https://www.jpgmonline.com/text.asp?2005/51/5/4/19807
Western pharmaceutical companies are beholden to their shareholders, and their shareholders expect profits. This skews drug development towards 'the diseases of the rich.' Most people in the world, however, live in poor countries where life expectancy and the quality of life are diminished by infectious diseases now rare in the Western world. Visceral leishmaniasis is one such disease. An affordable, safe, and effective treatment for kala azar would be of considerable benefit in endemic areas. Standard amphotericin has been used, but is far from ideal, because of systemic and renal adverse effects.
Liposomal therapy with amphotericin greatly reduces the incidence of systemic and renal adverse effects of the drug, but the standard commercial preparation is extremely expensive: a single day's treatment for an adult can easily cost over US$600.
It is rare for academic institutions to be responsible for the entire development of a new drug. The concept of an effective but affordable liposomal preparation, its careful investigation, and its development in animal models and then in human subjects is a signal achievement by the academic groups in Mumbai and their co-workers in Delhi, constrained as they were by limited resources. Patients with kala azar and serious fungal infections should be the beneficiaries.