Several major drug companies announced renewed investment in malaria and neglected tropical diseases (NTDs) at the recent Kigali Summit on Malaria and NTDs in Kigali, Rwanda. There were 241 million malaria cases in 2020. Over a billion people are impacted by NTDs, mainly in impoverished communities, according to the World Health Organization (WHO).
Much of the newly announced money targets malaria. GSK, which produces the first and only WHO-approved malaria vaccine, announced plans for further malaria vaccine development. So did BioNTech: the company announced plans to start human trials for messenger RNA–based malaria vaccine candidates later this year.
Novartis pledged $250 million over 5 years for R&D, $150 million of which is for antimalarials. GSK pledged $1 billion over 10 years for R&D in infectious diseases like malaria, tuberculosis, HIV, and NTDs, as well as antimicrobial resistance. The Bill and Melinda Gates Foundation pledged $140 million over 4 years to support African organizations working to combat malaria.
NTDs receiving commitments at the summit included trachoma, a bacterial infection that causes blindness, for which Pfizer extended its donation of the antibiotic azithromycin through 2030. The Wellcome Trust, a UK health research charity, pledged about $85 million to research treatments for poisoning from snake bites.
Novartis committed $100 million to its NTD program, which focuses on treatments for Chagas disease, dengue fever, visceral leishmaniasis, and cryptosporidium. GSK reaffirmed its pledge to donate the anti-worm medicine albendazole for two NTDs caused by parasitic worms, and expanded its donation to a third NTD.
NTDs are typically eclipsed in funding by diseases that are more prevalent in high-income countries. Even for diseases that affect low- and middle-income countries, NTDs are often overshadowed by diseases like malaria, tuberculosis, and HIV, says Maria Elena Bottazzi, associate dean of the National School of Tropical Medicine at the Baylor College of Medicine. “By no means I’m saying that malaria gets all the attention that is needed,” Bottazzi says. “But . . . NTDs get crumbles.”
One reason for this funding difference is that many NTDs aren’t usually fatal, Bottazzi says, but the disabilities they cause allow the cycle of poverty to continue.
The COVID-19 pandemic also pulled attention and resources away from NTDs and malaria. Rising malaria rates in 2020 were attributed to a lack of access during the pandemic to antimalarial measures such as bed nets and preventative drugs, says Catherine J. Merrick, a malaria expert at the University of Cambridge, in an email.
Without a highly effective vaccine, Merrick says, malaria will always be at a risk of resurgence. “Mosquitoes tend to evolve to resist insecticides or to change their biting behavior, while the parasite is extremely good at evolving to resist antimalarial drugs,” she says. “Therefore, we are in a constant arms race against this disease.”
Bottazzi says it’s important for companies to collaborate with people in the areas of need, and for funding to go directly to the impacted areas. “How and who gives and receives money, it’s still much dictated by the Global North,” (a term that refers to wealthy regions like North America, Australia, and Europe) and is not empowering scientists in the areas of need, she says.