Ciro Oiticica (Fiocruz News Agency)
Last Tuesday (March 29), Fiocruz and Drugs for Neglected Diseases initiative (DNDi) signed a Memorandum of Understanding for dengue fever research and treatment. The occasion also sealed a Strategic Research Alliance between the two institutions and the joint submission of a project to the Finep Public Call for Neglected Diseases.
In addition to signing the Memorandum of Understanding for dengue fever, the occasion sealed a Strategic Research Alliance (Photo: Peter Ilicciev)
Fiocruz president, Nísia Trindade Lima, welcomed at the Official Fiocruz Residence, in Rio de Janeiro, the committee that included the DNDi global director for research and development, Laurant Fraisse; the initiative’s president for Latin America, Michel Lotrowska; and the regional executive director of DNDi in Latin America, Sergio Sosa Estani, among other representatives. Lima praised the historical cooperation with the DNDi, which has been taking place since its creation, with a great number of shared projects. “The celebration is not only for the Memorandum of Understanding, but also for the consolidation of an entire journey and the marking of cooperation pathways. Formalizing this alliance is important, because it will allow us to think a strategic planf or the future in terms of diseases and neglected populations, which has been an approach adopted by Fiocruz in this strategic partnership”, she said.
Laurent Fraisse, the DNDi global director for research and development, also celebrated the milestones. “We want to prioritize our best partners. Fiocruz has been such a partner and will continue to be so. We wish to bring our own energy to contribute with this institution that has so much skill, and elevate our partnership to a strategic level”. Fraisse mentioned the meetings held earlier with Fiocruz vice-presidents Rodrigo Correa (Biological Research and Collections) and Marco Krieger (Production and Innovation in Health), who were also present at the Official Residence. “We had very productive and dynamic conversations in the morning regarding diseases such as Chagas and leishmaniasis. We have made progress in the research against dengue fever, a new DNDi project”, he said.
The DNDi is a non-profit organization of research and development that works to offer new treatments to neglected patients. Since its creation, in 2003, it has developed nine treatments against six neglected diseases. The organization has also been coordinating the Anticov clinical trial to find specific treatments for mild to moderate cases of COVID-19 in Africa. As a founding member of the DNDi, together with institutions such as the Pasteur Institute and Doctors without Borders, Fiocruz has a seat at the organization’s bodies, represented by researchers Jorge Bermudez, a member of the Council, and André Daher, at the Technical Committee.
Jorge Bermudez, who attended the meeting, has been following the evolution of the organization since its beginning. “I see progress, moving out of the traditional model of Tropical Diseases so as to also embrace hepatitis C, COVID”, he said. Bermudez also highlighted some aspects of the partnership. “Fiocruz, as an institution, acts as a complement to the DNDi, and it must still form an alliance with it in the Latin America region, with an eye on neglected populations and on the diseases that currently assail us. Among these is dengue fever, a crucial problem for the region and for the world as a whole”.
Memorandum of Understanding for dengue fever
The DNDi project for dengue fever has a wide-ranging approach and does not focus on the development of a single product. It evaluates opportunities for vaccines, drugs, diagnosis and others. The Memorandum of Understanding is taking place within a global partnership for research to find a treatment for dengue fever, coordinated by the DNDi and involving institutions from India, Thailand, and Malaysia. The organization also intends to include institutions from African countries, such as Ghana and the Democratic Republic of the Congo, to run more epidemiological studies. Fiocruz plays a central role in this network, thanks for the wide range of its activities.
Globally, the number of cases of dengue fever increased by 85% from 1990 to 2019. It is expected that increased temperatures caused by climate change will push these number even higher, to the point that the disease may come to affect 60% of the world’ population by 2080. The search for a wide-ranging approach to fight dengue fever must also include diagnosis and vaccines.
Marco Krieger, vice-president of Production and Innovation in Health, understands the importance of this new work flank. “We were defending this initiative even before the pandemic. It adds to projects we already had, such as for Chagas disease, leishmaniasis and malaria, an endemic line that is thematically important for the Latin America region”.
A Strategic Alliance between the DNDi and Fiocruz was also formalized. It aims to strengthen the existing relationship by establishing a Joint Strategic Committee to supervise all present and future collaborations taking place in different areas of reasearch and development, advocacy, and access programs for multiple infectious diseases. By 2028, the two institutionis hope to have contributed to strengthen capacities in the Latin America region and to make sure that new, effective, safe and accessible drugs are developed and delivered to neglected patients. The next steps involve the creation of a work group to develop the process, defining structure and governance, and the identification of potential areas in the contexts of research and development, implementation research, production in Chagas, leishmaniasis, HCV, dengue fever, and pediatric HIV.
Rodrigo Correa, vice-president of Biological Research and Collections, projected the partnership. He believes it will have much to gain with the exchange of information and experiences. “DNDi is also interested in using the Fiocruz network of biobanks”, he said. “Let us expand this partnership more and more”. Jorge Mendonça, director of the Institute of Drug Technology (Farmanguinhos/Fiocruz), revealed that one fruit of the partnership with the DNDi is bringing to Brazil a treatment against hepatitis C. “The next step will be to present the documentation to Anvisa”. The alliance will also make it possible, in his opinion, to incorporate diagnosis and treatments in a strategic fashion: “reducing the time between diagnosis and the arrival of the treatment will be very important for the health system”.
Another front of this alliance, highlighted by Sergio Sosa Estani, regional executive-director of the DNDi in Latin America, is the advocacy area. “We need a partnership environment if we want to develop action plans”, he explained. Optimizing this environment also envisions the specific action that is advocacy, so we can come closer to key actors”.
Projects for neglected diseases
The DNDi and Fiocruz have submitted a joint project to the Finep public call of promotion of research, development, and innovation in neglected, tropical and vector-transmitted diseases and other illnesses. The project “Accellerating pre-clinical and clinical development of dengue fever treatments through drug repositioning” has the goal of building the pre-clinical and translational basis to begin the clinical evaluation of repositioned drugs for early use, to prevent the onset and/or reduce the duration of symptoms and avoid progression into the severe form of the disease.
The project hopes to validate and select at least one clinical candidate (ideally a combination of an antiviral agent and an anti-inflammatory or anti-platelet) and prepare the regulatory steps necessary to submit a phase II clinical trial in Brazil, with the goal of clinically developing and approving a new treatment for dengue fever.
The project was selected from among more than fifty others. For these, Krieger stated there is a plan, as one of the first actions of the Strategic Alliance, to ellaborate a join call with DNDi. “It would be an additional initiative to attempt to embrace these two large nuclei, development of diagnosis for neglected diseases and evaluation of drug repositioning”.