How can new drugs for NTDs be developed?
The Drugs for Neglected Diseases Initiative (DNDi) was created in response to the frustration of clinicians and the desperation of patients faced with medicines that were ineffective, unsafe, unavailable, unaffordable, or that had never been developed at all. DNDi embraces the power of innovation, open science, partnerships, and advocacy to find solutions to a great injustice: the lack of medicines for life-threatening diseases that disproportionately impact poor and marginalized people.38 Through harnessing scientific advances in drug discovery, technologies to improve the efficiency and accelerate the pace of the R&D process, including artificial intelligence (AI)-driven drug discovery tools, novel imaging, diagnostic, and clinical trial design and operations technologies, and AI-driven data analysis are being employed. Evaluation of a range of strategies and compounds, including fast-evolving techniques such as the use of host-targeted therapies or development of specific monoclonal antibodies alongside repurposing of older agents aims to increase the therapeutic repertoire available for evaluation in clinical trials. Furthermore, efforts to develop drugs for NTDs must involve engaging members of the affected communities, and the control arms of randomized controlled trials of new drugs must at least include the existing national standard of care. Similar models have been used in partnerships such as the Medicines for Malaria Venture, Gavi (the vaccine alliance) and the COVID-19 Clinical Research Coalition.