By: Julien Potet, Neglected Tropical Diseases Policy Advisor at Médecins Sans Frontières’ Access Campaign

There are multiples challenges in improving access to drugs for neglected tropical diseases. More resources are desperately needed to scale up prevention and treatment programmes, and new incentives must be found to spur research into better treatments, due to the reluctance of pharmaceutical companies to invest resources into drug development for diseases without a lucrative market.

Maintaining a continuous supply of the existing medicines in sufficient quantities is another considerable challenge, as many drugs for neglected tropical diseases are produced by a single supplier. Often the reason for this is not patent protection, as most of the medicines I am talking about here are reasonably old and are no longer covered by any kind of intellectual property rights. These drugs are produced by a sole supplier because the absence of a highly valuable market makes it difficult to attract several producers.

Take benznidazole, the first-line treatment for Chagas disease. Benznidazole is far from being a perfect treatment, and more research and development into better medicines is needed. But benznidazole is safe and highly effective in acute cases of Chagas disease (predominantly seen in children), and is also feasible and beneficial for adolescents and adults with chronic Chagas disease. The Swiss multinational pharmaceutical company Roche decided to hand over its production of benznidazole to another company in the late 1990s. In2003, atechnology transfer agreement was reached with LAFEPE, a state-owned Brazilian company, and LAFEPE became the sole producer of benznidazole worldwide.

Relying on a single producer is risky. Last year, for a number of technical and political reasons, there was a global shortage of benznidazole. In October 2011, Médecins Sans Frontières publicly urged Brazil’s Ministry of Health to resolve the situation. Production was resumed at the end of 2011, but it is still unclear whether LAFEPE will be able to produce the quantities required.

There are many other drugs for neglected tropical diseases that rely on a single producer. They include nifurtimox, for Chagas disease and sleeping sickness (produced by Bayer); eflornithin, for sleeping sickness (produced by Sanofi-Aventis); and paromomycin, for kala azar (produced by Gland Pharma).

So it was really good news to hear an Argentinean company, ELEA, announce on 20 March that it was ready to produce and distribute its own 100mg and 50mg tablets of benznidazole. The arrival of this second producer is a huge relief. The product will initially be made available to Argentinean patients, but ELEA has announced that it could also supply other countries as back-up to LAFEPE. ELEA belongs to the Chemo Group, which also supports the philanthropic Fundacion Mundo Sano.

With two producers, global supplies of benznidazole should be more stable and better able to meet the needs of Chagas patients worldwide. Not only is this a piece of good news; it’s also a positive signal for the future. The emergence of a second supplier of benznidazole shows that the roll-out of antiparasitic treatment for Chagas disease is increasingly being seen as a public health priority in endemic countries, both by public authorities and by the pharma industry.

Getting treatment for Chagas disease onto the health agenda in Latin Americawould not have been possible without the mobilisation of patient groups and non-governmental organisations. Let’s keep up the pressure, so that more pharmaceutical companies commit to producing and distributing the essential drugs which sufferers of neglected tropical diseases simply cannot live without.