Washington University School of Medicine in St. Louis has announced a commitment of up to $24.7 million from the Bill & Melinda Gates Foundation in support of efforts to eliminate two neglected tropical diseases as a public health problem.
The funding will support clinical trials and related studies in Africa and Oceania that could help accelerate the elimination of lymphatic filariasis, which in severe cases causes elephantiasis, and river blindness, known more formally as onchocerciasis. About $6 million already has been committed to the Death to Onchocerciasis and Lymphatic Filariasis (DOLF) Project, with additional funding dependent on the results of the first wave of studies.
With the new funding, DOLF researchers will test a method of administering a combination of three drugs to treat people co-infected with parasitic worms that cause the two diseases. After earlier DOLF studies showed that a combination of ivermectin, diethylcarbamazine, and albendazole (IDA) was safe and more effective in treating lymphatic filariasis than the World Health Organization-recommended two-drug combinations, WHO began recommending the three-drug combination in 2017. The triple-drug combination is not recommended, however, in areas where both lymphatic filariasis and river blindness are endemic, because the medication that kills the worms that cause river blindness also releases toxic byproducts that can cause blindness. The new strategy will be "to pre-treat people with ivermectin to remove the parasites from the eyes and then, several months later, deliver IDA, which should then be safe," said Gary Weil, a professor of medicine and molecular microbiology and the principal investigator of the DOLF Project.
"Globally, enormous progress has been made in reducing lymphatic filariasis and river blindness, but it will take decades to achieve full elimination with current treatment strategies," said Weil. "So there is an urgent need to develop new tools and approaches to speed the elimination of both diseases."