Global dengue coalition to deliver treatment within 5 yrs: Lancet comment

A coalition of institutions from dengue-endemic countries aims to deliver a new treatment for dengue from repurposed drugs and combinations within 5 years, according to a comment published in The Lancet Global Health journal.

The mission of the alliance, The Dengue Alliance, is to accelerate research and development and deliver dengue therapeutics through an inclusive partnership, it said.

"An integrated approach that comprises vector control, use of safe and effective vaccines, and an effective treatment is needed to face the growing challenges of dengue infection," the alliance formed by the Drugs for Neglected Diseases initiative (DNDi), Switzerland, said in its comment.

The DNDi, founded in 2003, is an international, not-for-profit research and development organisation developing new affordable and patient-friendly treatments for neglected tropical diseases.

The Dengue Alliance, launched in 2022, is co-created, co-owned, and co-funded by dengue-endemic countries, and includes the Translational Health Science and Technology Institute in India, along with institutions from Brazil, Malaysia and Thailand.

Dengue, a global public health threat, is a climate-sensitive neglected tropical disease and currently the most rapidly spreading mosquito-borne viral infection in the world.

It is estimated to infect approximately 390 million individuals annually, with 96 million infections being symptomatic, the comment said.

The Dengue Alliance attributed the rapidly increasing incidence of dengue to climate change, rapid urbanisation, and widespread international travel.

Further, according to their comment, vector control, which involves taking measures for mosquito control, had so far been the only strategy adopted to reduce the burden of dengue, even though it alone was likely inadequate to reduce the burden.

The currently available dengue vaccines, while having shown to reduce hospitalisation, lack efficacy against some dengue serotypes, the alliance said.

"Therefore, an integrated approach that comprises vector control, use of safe and effective vaccines, and an effective treatment is needed to face the growing challenges of dengue infection," they said.

The alliance, involving different working groups and a steering committee, coordinates efforts to address gaps in knowledge, such as epidemiology (specifically in Africa), biomarkers and diagnostics, clinical trials, and regulatory framework, while promoting open science, it said.

In parallel, clinical trials for these drug candidates were being designed using the expertise of clinicians in these countries who have been treating patients with dengue for many years, with initiation planned by the end of 2023, the alliance said.

With climate change becoming more of a concern in high-income countries, there is an increasing possibility that many global funding organisations will acknowledge the true burden of dengue, the devastation it causes to health systems and patients in endemic countries, and, therefore, the importance of funding initiatives to accelerate the development of new treatments for dengue, they said in their comment.