Lymphatic filariasis (LF) is a neglected tropical disease (NTD) commonly known as elephantiasis. It is caused by parasitic worms and transmitted to humans by different types of mosquitoes. Infection is usually acquired in childhood causing hidden damage to the lymphatic system. The disease affects mostly the poorest municipalities in the country, the Department of Health (DoH) noted.
The painful and profoundly disfiguring visible manifestations of the disease — lymphoedema, elephantiasis (gross enlargement and swelling of an area of the body because of the accumulation of fluid, often the arms and legs), and scrotal swelling — occur later in life and can lead to permanent disability according to the World Health Organization (WHO). On top of being physically disabled, patients suffer mental, social and financial losses contributing to stigma and poverty, it added.
The US Centers for Disease Control and Prevention (CDC) said that filarial infection can also cause tropical pulmonary eosinophilia syndrome. Symptoms include cough, shortness of breath, and wheezing.
Lymphatic filariasis can be eliminated by stopping the spread of infection through preventive chemotherapy with safe medicine combinations repeated annually. An essential, recommended package of care can alleviate suffering and prevent further disability among people living with disease caused by LF.
The WHO said that an estimated 7 million Filipinos from six provinces are still at risk of LF. This is why the DoH National Filariasis Elimination Program (NFEP) is conducting annual mass drug administration in these remaining provinces while the 40 provinces under elimination status are under continuous monitoring. In spite of the coronavirus disease 2019 (COVID-19) pandemic, the DoH NFEP continued its mass drug administration campaign and delivery of routine services for LF.
One billion people worldwide — or one person in seven — suffer from NTDs. These illnesses primarily affect poor people in tropical and subtropical areas of the world. Nine NTDs represent more than 90% of the global NTD burden. These are LF, human African trypanosomiasis, Chagas disease, soil-transmitted helminthiases (STH), onchocerciasis, schistosomiasis (SCH), leprosy, fascioliasis, and blinding trachoma, said the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA).
NTDs kill or disable millions of people every year. At such a level of impact, NTDs cannot be ignored. These illnesses affect both children and adults for life, often lead to stigmatization, and can prevent children from developing to their fullest potential. As long as NTDs continue to be endemic in poor countries, they will remain a contributor to a vicious cycle of poverty in these regions.
The research-based pharmaceutical industry fights NTDs in several ways. Firstly, through cutting-edge research and development (R&D). IFPMA members are working on 82 projects either independently or in product development partnerships (PDPs). As a partner in public health, it partners to implement capacity-building efforts in developing countries. These efforts are complemented by medicine donation programs, several of which date back decades.
In the Philippines, these efforts included the projected donation of 261 million albendazole tablets by GlaxoSmithKline (GSK) in support of its goal to help eliminate LF. GSK has also donated at least 8 billion tablets of albendazole to help eliminate this disabling disease globally.
Since 2000, Novartis has also been providing multiple drug therapy (MDT) medications for free to leprosy patients through the WHO. The DoH and Novartis Foundation also signed a Memorandum of Understanding and formed a task force to help develop innovative approaches to leprosy control. One of its key outputs is the Leprosy Alert and Response Network System (LEARNS), the country’s first mobile phone-based leprosy teleconsultation system.
Globally, a paper published on behalf of the Royal Society of Tropical Medicine and Hygiene identified the pharmaceutical industry’s major partnerships to NTD programs.
MSD and Eisai, for example, have provided medicines for free to achieve elimination of LF worldwide. Pfizer, on the other hand, committed to the elimination of trachoma as a public health threat through medicine donation. Meanwhile, Sanofi donated medicines for the treatment of Human African trypanosomiasis (HAT), while Bayer provided medicines for HAT and Chagas disease also for free. Johnson & Johnson donated medicines for STH while Merck KGaA committed to the elimination of SCH.
For more than three decades, the research-based pharmaceutical industry has demonstrated its resolve to collaborate in addressing the burden of NTDs in the Philippines and worldwide.
Teodoro B. Padilla is the executive director of Pharmaceutical and Healthcare Association of the Philippines (PHAP), which represents the biopharmaceutical medicines and vaccines industry in the country. Its members are at the forefront of research and development efforts for COVID-19 and other diseases that affect Filipinos.
