Journal of Postgraduate Medicine Medknow Publications and Staff Society of Seth GS Medical College and KEM Hospital, Mumbai, India ISSN: 0022-3859 EISSN: 0972-2823 Vol. 51, Num. 5s1, 2005, pp. 4-4

Journal of Postgraduate Medicine, Vol. 51, No. 5s1 , 2005, pp. 4

Commentary

A Fruitful Idea

Ferner RE

City Hospital,Birmingham B18 7QH

Correspondence Address:E-mail: r.e.ferner@bham.ac.uk

Code Number: jp05125

Western pharmaceutical companies are beholden to their shareholders, and their shareholders expect profits. This skews drug development towards 'the diseases of the rich.'Most people in the world, however, live in poor countries where life expectancy and the quality of life are diminished by infectious diseases now rare in the Western world. Visceral leishmaniasis is one such disease. An affordable, safe, and effective treatment for kala azar would be of considerable benefit in endemic areas. Standard amphotericin has been used, but is far from ideal, because of systemic and renal adverse effects.

Liposomal therapy with amphotericin greatly reduces the incidence of systemic and renal adverse effects of the drug, but the standard commercial preparation is extremely expensive: a single day's treatment for an adult can easily cost over US$600.

It is rare for academic institutions to be responsible for the entire development of a new drug. The concept of an effective but affordable liposomal preparation, its careful investigation, and its development in animal models and then in human subjects is a signal achievement by the academic groups in Mumbai and their co-workers in Delhi, constrained as they were by limited resources. Patients with kala azar and serious fungal infections should be the beneficiaries.

Copyright 2005 - Journal of Postgraduate Medicine