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Animal dewormer cured whipworm in kids
A drug nobody funded
Moxidectin was developed as a deworming drug for animals in the 1980s. People thought it might be worth trying against worm infections in humans too, but there was little market for it. The people most affected by those infections live in poverty, as children in Africa and south Asia do, so no one showed interest in funding the trials that would prove it works and get it to market.
That changed when a nonprofit ran the work in the 2010s and more recently. Their trial showed that the drug could cure 70% of whipworm infections in kids in Tanzania.
A repeating pattern
The pattern repeats for other diseases of poverty and tropical diseases, where the people who have them can't pay, and companies have little incentive to test existing drugs for those uses even when they are on patent.
How does moxidectin kill worms?
Moxidectin belongs to the macrocyclic lactones, drugs that lock open glutamate-gated chloride channels in worm nerve and muscle cells and paralyze the parasite. These channels are found in invertebrates and are absent from mammals, which is why the drugs are safe enough for animals and people. Ivermectin, a related drug, works the same way. Its discoverers, William Campbell and Satoshi Ōmura, shared the 2015 Nobel Prize in Physiology or Medicine.
Why do drugs for poor regions get so little funding?
A 2006 analysis in The Lancet by Chirac and Torreele found that of 1,556 new drugs marketed worldwide between 1975 and 2004, only 21 were for tropical diseases and tuberculosis. Patients in affected regions often cannot pay prices that would repay development costs. In 2007 the US created a priority review voucher for tropical disease drugs, which a company can use to speed the FDA review of another drug or sell to someone else.
How was moxidectin approved for river blindness?
The nonprofit Medicines Development for Global Health ran the trials, and the FDA approved moxidectin in 2018 for river blindness in people 12 years and older. The disease is caused by a parasitic worm spread by blackflies that breed in fast-flowing rivers. Its name comes from the blindness that follows when the worm's larvae die in the eye.
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