Such a drug is Pentostam, which was developed in the 1930s. Treatment with Pentostam requires a painful course of injections directly into the muscles over a period of up to 40 days – with numerous side effects. This treatment is, in any case, often fruitless: in some parts of India where the disease is endemic, over 60 per cent of the pathogens have developed resistance to the antiquated drug.
Médecins Sans Frontières in Bihar is therefore using a newer drug, liposomal amphoterycin B, marketed under the brand name Ambisome®. “This is a very good drug. We have treated around 1,700 patients with it since July 2007 - sufferers can recover in as little as ten days,” says Gaurab Mitra. “In Sunder Devi’s case it took somewhat longer because she was also infected with hepatitis. But we were still able to discharge her after four weeks.”
However, even the Ambisome® drug has a disadvantage: its cost. Even after a sharp fall in price, it still costs about 280 US dollars to treat each patient. This is a price which many people in poorer countries are unable to pay, making it more difficult to establish the widespread use of the drug in Indian health centres.
It is for this reason that Médecins Sans Frontières’s access campaign is challenging the pharmaceutical industry to make further reductions in the price of Ambisome® and not to prevent the production of cheaper combination drugs. Médecins Sans Frontières is also calling on governments to make more money available for research into neglected diseases and to push for the development of improved testing procedures, drugs and preventative vaccines: this in the hope that the future will see more patients like Sunder Devi returning home restored to health after successful treatment.