[HTML][HTML] Cryptococcal meningitis: A neglected NTD?

SF Molloy, T Chiller, GS Greene, J Burry… - PLoS neglected …, 2017 - journals.plos.org
SF Molloy, T Chiller, GS Greene, J Burry, NP Govender, C Kanyama, S Mfinanga, S Lesikari…
PLoS neglected tropical diseases, 2017journals.plos.org
Although HIV/AIDS has been anything but neglected over the last decade, opportunistic
infections (OIs) are increasingly overlooked as large-scale donors shift their focus from acute
care to prevention and earlier antiretroviral treatment (ART) initiation. Of these OIs,
cryptococcal meningitis, a deadly invasive fungal infection, continues to affect hundreds of
thousands of HIV patients with advanced disease each year and is responsible for an
estimated 15%–20% of all AIDS-related deaths [1, 2]. Yet cryptococcal meningitis ranks …
Although HIV/AIDS has been anything but neglected over the last decade, opportunistic infections (OIs) are increasingly overlooked as large-scale donors shift their focus from acute care to prevention and earlier antiretroviral treatment (ART) initiation. Of these OIs, cryptococcal meningitis, a deadly invasive fungal infection, continues to affect hundreds of thousands of HIV patients with advanced disease each year and is responsible for an estimated 15%–20% of all AIDS-related deaths [1, 2]. Yet cryptococcal meningitis ranks amongst the most poorly funded “neglected” diseases in the world, receiving 0.2% of available relevant research and development (R&D) funding, according to Policy Cures’ 2016 Global Funding of Innovation for Neglected Diseases (G-Finder) Report [3, 4]. Although cryptococcal meningitis is not formally recognised by the World Health Organisation (WHO) or PLOS Neglected Tropical Diseases (PLOS NTDs) as a neglected tropical disease (NTD), it is listed in the G-Finder report, as it disproportionately affects people in low-and middle-income countries (LMICs), with market failure evident for existing essential antifungal medicines and an urgent need for new, effective, and less toxic medicines. PLOS NTDs defines NTDs as a “group of poverty-promoting chronic infectious diseases, which primarily occur in rural areas and poor urban areas of LMICs”[5] and according to the WHO, NTDs are “a proxy for poverty and disadvantage”, have “an important impact on morbidity and mortality”, and are relatively “neglected by research”[6]. Although the greatest burden of cryptococcal disease is undoubtedly related to HIV, we demonstrate herein that cryptococcal meningitis meets both the WHO and PLOS NTDs definitions of an NTD,
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