The exception of dengue

Neglected tropical diseases (NTDs) receive far too little attention, particularly in the area of research and development. Many profit-oriented companies simply do not consider them lucrative enough to make the necessary investments. In recent years, however, one specific neglected tropical disease has been exerting a strong pull on firms from the free market: dengue fever.

The simple reason is that when a disease, particularly an infection, is perceived as a serious health or security problem for people in richer countries too, more funds flow into research. This is not a polemic but rather a lesson from history, including from the early phase of the AIDS pandemic and the response to Ebola.

The fever, which is transmitted by various species of mosquito, is primarily concentrated in the global south. In past years, large portions of Latin America and Southeast Asia in particular have suffered tremendously from extensive and repeated outbreaks. What made headlines in German media, however, were several cases of dengue in Paris and near Lake Garda, a popular holiday destination for Germans in Italy.

The Robert Koch Institute (RKI) in Berlin is the central institution of Germany’s Federal Government in the field of disease surveillance and prevention. It determined that as yet there has been no documented evidence of dengue transmission through insects within Germany. Nevertheless, suitable vectors in the form of Asian tiger mosquitoes can now be found in the country. According to the RKI, the local affinity for far-flung travel destinations like Brazil and Thailand led to an unusually high number of cases in Germany, too, at the beginning of this year.

Travel medicine and the treatment of people in affluent markets promise significant returns. The research pipeline for dengue is now notably filled, with the exception of a few small weak points. Experts have long since started asking, increasingly publicly, whether the disease is still truly commercially “neglected” in a narrower sense. What sounds like a rather theoretical thought experiment has practical implications. Within the group of NTDs, a familiar dynamic is threatening to accelerate: some diseases are attracting significantly more attention, not least because of their growing importance for richer countries, while others are more or less being forgotten. 

Max Klein is a political scientist and conducts educational work for the German civil-society organisation BUKO Pharma-Kampagne, including on the topic of neglected tropical diseases.
mk@bukopharma.de