For some people, a mosquito bite only results in a red, itchy spot. But what if a single bite – whether from a mosquito, fly, tick or bug – could make you sick, or even significantly impact your life? This can happen if the arthropod is a vector of pathogens. Then, during blood feeding, bacteria, viruses or other parasites would be transferred to the human or animal host. This situation is, unfortunately, a reality in tropical and subtropical climates of Asia, Africa and parts of the Americas. Although these regions are often thought of as paradises of warmth and sun, they are also a haven for arthropod vectors that transmit pathogens while feeding on their human or animal host. This situation also puts people there at risk of vector-borne tropical diseases, such as dengue and malaria.
To tackle these conditions, Bayer takes a 360-degree approach, working across divisions. With their combined expertise, the working group strives to improve and prolong the lives of all people.
One of these patients was Frédéric Baur, Global Market Manager for Vector Control with Environmental Science at Bayer, based in Lyon, France.“While I was working for a cotton company in the bush in Togo, Western Africa, I got malaria. I had no medical assistance or means of communication,” he remembers. “My body was a mess. I had diarrhea, with terrible headaches, chills, hot sweat and very high fever. The medicine quinine, which can be used to treat malaria, temporarily made me almost blind. I was convinced that I was going to die.” Fortunately, after four days, Baur started to recover – but this experience has never left him. He knows that an experience like his, or worse, is all too common globally.
According to WHO, vector-borne diseases account for 17% of all infectious diseases, causing more than 700,000 deaths every year. For example, 3.9 billion people in over 128 countries are at risk of contracting dengue fever, with 96 million cases estimated every year. 
The Burden of Neglected Tropical Diseases and Malaria
While many people may be aware of malaria, other vector-borne tropical diseases remain largely unknown or neglected among the public in countries where the disease is not present. These diseases are aptly referred to as neglected tropical diseases as they generally receive less global attention as well as funding for research and development compared to other global health issues such as HIV or cancer. Neglected tropical diseases include Chagas disease, Zika, dengue, African sleeping sickness (African Trypanosomiasis), leishmaniasis, lymphatic filariasis, chikungunya, river blindness (onchocerciasis) and schistosomiasis.
“Prevention and cure of NTDs is often possible. These diseases don´t have to be neglected. They simply must receive enough attention and resources.”
Dr. Stefan Heinke, Global Senior Sustainable Development Manager with Crop Science at Bayer
“Children are extremely vulnerable when it comes to vector-borne diseases. This is especially true for malaria, where the majority of victims are children under the age of five,” says Dr. Stefan Heinke, Global Senior Sustainable Development Managerwith Crop Science at Bayer, in Monheim, Germany.“ And if older children get sick, they sometimes can’t follow very well in school and do not reach their full educational potential.”
Health organizations and research institutes have recognized that these infectious diseases are an issue disproportionately affecting the poorest nations in the world, with more than one billion people suffering. According to the World Health Organization (WHO), neglected tropical diseases affect over 70 percent People living in developing countries, particularly in rural and remote areas, often have limited or no access to health services. After Baur's first-hand experience with malaria, he became even more sensitive to the huge burden of neglected tropical diseases. “We need to tackle this fundamental humanitarian challenge,” he says. “It is everybody’s concern.”
|Medical examinations, such as blood tests, are key for early diagnosis of many infectious tropical diseases. In developed countries, nearby doctor offices and hospitals routinely provide these services. This is not always the case in developing countries: Depending on country and region, there may be no nearby doctors or tests.|
Contributing to the Fight for Better Public Health
To fight neglected tropical diseases and malaria, Bayer experts at Animal Health, Environmental Science and Pharmaceuticals came together in a cross-divisional Public Health working group in 2016. The team shares knowledge, following a triple mission: to prevent causes, provide cures and raise awareness through communication. “We further improve prevention measures for vector control through community training, partnerships, research and development. Beyond that, we help address challenges, such as insecticide resistance in vectors,” states Baur, one of the team members. His Berlin-based colleague, Dr. Ulrich Madeja, Head of Access to Medicines with Pharmaceuticals at Bayer, adds,“Public awareness and training of healthcare professionals is crucial.”
Both agree that prevention is key to stopping infections, but the majority of patients lack sufficient access to available treatments. “Two products in our portfolio are listed by WHO as essential medicines for treatment of African sleeping sickness and Chagas disease,” says Dr. Madeja. “Since 2002, we have been supporting WHO with the two medicines free of charge.” Meeting newly emerged medical needs, Bayer develops formulations of its nifurtimox for treatment of children with Chagas disease of all ages. Another compound, emodepside, is currently being investigated as a novel treatment for river blindness, a disease transmitted by blackflies.
|Prevention is the best cure – for human and animal health. Some vector-borne diseases, for example caused by insect bites, are highly pathogenic for both humans and animals.|
When it comes to public health and infectious diseases, it is not just humans who are at risk. “Many vector-borne diseases caused by the bite of insects, fleas or ticks are highly pathogenic for both humans and animals. This is called zoonosis,” explains Prof. Dr. Norbert Mencke, Head of Policy & Stakeholder Affairs with Animal Health at Bayer in Monheim, Germany. “If a vector bites an infected animal or human, it will ingest the disease-causing pathogen. During further blood meals, the vector injects these microorganisms into new hosts.” Prof. Dr. Mencke notes that Bayer is a leader in developing parasiticides to repel or fight ticks and other blood-sucking insects.
The company also contributes towards active prevention of leishmaniasis, a neglected tropical disease that is transferred by sandflies – and a deadly disease for both humans and animals.“We have good scientific knowledge of parasites causing zoonotic diseases, and we have strong interactions with international leaders in science,” says Prof. Dr. Mencke. The members of Bayer's cross-divisional Public Health working group look at a disease from different angles. This makes their cross-divisional exchange fruitful. “We can have a larger impact on neglected tropical diseases and malaria if we collaborate with different measures to control and eliminate the diseases,” Prof. Dr. Mencke adds. "This is why even more stakeholders need to come together to combine their expertise to jointly tackle vector-borne diseases.”
“Medications for tropical diseases, if it comes to research and development of these compounds, follow and need to follow the same processes as for other pharmaceutical compounds.”
Dr. Maria-Luisa Rodriguez, Global Program Head with Pharmaceuticals at Bayer
Passionate About Making a Difference
The team's commitment is based upon an understanding that neglected tropical diseases and malaria cause far-reaching physical and emotional suffering. “They hamper a person's ability to work, reduce life expectancy, keep children out of school and prevent families and communities from thriving,” explains Dr. Maria-Luisa Rodriguez,“Patients with neglected tropical diseases or malaria can suffer long-term disabilities from disfigurement and severe organ damage. Some of these diseases kill people when they are young, taking them away from their families. These infections can also cause pregnancy complications and hamper children’s development,” she adds. Overall, vector-borne tropical diseases severely impact the socio-economic progress in many developing nations.
“Without access to medical treatments, people in the poorest parts of the world often travel hours to get to the next hospital.”
Dr. Ulrich Madeja, Global Head of Access to Medicines with Pharmaceuticals at Bayer
Access and Awareness for Healthcare
Making a difference for people in developing countries requires facing various aspects of infrastructure and economics: Many villages have poor sanitation or inadequate surveillance systems, and access to medical treatment is not yet available for everyone. “People need systematic screenings for early-stage disease detection. This way, healthcare experts can treat them before the disease will progress,” says Dr. Madeja. “This is why we support WHO and their mobile intervention teams in the fight against African sleeping sickness in the Democratic Republic of Congo.” Improved access to existing effective and affordable tools for treatment and diagnosis is crucial, but also prevention of vector-borne diseases by insect repellants or bed nets. “Even people who are not trained healthcare providers, such as schoolteachers or local volunteers, could create awareness for the diseases and train people to prevent such diseases,” adds Dr. Madeja.
|Team Spirit: The cross-divisional working group within Bayer is passionate and dedicated to help people who are at risk or who suffer from neglected tropical diseases and malaria.|
Standing Together as One
Since 2012, international partnerships have aimed to control neglected tropical diseases, such as the signings of the United Nations Sustainable Development Goals (by 2030) and the second London Declaration. The WHO Roadmap on neglected tropical diseases set out a comprehensive plan for the control, elimination and eradication of 17 neglected tropical diseases by 2020. The roadmap was described by Margaret Chan – former WHO Director-General from 2006 to 2017 – as the “next step forward” in relieving and ending these “ancient diseases of poverty.” With its focus on elimination of the 10 most devastating diseases, the London Declaration was a call for action and acceleration of efforts by a broad spectrum of stakeholders. At the Commonwealth Heads of Government Meeting in London 2018, Bayer also signed a declaration under the ‘ZERO by 40’ banner – to provide innovative vector control solutions to help eradicate malaria by 2040.
“Our 360-degree approach will ensure that all the stakeholders and specialists work in the same direction with a global perspective of the diseases.”
Frédéric Baur, Global Market Manager for Vector Control with Environmental Science at Bayer
Bayer is proud to be part of this fight against neglected tropical diseases and malaria in a unique global position. “We are the only company with competencies in vector control and pharmaceutical treatments for some neglected tropical diseases and can therefore contribute to the fight from the vector to the episode,” says Baur. As signatory of the London Declaration, Bayer is committed to further work on its scientific contributions. “The studies with our compound emodepside illustrate our willingness to combine expertise,” Dr. Madeja explains. Emodepside has already proven its worth in veterinary medicine. Bayer's Animal Health business unit has been offering this antiparasitic agent since 2005 in various combinations of active ingredients to combat worms in animals. Prof. Dr. Mencke is convinced: “Bayer is a life science company. Our expertise in animal health as well as pharmaceuticals helps to find a novel treatment for the poorest of the poor. This really makes me proud,” he smiles.
“The seriousness of NTDs and malaria reflects to us the necessity of a 'One Health’ approach.”
Prof. Dr. Norbert Mencke, Global Head of Policy & Stakeholder Affairs, with Animal Health at Bayer
“The currently available drugs against river blindness are only effective against the parasites' larvae and young worms and must be applied as mass drug application for the lifespan of the adult worms. Emodepside, by contrast, is a macrofilaricide, which also kills the adult nematode. This could provide the first causal treatments and significantly shorten the duration of treatment. This development of emodepside together with DNDi (Drugs for Neglected Diseases initiative) – an independent, not-for-profit organization working to develop and introduce new drugs and therapies for the most neglected diseases – is a product-development partnership,” explains Dr. Rodriguez. “Through such partnerships, Bayer is contributing to progress in healthcare for diseases like this,” says Dr. Rodriguez. With the right protective measures and treatments, most neglected tropical diseases and malaria can be effectively prevented and treated. “To reach the goal of eliminating or at least controlling these diseases, prevention, diagnosis and treatment must go hand in hand,” Dr. Madeja adds. These experts agree: Awareness supports information and networking. The communication between all relevant stakeholders is key.
“All our energy combined can move mountains and make a significant contribution in fighting neglected tropical diseases and malaria,” says Baur. Prof. Dr. Mencke is also convinced they will achieve their ambitious goal: “Let’s do this. We within Bayer have a lot of tools and expertise. If we can’t make a contribution, who else can?”