Diarrhea the leading cause of death among the developing world's children

Aug 23 2004

To most people in the developed world, diarrhea is a nuisance. It means some discomfort and maybe a trip to the local pharmacy.

However, many would be shocked to learn that it is one of the leading causes of death among the developing world's children, responsible for approximately two million deaths each year. Even more shocking, diarrhea contributes to the death of four to six million people of all ages every year around the globe.

The Institute for OneWorld Health, the first nonprofit pharmaceutical in the U.S., is working to solve this problem. OneWorld Health is conducting a landscape analysis in the field of infectious diarrhea. As a first step, OneWorld Health will use the findings from a recently held workshop of experts to examine the feasibility of an international diarrheal vaccine effort, with particular emphasis on pediatric solutions.

The group explored the state of vaccine- and diarrheal-disease research, clinical, regulatory, and legal issues, and health economics. Vaccines against the viral- and bacterial-causing agents represent one of the greatest hopes for near-term solutions for the second largest killer of children under the age of five years. In the following months, OneWorld Health will conduct follow-up meetings, issue reports and present findings to gauge international interest and potential research and development paths.

"This neglected disease area is devastating, not only because one in 200 children who contract infectious diarrhea will die from it, but for those who survive, it has a lifelong, generation-wide impact," stated Victoria Hale, Founder and CEO of OneWorld Health. She added that of all childhood infectious diseases, diarrhea is thought to have the greatest impact on fitness, cognitive function, and school performance. "We will find ways to change this, through the development of new treatments for the world's most vulnerable infants and children," Dr. Hale said.

What is being done about this today? Currently marketed antidiarrheal drugs are not safe for use in young children, and there are no approved drugs for children with diarrhea. Most therapies today target the adult travelers' market with little consideration for pediatric use. Some vaccines focus on one pathogen, such as rotavirus, although there are multiple causative pathogens.

Efforts are also underway to prevent exposure to the pathogens responsible for diarrhea in developing countries. However, these require massive improvements in sanitation, hygiene, and nutritional status in developing countries, which are unlikely to have an impact in the short term.

In response, OneWorld Health is pursuing safe, effective, and affordable drug candidates for pediatric diarrhea that will reduce stool output and save babies' lives. A new drug may be used in conjunction with oral rehydration therapy (ORT) in the developing world. ORT is the globally approved treatment for secretory (watery) diarrhea that has been credited with reducing infant mortality by about half. ORT involves giving a dilute solution of sugar and salt orally to children to replace both the water and vital nutrients (electrolytes) lost in diarrhea; it does not treat the diarrhea itself. Parents, out of frustration that ORT does not reduce stool output, purchase antibiotics for their children, which are almost always ineffective and disturb normal intestinal balance.