Diarrheal Disease

Diarrheal Diseases Kill Almost 2 Million Children a Year

The Global Burden of Diarrheal Disease

Diarrheal diseases are the major cause of childhood hospitalization, primarily for dehydration. The pediatric death toll due to diarrheal illnesses exceeds that of AIDS, tuberculosis, and malaria combined.  In poor countries, diarrheal disease is second only to pneumonia in causing the deaths of children under five years old. Every week, 31,000 children in low-income countries die from diarrheal diseases – approximately 4,500 deaths every single day.

Diarrheal episodes can be either acute or persistent (lasting two weeks or more). Of all childhood infectious diseases, diarrheal diseases are thought to have the greatest effect on growth, by reducing appetite, altering feeding patterns, and decreasing absorption of nutrients. The number of diarrheal episodes in the first two years of life has been shown not only to affect growth but also fitness, cognitive function, and school performance.

OneWorld Health’s Response

The Institute for OneWorld Health is committed to becoming a thought leader and change agent in the area of diarrheal disease control, in partnership with stakeholders and experts in the field.  We have conducted an extensive landscape analysis on the needs and gaps in the field, and have begun to engage researchers, policy experts, funding organizations, and bio/pharma companies to better understand the scope of the diseases.  In collaboration with the global community, iOWH aims to develop safe, effective, and affordable medicines for diarrheal diseases,  that complement existing standard-of-care interventions such as Oral Rehydration Therapy (ORT) and zinc. 

In 2006, iOWH received a grant from the Bill & Melinda Gates Foundation to develop novel anti-secretory drugs to be used as an adjunct to ORT that will safely reduce stool output and shorten duration of diarrheal episodes.  As part of this grant, iOWH assembled both technical and strategic advisory committees for guidance on the critical needs for diarrhea treatment.  Under their guidance, iOWH has identified a number of significant treatment gaps to target in the areas of acute watery diarrhea, dysentery (bloody diarrhea), and persistent diarrhea.

In the near term, iOWH will focus primarily on developing drugs to treat massive fluid and electrolyte loss, the life-threatening symptom of acute watery diarrhea.  In the medium and longer term, the organization plans to address significant unmet needs in anti-microbial therapy and in persistent diarrhea.  iOWH is leveraging both our in-house expertise and collaboration with pharmaceutical companies to increase the probability for technical success to develop a new treatment for acute watery diarrhea.

In the spring of 2008, iOWH entered into a research collaboration with Roche under which iOWH was able to screen over 780,000 molecules from Roche’s compound library to identify a potential new drug for the treatment of diarrheal diseases.  In May 2009, iOWH successfully completed our first screening campaign and announced that up to 40 new drug leads would be selected for further study intended to identify a new treatment for childhood diarrhea.

Building upon this success, iOWH recently-signed a collaboration agreement with Novartis which will allow iOWH to select promising drug candidates that are ready for pre-clinical testing.  OneWorld Health and the Novartis Institutes for BioMedical Research have joined forces to discover drugs to treat infectious diarrhea via inhibition of the Cystic Fibrosis Transmembrane Conductance Regulator chloride channel. Therapy for infectious diarrhea today involves oral rehydration, effective if begun early enough in the course of illness.  Because infectious diarrhea is caused in many cases by over-activation of the Cystic Fibrosis (CF) channel, a CF channel blocker could be a powerful addition to currently available treatments, directly reducing fluid and electrolyte loss.

As development of new products progresses, iOWH will expand our network of partners and foster mutual relationships in the field that will further the goal of reducing diarrheal disease mortality and morbidity.