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Article ; Online: Partnerships for better neglected disease drug discovery and development: how have we fared?

Sunyoto, Temmy

2020 Volume 15, Issue 5, Page(s) 531–537

Abstract: ... ...

Abstract	Introduction
MeSH term(s)	Animals ; Drug Development/organization & administration ; Drug Discovery/organization & administration ; Humans ; Neglected Diseases/drug therapy ; Public Policy ; Public-Private Sector Partnerships/organization & administration ; Vaccines/administration & dosage
Chemical Substances	Vaccines
Language	English
Publishing date	2020-03-10
Publishing country	England
Document type	Journal Article
ZDB-ID	2259618-5
ISSN	1746-045X ; 1746-0441
ISSN (online)	1746-045X
ISSN	1746-0441
DOI	10.1080/17460441.2020.1736550
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Article ; Online: Whole-genome sequencing for surveillance of antimicrobial resistance in Ecuador: present and future implications.

Calero-Cáceres, William / Ortuño-Gutiérrez, Nimer / Sunyoto, Temmy / Gomes-Dias, Cícero-Armídio / Bastidas-Caldes, Carlos / Ramírez, Ma Soledad / Harries, Anthony D

Revista panamericana de salud publica = Pan American journal of public health

2023 Volume 47, Page(s) e8

Abstract: Whole-genome sequencing is becoming the gold standard for pathogen characterization and offers considerable advantages for understanding the evolution and dissemination of new determinants of antimicrobial resistance. Despite the benefits of whole-genome ...

Abstract	Whole-genome sequencing is becoming the gold standard for pathogen characterization and offers considerable advantages for understanding the evolution and dissemination of new determinants of antimicrobial resistance. Despite the benefits of whole-genome sequencing for pathogen characterization, implementation costs and lack of expertise may limit its use by public health laboratories. This article reviews the advantages of whole-genome sequencing for pathogen characterization and the current status of the use of whole-genome sequencing for antimicrobial resistance surveillance in Ecuador. A roadmap is suggested for including whole-genome sequencing for pathogen characterization based on the needs of the health reference institutions through alliances with Ecuadorian universities. Establishing a partnership between public health institutions and academia would be valuable for clinicians, policy-makers, and epidemiologists who could then take reasonable measures in those areas and establish a basis for adapting One Health strategies to tackle antimicrobial resistance in Ecuador.
Language	English
Publishing date	2023-04-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	1376934-0
ISSN	1680-5348 ; 1020-4989
ISSN (online)	1680-5348
ISSN	1020-4989
DOI	10.26633/RPSP.2023.8
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Article: Genomic insights of

Calero-Cáceres, William / Rodríguez, Kerly / Medina, Anabell / Medina, Jennifer / Ortuño-Gutiérrez, Nimer / Sunyoto, Temmy / Dias, Cícero Armídio Gomes / Bastidas-Caldes, Carlos / Ramírez, Maria Soledad / Harries, Anthony David

Frontiers in microbiology

2023 Volume 13, Page(s) 1032753

Abstract: The importance of the One Health concept in attempting to deal with the increasing levels of multidrug-resistant bacteria in both human and animal health is a challenge for the scientific community, policymakers, and the industry. The discovery of the ... ...

Abstract	The importance of the One Health concept in attempting to deal with the increasing levels of multidrug-resistant bacteria in both human and animal health is a challenge for the scientific community, policymakers, and the industry. The discovery of the plasmid-borne mobile colistin resistance (
Language	English
Publishing date	2023-01-16
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2587354-4
ISSN	1664-302X
ISSN	1664-302X
DOI	10.3389/fmicb.2022.1032753
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Article ; Online: Colistin resistance in

Bastidas-Caldes, Carlos / Guerrero-Freire, Salomé / Ortuño-Gutiérrez, Nimer / Sunyoto, Temmy / Gomes-Dias, Cícero Armídio / Ramírez, Maria Soledad / Calero-Cáceres, William / Harries, Anthony D / Rey, Joaquín / de Waard, Jacobus H / Calvopiña, Manuel

Revista panamericana de salud publica = Pan American journal of public health

2023 Volume 47, Page(s) e48

Abstract: Objective: Colistin is an antibiotic of last resort for treating serious Gram-negative bacterial infections. However, the misuse of colistin, especially as an animal growth promoter, has contributed to increasing antimicrobial resistance, mediated ... ...

Abstract	Objective: Colistin is an antibiotic of last resort for treating serious Gram-negative bacterial infections. However, the misuse of colistin, especially as an animal growth promoter, has contributed to increasing antimicrobial resistance, mediated mainly through plasmid transfer of the Methods: Fecal samples were collected from humans and their chickens and pigs in two rural coastal and Amazon regions between April and August 2020. Gram-negative bacteria were isolated and identified using conventional techniques. Phenotypic resistance was determined using the broth microdilution technique, and the Results: A total of 438 fecal samples were obtained from 137 humans, 147 pigs and 154 chickens. The prevalence of Conclusions: Despite a low prevalence of phenotypic resistance to colistin, the high prevalence of the
Language	English
Publishing date	2023-04-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	1376934-0
ISSN	1680-5348 ; 1020-4989
ISSN (online)	1680-5348
ISSN	1020-4989
DOI	10.26633/RPSP.2023.48
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Article: Why miltefosine-a life-saving drug for leishmaniasis-is unavailable to people who need it the most.

Sunyoto, Temmy / Potet, Julien / Boelaert, Marleen

BMJ global health

2018 Volume 3, Issue 3, Page(s) e000709

Abstract: Miltefosine, the only oral drug approved for the treatment of leishmaniasis-a parasitic disease transmitted by sandflies-is considered as a success story of research and development (R&D) by a public-private partnership (PPP). It epitomises the multiple ... ...

Abstract	Miltefosine, the only oral drug approved for the treatment of leishmaniasis-a parasitic disease transmitted by sandflies-is considered as a success story of research and development (R&D) by a public-private partnership (PPP). It epitomises the multiple market failures faced by a neglected disease drug: patients with low ability to pay, neglect by authorities and uncertain market size. Originally developed as an anticancer agent in the 1990s, the drug was registered in India in 2002 to treat the fatal visceral leishmaniasis. At the time, miltefosine was considered a breakthrough in the treatment, making it feasible to eliminate a regional disease. Today, access to miltefosine remains far from secure. The initial PPP agreement which includes access to the public sector is not enforced. The reality on the ground has been challenging: shortages due to inefficient supply chains, and use of a substandard product which led to a high number of treatment failures and deaths. Miltefosine received orphan drug status in the USA; when it was registered there in 2014, a priority review voucher (PRV) was awarded. The PRV, meant to facilitate drug development for neglected disease, was subsequently sold to another company for US$125 million without, to date, any apparent impact on drug access. At the heart of these concerns are questions on how to protect societal benefit of a drug developed with public investment, while clinicians worldwide struggle with its lack of affordability, limited availability and sustainability of access. This article analyses the reasons behind the postregistration access failure of miltefosine and provides the lessons learnt.
Language	English
Publishing date	2018-05-03
Publishing country	England
Document type	Journal Article ; Review
ISSN	2059-7908
ISSN	2059-7908
DOI	10.1136/bmjgh-2018-000709
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Article ; Online: Understanding the economic impact of leishmaniasis on households in endemic countries: a systematic review.

Sunyoto, Temmy / Boelaert, Marleen / Meheus, Filip

Expert review of anti-infective therapy

2018 Volume 17, Issue 1, Page(s) 57–69

Abstract: Introduction: Leishmaniasis is a poverty-related disease that causes a significant socioeconomic burden to affected households. Visceral leishmaniasis is fatal if untreated, yet illness costs may lead to delays in accessing care. Skin manifestations of ... ...

Abstract	Introduction: Leishmaniasis is a poverty-related disease that causes a significant socioeconomic burden to affected households. Visceral leishmaniasis is fatal if untreated, yet illness costs may lead to delays in accessing care. Skin manifestations of leishmaniasis cause a psychological burden and even longer treatment trajectories. The objective of this review is to evaluate illness costs associated with leishmaniasis across different settings (Asia, Africa, and Latin America) and the consequences to households. Areas covered: Through a systematic review of cost-of-illness studies, we documented the distribution of costs, the health-seeking behavior, and the consequences of leishmaniasis. We discuss the value of cost-of-illness studies for leishmaniasis. Expert commentary: Despite the free provision of diagnostics and treatment in the public health care sector, out-of-pocket payments remain substantial. There has been progress in addressing the economic burden of leishmaniasis, particularly through the elimination initiative in the Indian subcontinent. Though the illness cost is decreasing due to shorter treatment regimens and better access to care, the situation remains challenging in Africa. Improvement of control tools is critical. There is a need to update cost estimates to inform policy-making and ensure sustainable solutions to reduce financial barriers to leishmaniasis care, especially in pursuing universal health coverage.
MeSH term(s)	Cost of Illness ; Health Services Accessibility/economics ; Humans ; Leishmaniasis/economics ; Leishmaniasis/epidemiology ; Leishmaniasis/therapy ; Leishmaniasis, Visceral/economics ; Leishmaniasis, Visceral/epidemiology ; Leishmaniasis, Visceral/therapy ; Patient Acceptance of Health Care ; Poverty ; Public Health/economics ; Socioeconomic Factors
Language	English
Publishing date	2018-12-12
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Systematic Review
ZDB-ID	2181279-2
ISSN	1744-8336 ; 1478-7210
ISSN (online)	1744-8336
ISSN	1478-7210
DOI	10.1080/14787210.2019.1555471
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Article ; Online: Whole-genome sequencing for surveillance of antimicrobial resistance in Ecuador

William Calero-Cáceres / Nimer Ortuño-Gutiérrez / Temmy Sunyoto / Cícero-Armídio Gomes-Dias / Carlos Bastidas-Caldes / Ma. Soledad Ramírez / Anthony D. Harries

Revista Panamericana de Salud Pública, Vol 47, Iss 8, Pp 1-

present and future implications

2023 Volume 7

Abstract	Whole-genome sequencing is becoming the gold standard for pathogen characterization and offers considerable advantages for understanding the evolution and dissemination of new determinants of antimicrobial resistance. Despite the benefits of whole-genome sequencing for pathogen characterization, implementation costs and lack of expertise may limit its use by public health laboratories. This article reviews the advantages of whole-genome sequencing for pathogen characterization and the current status of the use of whole-genome sequencing for antimicrobial resistance surveillance in Ecuador. A roadmap is suggested for including whole-genome sequencing for pathogen characterization based on the needs of the health reference institutions through alliances with Ecuadorian universities. Establishing a partnership between public health institutions and academia would be valuable for clinicians, policy-makers, and epidemiologists who could then take reasonable measures in those areas and establish a basis for adapting One Health strategies to tackle antimicrobial resistance in Ecuador.
Keywords	environmental health surveillance ; drug resistance ; microbial ; whole genome sequencing ; ecuador ; Medicine ; R ; Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2023-04-01T00:00:00Z
Publisher	Pan American Health Organization
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Are public-private partnerships the solution to tackle neglected tropical diseases? A systematic review of the literature.

Aerts, Céline / Sunyoto, Temmy / Tediosi, Fabrizio / Sicuri, Elisa

Health policy (Amsterdam, Netherlands)

2017 Volume 121, Issue 7, Page(s) 745–754

Abstract: Pharmaceutical companies are reluctant to invest in research and development (R&D) of products for neglected tropical diseases (NTDs) mainly due to the low ability-to-pay of health insurance systems and of potential consumers. The available preventive ... ...

Abstract	Pharmaceutical companies are reluctant to invest in research and development (R&D) of products for neglected tropical diseases (NTDs) mainly due to the low ability-to-pay of health insurance systems and of potential consumers. The available preventive and curative interventions for NTDs mostly rely on old technologies and products that are often not adequate. Moreover, NTDs mostly affect populations living in remote rural areas and conflict zones, thereby hampering access to healthcare. The challenges posed by NTDs have led to the proliferation of a variety of public-private partnerships (PPPs) in the last decades. We conducted a systematic review to assess the functioning and impact of these partnerships on the development of and access to better technologies for NTDs. Our systematic review revealed a clear lack of empirical assessment of PPPs: we could not find any impact evaluation analyses, while these are crucial to realize the full potential of PPPs and to progress further towards NTDs elimination.
Language	English
Publishing date	2017-07
Publishing country	Ireland
Document type	Journal Article ; Review
ZDB-ID	605805-x
ISSN	1872-6054 ; 0168-8510
ISSN (online)	1872-6054
ISSN	0168-8510
DOI	10.1016/j.healthpol.2017.05.005
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Article ; Online: Colistin resistance in Escherichia coli and Klebsiella pneumoniae in humans and backyard animals in Ecuador

Carlos Bastidas-Caldes / Salomé Guerrero-Freire / Nimer Ortuño-Gutiérrez / Temmy Sunyoto / Cícero Armídio Gomes-Dias / Maria Soledad Ramírez / William Calero-Cáceres / Anthony D. Harries / Joaquín Rey / Jacobus H. de Waard / Manuel Calvopiña

Revista Panamericana de Salud Pública, Vol 47, Iss 48, Pp 1-

2023 Volume 8

Abstract: Objective. Colistin is an antibiotic of last resort for treating serious Gram-negative bacterial infections. However, the misuse of colistin, especially as an animal growth promoter, has contributed to increasing antimicrobial resistance, mediated mainly ...

Abstract	Objective. Colistin is an antibiotic of last resort for treating serious Gram-negative bacterial infections. However, the misuse of colistin, especially as an animal growth promoter, has contributed to increasing antimicrobial resistance, mediated mainly through plasmid transfer of the mcr-1 gene. This study assessed the prevalence of phenotypic and molecular colistin resistance in Escherichia coli and Klebsiella pneumoniae in Ecuador in healthy humans and their chickens and pigs. Methods. Fecal samples were collected from humans and their chickens and pigs in two rural coastal and Amazon regions between April and August 2020. Gram-negative bacteria were isolated and identified using conventional techniques. Phenotypic resistance was determined using the broth microdilution technique, and the mcr-1 gene was detected using conventional polymerase chain reaction. Results. A total of 438 fecal samples were obtained from 137 humans, 147 pigs and 154 chickens. The prevalence of E. coli isolates was 86.3% (378/438) and K. pneumoniae, 37.4% (164/438). Overall, the mcr-1 gene was found in 90% (340/378) of E. coli isolates, with higher prevalences found in isolates from coastal regions (96.5%, 191/198), humans (95.6%, 111/116) and chickens (91.8%, 123/134); for K. pneumoniae, the gene was found in 19.5% (32/164) of isolates, with equal distribution between regions and hosts. Only four isolates, two E. coli and two K. pneumoniae, showed phenotypic resistance: mcr-1 was present in both E. coli strains but absent in the K. pneumoniae strains. Conclusions. Despite a low prevalence of phenotypic resistance to colistin, the high prevalence of the mcr-1 gene in E. coli is of concern. Ecuador’s ban on using colistin in animal husbandry must be enforced, and continual monitoring of the situation should be implemented.
Keywords	colistin ; escherichia coli ; klebsiella pneumoniae ; humans ; animals ; drug resistance ; genes ; mdr ; operational research ; ecuador ; Medicine ; R ; Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
Subject code	630
Language	English
Publishing date	2023-04-01T00:00:00Z
Publisher	Pan American Health Organization
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Visceral leishmaniasis in Somalia: A review of epidemiology and access to care.

Sunyoto, Temmy / Potet, Julien / Boelaert, Marleen

PLoS neglected tropical diseases

2017 Volume 11, Issue 3, Page(s) e0005231

Abstract: Somalia, ravaged by conflict since 1991, has areas endemic for visceral leishmaniasis (VL), a deadly parasitic disease affecting the rural poor, internally displaced, and pastoralists. Very little is known about VL burden in Somalia, where the protracted ...

Abstract	Somalia, ravaged by conflict since 1991, has areas endemic for visceral leishmaniasis (VL), a deadly parasitic disease affecting the rural poor, internally displaced, and pastoralists. Very little is known about VL burden in Somalia, where the protracted crisis hampers access to health care. We reviewed evidence about VL epidemiology in Somalia and appraised control options within the context of this fragile state's health system. VL has been reported in Somalia since 1934 and has persisted ever since in foci in the southern parts of the country. The only feasible VL control option is early diagnosis and treatment, currently mostly provided by nonstate actors. The availability of VL care in Somalia is limited and insufficient at best, both in coverage and quality. Precarious security remains a major obstacle to reach VL patients in the endemic areas, and the true VL burden and its impact remain unknown. Locally adjusted, innovative approaches in VL care provision should be explored, without undermining ongoing health system development in Somalia. Ensuring VL care is accessible is a moral imperative, and the limitations of the current VL diagnostic and treatment tools in Somalia and other endemic settings affected by conflict should be overcome.
MeSH term(s)	Health Services Accessibility ; Humans ; Leishmaniasis, Visceral/diagnosis ; Leishmaniasis, Visceral/drug therapy ; Leishmaniasis, Visceral/epidemiology ; Somalia/epidemiology
Language	English
Publishing date	2017-03-09
Publishing country	United States
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2429704-5
ISSN	1935-2735 ; 1935-2735
ISSN (online)	1935-2735
ISSN	1935-2735
DOI	10.1371/journal.pntd.0005231
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