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Nipah virus disease: what can we do to improve patient care?

Abstract:
The year 2023 marked the 25th anniversary of the first detected outbreak of Nipah virus disease. Despite Nipah virus being a priority pathogen in the WHO Research and Development blueprint, the disease it causes still carries high mortality, unchanged since the first reported outbreaks. Although candidate vaccines for Nipah virus disease exist, developing new therapeutics has been underinvested. Nipah virus disease illustrates the typical market failure of medicine development for a high-consequence pathogen. The unpredictability of outbreaks and low number of infections affecting populations in low-income countries does not make an attractive business case for developing treatments for Nipah virus disease—a situation compounded by methodological challenges in clinical trial design. Nipah virus therapeutics development is not motivated by commercial interest. Therefore, we propose a regionally led, patient-centred, and public health-centred, end-to-end framework that articulates a public health vision and a roadmap for research, development, manufacturing, and access towards the goal of improving patient outcomes. This framework includes co-creating a regulatory-compliant, clinically meaningful, and context-specific clinical development plan and establishing quality standards in clinical care and research capabilities at sites where the disease occurs. The success of this approach will be measured by the availability and accessibility of improved Nipah virus treatments in affected communities and reduced mortality.
Publication status:
Published
Peer review status:
Reviewed (other)

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Publisher copy:
10.1016/S1473-3099(23)00707-7

Authors

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Institution:
University of Oxford
Division:
MSD
Department:
NDM
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDM
Role:
Author


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Grant:
215091/Z/18/Z
Grant:
OPP1209135


Publisher:
Elsevier
Journal:
Lancet Infectious Diseases More from this journal
Volume:
24
Issue:
4
Pages:
e463-e471
Publication date:
2024-01-04
Acceptance date:
2023-11-10
DOI:
EISSN:
1474-4457
ISSN:
1473-3099


Language:
English
Pubs id:
1598386
Local pid:
pubs:1598386
Deposit date:
2024-01-10
ARK identifier:

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