Abstract
Leishmaniasis is vector borne disease, caused by various species of protozoan parasite belonging to the genus Leishmania. Worldwide, there are more than 12 million reported cases of leishmaniasis and about 350 million people are at risk in at least 98 developing countries in Africa, South-East Asia and the Americas. The three clinical manifestations are cutaneous leishmaniasis (CL), mucocutaneous leishmaniasis (MCL) and fatal visceral leishmaniasis (VL). India together with Brazil, Sudan, Bangladesh and Nepal, carries 90% of the global burden of VL. In the absence of any vaccine, chemotherapy is the only way to tackle the control of this disease. Unfortunately, the clinically approved drugs are costly, toxic, require longer periods of administration and have the problem of resistance. The leishmaniasis elimination program, launched by WHO in 2005, had the projected target of eliminating the disease in India by 2017; however, until date, target could not be achieved. This underscores the need for development of new antileishmanial agent that is administered orally. Research efforts to identify new chemical entities, using both phenotypic and target-based screening led to the identification of several scaffolds, eliciting antileishmanial activity against intracellular stage of parasite mostly under in vitro condition. However, only a few of them are under developmental stage, resulting in inefficient drug pipeline. Simultaneously, there is lack of interest from Pharma-industry to support discovery of new medicines for leishmaniasis due to limited business, it would generate. Therefore, responsibility to discover and develop new chemotherapy lies on academia and philanthropic agencies including Drugs for Neglected Diseases initiative (DNDi). Recently, with increasing societal pressure to share the responsibility, a few pharma companies are collaborating with WHO and National control agencies to assist control programs on neglected diseases specially in endemic areas. In one such effort, Gilead Biosciences is donating liposomized AmphotericinB to support VL elimination program in endemic countries of South-East Asia including India. This chapter would assimilate the status of visceral leishmaniasis in Indian context and the ongoing drug discovery efforts being pursued to treat it.
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References
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Goyal, N., Patel, M., Batra, S. (2021). Modern Drug Discovery and Development in the Area of Leishmaniasis. In: Dikshit, M. (eds) Drug Discovery and Drug Development. Springer, Singapore. https://doi.org/10.1007/978-981-15-8002-4_5
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