Professor David Denning, who is recognised as an international expert in infectious and fungal diseases, has campaigned with others to have two drugs reinstated on the Essential Medicines List following a definitive trial from Vietnam, lead by Dr Jeremy Day. Dr Day who trained in Manchester, has published studies which show that combined therapy with oral flucytosine and intravenous amphotericin B, demonstrated a 40 per cent lower chance of death. Cryptococcal meningitis (see news) is a serious infection of the brain and spinal column that can occur in adults and children living with HIV. It claims the lives of over half a million people every year and is caused by a fungus, Cryptococcus neoformans which is very common in the environment and can be found in soil and in pigeon droppings.
Professor David Denning, who is Professor of Infectious Diseases and Global Health at UHSM (University Hospital of South Manchester) says: “The WHO has two lists – main and complementary. Flucytosine was put on the complementary list and then was dropped many years ago because other antifungals were developed, like fluconazole and it was perceived that it was unnecessary, indeed its sales are low at about $3M annually.” The recent work by Day at al has consolidated its position, putting it back in a prime spot.
“I believe the WHO’s enlightened decision opens the door to saving many thousands of lives weekly from this devastating fungal meningitis in AIDS patients. The challenge now is to translate this recommendation into local availability and actual treatment on the ground in every country.”