1974 Tropical Disease Research
In the early 1970s, the Edna McConnell Clark Foundation (whose namesake, heir to the Avon fortune, had recently doubled its endowment) was searching for candidates for its first international grants. They wanted a cause where needs were palpable, and measured progress was possible. Tropical diseases were getting relatively little attention from research scientists, drug developers, governments, and philanthropists. In the heavily regulated, litigious, and extremely expensive world of pharmaceutical research, the high risks of drug development and low opportunities for economic payback on maladies afflicting only very poor residents of the equatorial regions created serious obstacles to battling the parasitic diseases of the developing world. It was estimated in the mid-1970s that the poor-nation afflictions representing 90 percent of the global disease burden got only 10 percent of global health-research spending. Only about 1 percent of all drugs approved for human use worldwide were specifically for tropical diseases.
And so in 1974, the Clark Foundation committed itself to a program of tropical disease research. During the next 25 years, its small staff of three steered $90 million of grants into measures aimed at suppressing three particular chronic illnesses, each of which afflicts tens or hundreds of millions of people: schistosomiasis (snail fever), onchocerciasis (river blindness), and trachoma (a painful eye disease). The effort ended up being a partial success.
About half of the $32 million Clark spent against schistosomiasis went toward an unsuccessful effort to find a vaccine. But when the foundation exited “schisto” research in 1994 the field had been advanced considerably, and the baton was picked up by the Carter Center, the Gates Foundation, and others. Clark’s work against river blindness followed a very similar course: progress in scientific understanding and public health counter-measures, accompanied by failure to find a vaccine. For trachoma, Clark spurred some of the first systematic research ever conducted on the disease, and birthed a promising public-health and drug-donation response. As of this writing, a new coalition has taken up the Clark mantle with the aim of eliminating blinding trachoma by 2020.
- Duke University case study, cspcs.sanford.duke.edu/sites/default/files/EMClarkTDRfinal.pdf