New Urgency Against Tropical Diseases

  • Overseas
  • 1974

In the early 1970s, the Edna McConnell Clark Foundation was searching for worthy candidates for its first international grants. The foundation’s namesake, heir to the Avon fortune, had recently doubled its endowment. Now Clark wanted a cause where the needs were palpable and clear progress possible.

Tropical diseases were then 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. Over the next 25 years, a 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). For most of these diseases,  Clark was the largest funder, public or private, on the globe. 

Of the $32 million Clark spent against schistosomiasis from 1974 to 1994, an effort to find a vaccine consumed about half of the funding. That ended without success, yet the field had been advanced considerably when the foundation exited “schisto” research in 1994, 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: failure to find a vaccine, but major progress in scientific understanding and public-health countermeasures. For trachoma, Clark spurred some of the first systematic research ever conducted on the disease, and the foundation’s mantle was taken up by a promising drug-donation effort that aims to eliminate blinding trachoma by 2020. (See 1987 entry on this list for details.)

The Gates Foundation spent a billion dollars over a decade after picking up Clark’s mantle to battle neglected tropical diseases. In 2017, Bill Gates pledged an additional $335 million over the next four years. Those funds will pay for more treatment, research new ways of battling these afflictions, and also be applied to attracting pharmaceutical companies to invest in fresh drugs and cures. “We need a broader, deeper bench of investors…so that by 2030 we can achieve the goal of reaching 90 percent of the people who need treatment,” said Gates as he announced his pledge.