Frequently Asked Questions
We do direct MDA and make medicines that are to be given directly to patients. In indirect MDA, the drug is added to food, such as the fortification of salt.
Any country with lympatic filariasis without loa loa and onchocerciasis or other contraindications. Patients with loa loa co-infection should not be treated with ivermectin without consulting an expert on loiasis due to the risk of a fatal encephalitic reaction. Patients with onchocerciasis should not be treated with DEC because of a severe hypersensitivity reaction to released filarial antigens, damaging skin, eyes, and leading to cardiovascular collapse. Countries like Nigeria with both loa loa and onchocerciasis should use albendazole alone for lymphatic filariasis MDA.
Bend Biomedical has four primary MDA targets. Are there other good targets for MDA?
Yes, there are three other main MDA targets: azithromycin for under-five mortality, trachoma, and yaws; praziquantel for schistosomiasis, foodborne trematodiases, and taeniasis; and dihydroartemisinin-piperaquine (DHA-PPQ) for falciparum malaria. But there are lingering questions about all three.
--Azithromycin for trachoma and yaws is currently being donated, however no drug company is donating azithromycin for under-five mortality. Giving azithromycin to infants in sub-Saharan Africa can reduce under-five mortality by nearly 75%. There is concern though about the development of drug resistance by other bacteria that are killed by azithromycin. Also, it is about 60 cents a dose, so it is expensive compared to other MDA drugs.
--At-risk adults are frequently left out of schistosomiasis mass drug administration, because treatment and monitoring efforts with praziquantel have typically focused on children. WHO’s new guidance recommends treatment of all ages when the prevalence is greater than 10%, however, the quantity of donated drug is limited and may not be sufficient to achieve this goal.
--There are now two new vaccines for malaria that are moderately effective. Donors may still need to complement these vaccines with a combination antimalarial drug like DHA-PPQ or something newer to reach elimination in some areas.
A CMO is a contract manufacturing organization. We use them when it makes sense. CMOs are the norm for pharmaceutical manufacturing. Today, 70% of pharmaceutical companies outsource their manufacturing.
Sometimes pills are too big for children. To prevent choking, tablets are commonly crushed before administering them. In some cases though it doesn't work well, and the preferred form would be dihydrates as liquid or in soft gel caps that can be opened with scissors or nail clippers and the liquid squeezed into the child's mouth.
What are asymptomatic reservoirs?
They are persons with inapparent infection but capable of transmitting the pathogen to others. Asymptomatic reservoirs are sometimes called passive or healthy "carriers." They never experience symptoms despite being infected. Thus the need for mass drug administration to treat everyone, especially when diagnostics are not feasible.
Are blister packs more environmentally friendly than pills in bottles?
Blister packs are regarded as the more environmentally-friendly option. They are child-resistant and reduce plastic use by more than 80%.
What languages will be provided on your labels and instructions?
Right now we are planning versions in Hindi, Swahili, and Arabic.