00:00On this small island off the coast of Tanzania,
00:03an experiment is underway that could transform hundreds of millions of lives.
00:07Researchers are trialing a new drug to get rid of these little guys.
00:11Dogs and cats have had access to the anti-parasitic being tested for 20 years.
00:15It's long shown potential for humans.
00:18I've never seen such an active drug in our lab.
00:21So why has it only been restricted to pets?
00:24And what does all this have to do with this Japanese plant?
00:28About half a billion people around the world are infected with whipworms at any given moment.
00:33Here on Pemba Island, most residents have had them at one point.
00:37They get bloody diarrhoea, nausea, and in extreme cases, the infection can even stunt children's growth.
00:43It's sometimes called poverty disease.
00:48This is Saeed Muhammad Ali, the local coordinator of the trial.
00:51In most areas of this island, there are still an issue of lifestyle, which include lack of the use of
01:02latrines and toilets.
01:04You know, children are playing in the bush. They are playing on the soil.
01:09They defecate openly sometime, and the transmission happens from there.
01:15Because they ingest these eggs or these worms.
01:20Saeed Muhammad Ali was already supposed to be retired, but couldn't pass up this project.
01:25He's coordinating a team testing if a drug called emidepside could help.
01:29For this, the scientists analyse participants' stool samples for worm eggs in the beginning of the trial,
01:35and then again after they've taken the drug.
01:38Over 7,000 kilometres away at the Swiss Tropical and Public Health Institute in Basel,
01:43we meet the woman whose research project is providing the meds.
01:46She's really made it her mission to fight whipworms.
01:49Even though they silently afflict hundreds of millions of people,
01:52there's never really been a drug for humans that targeted this specific type of worm very effectively.
01:57Neglected tropical diseases mostly have no market because it affects the poorest of the poor populations.
02:03So we have to be quite creative when it comes to discovering and developing a new drug.
02:09More often than not, that means getting some inspo from animal medicine,
02:13because a pretty good treatment had already been around for a while, since 2006, but only for cats and dogs.
02:21Emidepside was developed for the pharma giant Bayer by this guy, Achim Harder.
02:26You could say he knows a thing or two about worms.
02:31This is a roundworm from cattle.
02:34This is the so-called heartworm.
02:37This is a roundworm in humans.
02:39Oscaris suum from pigs.
02:41And so, we already have four different types of roundworm.
02:48In the 1990s, he was asked to develop something that would work on worms building up resistance against existing medicine.
02:54So he looked to nature, where a lot of our drugs come from.
02:58Think penicillin or aspirin.
03:00Inspiration struck when a Japanese researcher told him about this plant, Camellia japonica.
03:05In its leaves, there's a fungus that produces a chemical substance.
03:11And that penetrates the plant, goes into the root, and the compound is stored in the roots.
03:22And it can protect the Camellia from soil nematodes.
03:29Basically, the substance helps the plant protect itself from all sorts of tiny worms.
03:34Achim Harder thought to himself, if it kills worms in the soil, maybe it could kill parasitic worms in animals
03:39too.
03:40So, he collaborated with Japanese chemists to turn the substance into a drug called emidepside.
03:48And we quickly saw in our animal models that the compound works extremely well, and on a broad spectrum.
04:00That's also important for marketing.
04:04We targeted the whipworm, hookworms, roundworms, and then a whole range of other worms as well.
04:16And in 2006, this medicine containing emidepside went on the market for dogs and cats.
04:24It's rare to be so lucky.
04:28But back then, Bayer wasn't interested in testing the drug on humans.
04:36That's a very, very difficult topic.
04:40Because the primary goal is to make money.
04:45The market for pets is very big.
04:49So Bayer was able to make money there.
04:54But antiparasitic drugs for humans basically have no market.
04:58Pharma companies usually donate them.
05:00Not a great return on investment.
05:03Ultimately, these companies need to make money.
05:05They're not philanthropists.
05:08So, what has changed?
05:10Why is Jennifer Kaiser able to test emidepside on humans 20 years later?
05:15For one, there's more money in it this time round.
05:18A Swiss initiative to treat neglected tropical diseases secured significant philanthropic funding.
05:24And the US Drug Authority FDA is offering financial rewards to encourage researchers to develop treatments for these sorts of
05:31infections.
05:32Also, many parasitic worms are developing a resistance to the drugs on the market.
05:37So there's greater pressure to come up with new meds.
05:40In 2018, the conditions to look into emidepside for humans were finally right.
05:45Well, almost.
05:47Bayer was not fully on board and didn't want to hand over the drug to be studied just yet.
05:52So Jennifer Kaiser took matters into her own hands.
05:55The quickest way was to obtain dogs and cats medicine from the pharmacy.
06:01And I had a chemist in the group and she quickly extracted the active ingredient and then we could run
06:06our assays.
06:08Her persistence paid off. The results were so good they convinced Bayer.
06:12The company is now helping with the formulation of the drug, the data management and getting it approved.
06:18When it came to testing the emidepside, Jennifer Kaiser knew where she wanted to do it.
06:23On PEMBA, where she's been working with researchers for 15 years.
06:26It's really a dream working in this environment.
06:30And whipworms are everywhere on the island.
06:32The good news, the test found that the drug killed whipworm eggs in almost all of the participants' stall.
06:38Now the team is running another trial.
06:40It's still too early to analyse these new results.
06:43But the feedback from most locals has been positive.
06:48Before taking the medicine, I had a bit of a problem with loss of appetite and often felt dizzy.
06:55But after taking the medication, I felt much better.
06:58Even though the medicine has caused some minor side effects, such as temporary blurred vision, I was generally fine.
07:05I don't have problems and the medicine hasn't caused serious side effects.
07:10Researchers are prepping a final trial in the Philippines before submitting the drug for registration.
07:16If emidepside is approved, Bayer will most likely sell it at a social price instead of donating it.
07:21That means it will charge a low price that covers its production costs, a compromise between Bayer and seller.
07:27There's a chance this approval could still come this decade, which would be a real breakthrough.
07:33I couldn't believe it.
07:35For me, it will be a good memory to see that my contribution to a new drug worked well.
07:45It's probably the dream of every scientist.
07:48But it's worth remembering, the drug that could improve hundreds of millions of lives was there 20 years ago.
07:54What was missing wasn't the science.
07:56It was financial incentive.
07:58The drug that could be effective.
08:00That's a great thing.
08:03I chose a good memory to the drug for a deaf child.
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