Kinetoplastida: New therapeutic strategies

New formulations and therapeutic switching of the established drugs, amphotericin B and paromomycin, together with the discovery of miltefosine, hove significantly improved the opportunities for treatment of visceral leishmaniasis (VI) chemotherapy. However, for human African trypanosomiasis (HAT), Chagas disease and cutaneous leishmanioses there has been limited progress. For HAT, a novel diamidine, parfuramidine, is in phase III clinical trial for early-stage disease, but for the treatment of late-stage disease there are no new drugs and combinations of eflornithine with melarsoprol a, nifurtimox have been the focus of clinical studies. For Chagas disease, different classes of compounds that hove validated biochemical targets, sterol biosynthesis methylases and cysteine proteases, are in various stages of development. The genome sequences that ore now available for the pathogens that cause the leishmanioses and trypanosomiases, and new methods for rapid validation of targets, ore part of the solution to discover new drugs. The integration of medicinal chemistry, pharmacokinetics, project planning and interaction with the pharma/biotech sector are essential if progress is to be made. Although there are financial constraints, the appearance of new funding sources and not-for-profit product development partnerships offers hope for drug development.