BioEd Online

Indonesia is set to attack both dengue fever and tuberculosis, in a move that should both boost the country's profile in clinical research and tackle two devastating diseases.

A collaboration between the Novartis Institute of Tropical Diseases (NITD) and two Indonesian research centres was announced on 25 January at Hasanuddin University in Makassar, the capital of South Sulawesi. "This will be the first true clinical research centre in Indonesia. It's an important milestone," says Sangkot Marzuki, director of the Eijkman Institute for Molecular Biology in Jakarta — the second participating centre.

The World Health Organization (WHO) estimates that there are 50 million cases of dengue worldwide each year, and the number is thought to be rising as global warming opens up a greater range for the mosquitoes that transmit it.

Hospitals in some Indonesian communities are currently reporting inundations of dengue patients as the rainy season sets in: patients are sleeping in hallways, and already this year 3,000 infections in the country have led to 35 deaths. This is not atypical for the country. One regional government, Bantul, is offering a 100 million Rupiah (US$10,000) prize to any village that can remain Dengue-free. In 2004, Indonesia treated 79,000 cases of dengue fever.

Tuberculosis infects one in three people worldwide and killed 1.7 million people in 2004, according to the WHO; and strains that are resistant to drug treatment are on the rise. Indonesia has some 500,000 new tuberculosis patients each year, making it the third worst affected country in the world after India and China.

Patient load

Hasanuddin University, through its affiliated hospital, will provide patients for clinical trials on new candidate drugs against both diseases. NITD, a non-profit organization established by the Swiss-based pharmaceutical giant Novartis, already has a candidate family of molecules in mind as new medicine for each affliction. "They're still just a gleam in the eye," says Alex Matter, the institute's director. But within a year, NITD hopes to be starting the first clinical trials and have a drug on the market by 2012.

The hospital, the only teaching hospital in eastern Indonesia, usually has some 60 tuberculosis patients.

The collaboration will start, however, with a more modest project — establishing better diagnostic tests.

The Eijkman Institute will contribute by carrying out DNA and other lab analyses of samples. The institute has a sparkling new level-3 biosafety laboratory, a facility necessary for the analysis of dangerous pathogens such as the tuberculosis bacterium.

First aid

The collaboration was triggered by the tsunami disaster in December 2004, which devastated the country, says NITD's Matter. "We couldn't just stand by. We couldn't build houses, but we thought we could foster a partnership that would help develop the country."

Novartis has invested US$3.75 million for the first five years of the project. Matter says this is "just a start". Novartis also provided US$500,000 to refurbish rooms at Hasanuddin.

"This will be Indonesia's first good lesson in how to do clinical research," says Kusmayanto Kadiman, Indonesia's minister of research and technology. "Novartis is not just another company. It's a big one."