fighting the epidemic

Transcription

1 news issue a t r i - a n n u a l ne w s l e t t e r f r om I n d u s t r i K a p i ta l 1 7 autumn SLEEPING SICKNESS IN UGANDA fighting the epidemic Gustavson on PE 4 Minimax s global ambitions 8 ELFA looks east 12 Focus on France 20

2 TREATING LIVESTOCK IN UGANDA Sleeping sickness is caused by a parasite that is transmitted to humans by tsetse flies that feed on infected cattle or wildlife. Cattle often carry the parasites without themselves showing any symptoms. 10 ik news

3 Cover story SOS Stamping out sleeping sickness When the academic and business world join forces, less can mean much more. A focused effort combines effective drugs and the necessary field work, i.e. training, spraying, testing, analysis and documentation. Two strains of Human African Trypanosomiasis (HAT) also known as sleeping sickness threaten to converge in Uganda. This could have a catastrophic effect for the already stretched local health services. In April this year IK was alerted to this accelerating emergency situation in Uganda by its portfolio company Ceva Santé Animale SA. The impending disaster centred on the spread of sleeping sickness, a disease which kills 100 people each day in Africa, into previously unaffected territories. Trypanosomiasis takes two forms: trypanosoma brucei (Tb) rhodesiense an acute form of sleeping sickness which causes death within six months; and the more prevalent chronic form of the disease, Tb gambiense, from which death may take several years but which causes serious damage to the central nervous system even before symptoms emerge. Uganda is the only country to be afflicted by both strains Tb rhodesiense in the south-east and Tb gambiense in the north-west, close to the Sudanese border. But since the late 1980s, the rhodesiense sleeping sickness has been spreading north and there is now a real risk that the two forms of the disease will overlap. Surveys in 2005 put them at only 150 km apart. The diagnosis and treatment of sleeping sickness is already problematic, but if the two forms of the disease were to meet then the situation would become almost impossible. These infections require different drugs but are extremely difficult to tell apart, hence diagnosis and treatment would be severely compromised, says IK partner Anne Holm Rannaleet. Cattle treatment recommended. The sleeping sickness problem has been exacerbated in Uganda by over 20 years of civil war in the northern part of the country, where large areas have been depopulated. With previously farmed lands left unattended and covered again by shrubbery and dense growth, tsetse flies the main carriers of sleeping sickness have proliferated. The flies are mainly found in vegetation next to rivers, swamps and lakes. In addition, following years of insecurity and cattle rustling, large-scale restocking programmes are being carried out with cattle being moved from rhodesienseendemic areas in the south-east to restock districts further north. The population at risk in Uganda is approximately eight million. More than one million cattle are also in danger, both as carriers and the main reservoir of the human-infective form of the disease, as well as ik news 11

4 RESTRICTED APPLICATION The method of applying insecticide includes bringing heards of cattle in for treatment. being themselves infected by various tick-born diseases which often co-exist, leading to deteriorated condition, decreased milk production and increased mortality. The Ugandan government is well aware of the need for urgent action, and a meeting convened by the World Health Organisation (WHO) in late 2005 recommended the mass treatment of cattle with trypanocidal drugs in the newly affected areas. However, there was no funding available to implement such a recommendation. The last five years have seen increased efforts by G8 nations and UN agencies to improve the health of the world s 3 billion poorest people those living on less than $2 a day. But funding has tended to focus on fighting the Big Three diseases HIV/AIDS, tuberculosis, and malaria. Significantly less resources are devoted to the group of tropical diseases, trypanosomiasis among them, that exclusively affect the poor and powerless. 12 ik news It was amazing to see how much can actually be accomplished with relatively limited resources. Anne Holm Rannaleet, IK partner Enabling block treatment. The University of Edinburgh s Centre for Tropical Veterinary Medicine and Makerere University in Kampala, Uganda, are the team behind the latest trypanosomiasis research findings. For years the international veterinary laboratory CEVA has also been involved in trypanomiasis treatment and prevention in animals. But while the universities could conduct all the necessary field work (including training, spraying, testing, analysis and documentation) to fight the disease and CEVA could provide the necessary drugs and insecticides, they lacked continued funding to undertake such block treatments. This has now been provided by IK, channelled through a newly-formed independent vehicle, Industri Kapital Aid & Relief Enterprise (IKARE). Intensive work started during the spring, in order to develop a joint work plan for the first phase of the intervention to try to stop the northward spread of Tb rhodesiense and prevent it from overlapping with Tb gambiense. A memorandum of understanding was also entered into with the Uganda Trypanosomiasis Control Council (UTCC). IK has been involved in various charity-related activities since its inception in These, however, tended to be run on a rather ad hoc basis. We have, over the last few years, tried to take a more formalised, considered approach, but it was the emergency situation in Uganda that really focused our efforts, says Anne Holm Rannaleet. To proceed in a structured and lasting manner, it was decided to incorporate an independent UK company limited by guarantee, accredited by the UK Charity Commission IKARE as a dedicated vehicle for the firm s charitable efforts. Business-oriented approach. As well as providing controlled, closely-targeted funding, IKARE will also endeavour to overlay private equity investment and management tools and techniques to projects to maximise their impact. The intention is to take a more analytical, business-oriented approach to charitable causes so that we can achieve more than by simply handing over money, says Holm Rannaleet. As with a standard PE investment, the Ugandan project is very much a partnership effort, combining commercial and corporate interests with academic and scientific know-how and research, coupled with local involvement and support. CEVA will supply the drugs, chemicals and pharmaceutical know-how, says Holm Rannaleet.

5 Cover story A SIMPLE CURE Tb rhodisiense is caused by a parasite that is transmitted to humans by tsetse flies that feed on infected cattle or wildlife. Cattle often carry the parasites without themselves showing any symptoms. Latest estimates suggest that nearly all cattle in endemic areas carry the parasites. Since cattle play such an important part as reservoirs for the disease, the aim is to tackle its spread in a new way, by treating the cattle as well as people. It has been calculated that a person is a thousand times more likely to acquire sleeping sickness via the bite of a tsetse fly coming from a cow than from another infected person. Encouragingly, treatment of the disease in cattle is relatively simple and cost-effective with drugs and insecticides. ik news 13

6 Cover story Gardena, another of our portfolio companies, is providing the pump sprayers for this first emergency intervention. The Universities will do the testing and sampling as well as training of the veterinary students, local veterinarians and local council leaders. They will also be relying on strong local involvement by bringing the project as close as possible to the Ugandan farmers. This project has a big teaching and training element. We want to build awareness and transfer knowledge on the interaction of human and animal health as well as sickness prevention techniques. Ultimately it is about helping people to do it for themselves. Common cause. Anne Holm Rannaleet travelled with fellow IKARE Trustee Christopher Masek to Uganda for the intervention s official launch in Kampala on 11 October 2006, followed by a field trip. It was amazing to see how much that can actually be accomplished with relatively limited resources when a group of dedicated people representing different skill-sets get together united by a common cause, she says. The enthusiasm shown by the veterinary students involved in the field work, treating and spraying as many as 700 cows per team per day, was inspirational and encouraging, Masek adds. We want to leave a permanent mark and develop something that will endure and become self-sustaining. This emergency intervention is hopefully just the beginning, Rannaleet continues. If we can prove that it can be done on this smaller controlled scale then the aim is to roll it out across the country. For this second phase, external funding also needs to be sought. IKARE envisages extending its initiative to include further support from others of its portfolio companies, its corporate network and the wider PE community. We want to develop something that will endure and become selfsustaining. Christopher Masek, IK partner TELL IT LIKE IT IS Farmers are trained by local people who, in turn, have been trained by specialists from the University of Edinburgh and the Makerere University in Kampala. DIAGNOSIS The method suppresses the spread of sleeping sickness by treating cattle as well as people. It has been calculated that a person is a thousand times more likely to acquire sleeping sickness via the bite of a tsetse fly coming from a cow than from another infected person. cooperation is key The emergency intervention in Uganda relies on supplying drugs and easily usable insecticide products to farmers in the affected part of Uganda. The farmers are to be trained by local people who, in turn, have been trained by specialists from the University of Edinburgh and the Makerere University in Kampala. The programme is supported by a thorough educational and awareness campaign through radio messages, posters and so on in the districts concerned. CEVA Santé Animale has been working in co-operation with the University of Edinburgh, Makerere University and UTCC/COCTU in Kampala to tackle the emerging sleeping sickness crisis in Uganda. Headquartered in Libourne, near Bordeaux in France, the international veterinary company develops, manufactures and distributes animal health products. The company s main expertise is in anti-infectives, vaccines and reproduction control devices. Gardena, which has provided a consignment of pump sprayers to help out in Phase 1 of the block treatment programme, is Europe s leading gardening equipment company. 14 ik news