Our consortium of experts in filarial infections aims to establish a Filarial Clinical Trial & Research Platform (F-CuRE). With the current funding and research landscape in filarial diseases, it can be expected that new drug candidates will soon be identified (e.g. Macrofil accelerator initiative by the Bill & Melinda Gates Foundation (BMGF), or the macrofil initiative by DNDi) and eventually will have to be translated for human use. To initiate F-CuRE in the most effective way with the goal to harmonize the procedure for clinical trials in filariasis, we will perform multinational clinical trials in different countries to improve treatment regimens for morbidity control of LE of filarial and non-filarial (podoconiosis) origins. We aim to strengthen the teaching capacities for scientific and clinical staff by engaging Ministries of Health in the African partner countries, control programmes and WHO throughout the development process. A core facility for non-invasive biomarker-based diagnostics to evaluate the efficacy of MDA and new anti-helminthic drug candidates will be established to validate upcoming promising biomarkers (identified by our and the other consortia) for its use in the field.

A further pillar will be the implementation of an awareness programme to roll out doxycycline with its dual activity for LE of filarial and non-filarial origin.

Furthermore, the HIV pandemic also affects areas endemic for filariasis. First data from this consortium suggest that HIV does not alter worm burdens, but diminishes anti-filarial immune reactions and thus, pathology. Conversely it has been hypothesized that treatment of HIV may have an impact on filarial pathology, i.e. that LE or hydrocele may aggravate after ART against HIV, with T cell responses re-emerging. Members of this consortium researching HIV-filaria co-infection will address this issue.

In the first phase of the project we will prepare the establishment of F-CuRE (Filariasis Clinical Trial and Research)