Advanced Therapeutic Technologies for Malaria, Tuberculosis, HIV Infection and Neglected Tropical Diseases

We are pleased to present this special issue to highlight advances in therapeutic technologies for infectious diseases, in particular for treatment of tuberculosis (TB), HIV/AIDS and malaria. Informative reviews as well as original research articles form part of this Issue. The world's deadliest infectious diseases TB, HIV/AIDS and malaria are responsible for close to 2.5 million deaths world-wide, each year.[1] Over 90% of deaths due to malaria occur in sub-Saharan Africa, with the majority of deaths occurring in children under 5 years of age. Infectious diseases are responsible for ≈704 million disability-adjusted life-years (DALYs) and the African region bears the highest burden, with ≈314 million DALYs; while high-income countries account for only ≈31.8 million DALYs.[2] While drugs to treat TB and malaria and in the case of HIV/AIDS, to control the infection, are available, most are faced with various challenges which lead to, in some cases, failure to cure the diseases and the generation of drug-resistant strains. For example, lengthy duration of treatment which affects patient adherence, debilitating side effects, poor oral bioavailability, and challenges in effectively accessing pathogen reservoir sites.[3] Advanced therapeutics have a role to play in improving the treatment of infectious diseases and in the case of HIV/AIDS, achieving a functional cure. We are already witnessing the impact of such therapeutics in improving treatment of HIV/AIDS as evidenced by the clinical effectiveness of long-acting anti-retroviral injectable therapies.[4] A seismic advancement in addressing the burden of infectious diseases was demonstrated with the use of lipid nanoparticles to deliver COVID-19 mRNA vaccines.[5] In this special issue, Schäfer and colleagues investigate a host-directed therapy (HDT) approach to combine a compound that can boost the natural ability of host cells to kill pathogens, with an antibiotic. Everolimus and the antibiotic were encapsulated within micelles and investigated for efficacy against a Mycobacterium infection in cells and in zebrafish embryos. The authors report that the nanoparticles are more efficient in protecting the cells and zebrafish embryos against infection (202400174). Gholap and colleagues expand on the significance of HDT as a strategy to combat viral infections. Systems biology approaches are highlighted providing a platform for development of innovative HDTs for infectious diseases (202400169). Kutscher and colleagues report on the pulmonary delivery of the antibiotic rifampin in immunostimulatory polymeric nanoparticles leading to sustained drug concentrations of the antibiotic in lung fluid and serum and increased secretion of cytokines (202400057). Although TB is a serious infectious disease on its own, it is also one of the most common co-infections with HIV/AIDS. Aliyu and Adeleke review drug formulation approaches for TB-HIV/AIDS co-infection, including long-acting injectable formulations and child-friendly formulations (202400033). Akinawwo and Dube review clinically relevant metallic nanoparticles for diagnosis and treatment of TB (202400189). Ochola and colleagues review the biology of malaria and resistance, and how this impacts treatment. Advanced therapeutic approaches for treatment including nanoparticle drug delivery systems are also discussed (202400453). It is our hope that readers will not only find these articles informative but that they will illuminate the potential of advanced therapeutic systems to address unmet clinical needs in both well-known and neglected infectious diseases. Our goal is for this special topic to serve as a catalyst for robust support, research, and development from policymakers, funders, and researchers. We believe that sustainable global health goals can be achieved through the innovative application of modern pharmacological and diagnostic technologies to persistent challenges in these diseases, which predominantly affect the poorest and most vulnerable populations. The authors declare no conflict of interest. Admire Dube is a Professor at the School of Pharmacy, University of the Western Cape (UWC) in South Africa. His research focuses on nanomedicines for treatment of infectious diseases, with emphasis on nanoparticle host directed therapies. He holds a PhD in Pharmaceutical Sciences from Monash University, Australia. Prior to UWC, he was a senior researcher at the Council for Scientific and Industrial Research (CSIR), South Africa, and was involved in translation of nanomedicines for infectious diseases. Garry Laverty is a Senior Lecturer at the School of Pharmacy, Queen's University Belfast in N. Ireland. His research focuses on peptide-like hydrogels for drug delivery and biomaterial applications, including as long-acting injectable platforms to improve patient adherence to medicines for diseases such as HIV/AIDS and tuberculosis. He also utilizes neutrons methods to study the fundamental characteristics of these gels and to tailor their properties for sustained delivery. Mohammed Balogun is a Principal Researcher and the Principal Investigator of the Bio-polymer Modification & Advanced Therapeutics Laboratory at the CSIR in South Africa. He holds a BSc and an MSc in Biochemistry, as well as a PhD in Organic Chemistry. His research focuses on the development of nanomedicines for infectious diseases, with recent work concentrating on polymer therapeutics for the treatment of severe malaria. He has over 20 years’ experience in infectious disease research.