TOKYO/JAKARTA -- Pharmaceutical companies have largely been unwilling to develop vaccines and treatment for dengue fever, citing small demand due to the disease primarily occurring in emerging nations. But as the disease spreads, with the current outbreak in Japan already topping 100 cases, major drugmakers are now rushing to tackle the threat.
A familiar foe
"I suddenly felt a chill and had a fever of nearly 40 degrees. It was an unimaginable experience," said a Japanese trading house official based in Jakarta who contracted dengue fever for the first time earlier this year.
The disease is transmitted to humans by mosquitoes carrying the dengue virus. It is estimated that more than 50 million people develop the disease every year worldwide, primarily in tropical areas. Sufferers typically experience headaches and joint pain, with fever lasting a week or so. In the most severe cases, patients die due to plasma leakage.
In Indonesia, dengue fever is a familiar disease. "Three to four staff members have contracted the disease since the beginning of the year," the trading house official said.
Last year, Indonesia recorded about 101,200 cases of dengue fever. In West Java, a province where several Japanese manufacturers have plants, the number reached 21,600. Dengue patients normally recover in a week or so, but in more than a few cases, the disease is fatal. Dengue fever is now a national affliction in Indonesia. In the tropical regions of Southeast Asia, Africa and Latin America, anyone can become infected with it.
An opportunity for growth
Despite the huge number of sufferers, effective drugs and vaccines have not yet been commercially produced because dengue is prevalent chiefly in developing countries with relatively small markets. Japan's major drugmakers have focused on exploring the domestic and Western markets, putting treatment of epidemics in emerging nations on the back burner.
But as sales of their mainstay drugs, such as those for diabetes and hypertension, show signs of declining in developed countries, Japanese pharmaceutical companies are finally turning their attention to the developing world.
Attempts to create dengue treatment and vaccines started as part of their strategies to tap emerging markets. In 2013, Takeda Pharmaceutical, Japan's biggest drugmaker, acquired Inviragen, a U.S. venture firm that has the basic technology to make a dengue vaccine. Takeda is currently working on the development of a vaccine that is effective against all four types of the dengue virus. A vaccine that cannot immunize against all four types can cause more severe symptoms if a patient contracts a different strain of the virus. The Takeda group is currently conducting clinical trials of the vaccine, aiming for commercial production in 2017 or 2018.
Another Japanese drugmaker, Astellas Pharma, began developing dengue medication in 2013 in cooperation with the Tokyo Institute of Technology and Nagasaki University. Using the institute's supercomputer, dubbed Tsubame, the team hopes to create a drug rapidly. However, it is still carrying out computer-based simulations to determine the effectiveness of candidate compounds.
All on board
The Japanese government is supporting the development of remedies for dengue fever and other diseases that are devastating emerging nations. Last year, the Ministry of Health, Labor and Welfare and the Ministry of Foreign Affairs together with five Japanese drug companies -- Takeda, Astellas, Daiichi Sankyo, Eisai and Shionogi & Co. -- as well as the Bill & Melinda Gates Foundation of the U.S. and others, set up the Global Health Innovative Technology Fund to help develop drugs for infectious diseases prevalent in emerging countries.
The government contributed 5 billion yen ($46.2 million) to the GHIT Fund, with the drugmakers and private funds putting up another 5 billion yen. With 10 billion yen in assets, the fund shoulders 100% of initial development costs.
Along with the increasing flow of people and goods amid rapid globalization, diseases that used to be confined to a particular region are now spreading to wider areas.
Last year, a case of Chagas disease, which occurs primarily in Latin America and can trigger heart disorders, was confirmed in Japan, for instance. Japan could also see the outbreak of a number of other overseas diseases, such as chikungunya fever, yellow fever, West Nile fever or even Ebola, at any time.
The infection route for the current outbreak of dengue fever in Japan, has not yet been determined, though the first batch of patients seem to have contracted it from mosquitoes in Tokyo's Yoyogi Park. Dealing with infectious diseases will pose an increasing challenge to Japan and other developed countries as global warming leads to outbreaks in new regions.