Many people do not know what schistosomiasis is, let alone its symptoms, yet schistosomiasis is a high-risk tropical disease affecting nearly 250 million people worldwide. There is a class of diseases called the Neglected Tropical Diseases, to which schistosomiasis belongs. They are characterized by their widespread presence in tropical regions combined with a general neglect for treatment. Dr. James McKerrow of University of California, San Diego (UCSD), is working to discover treatments synthesized from compounds donated by chemical teams or extracted from natural environments. He is screening potential drugs against the organisms causing NTDs in a unique end-to-end approach that grants him extensive oversight over the entire drug development process. NTDs affect millions of individuals in some of the most impoverished regions of the world, and developing inexpensive yet effective drugs promises to greatly increase the quality of life for infected individuals and the productivity and quality of life of their communities. By deriving remedies from natural products, there is an added benefit of increasing local interest in protecting natural environments of biological diversity.

Neglected Tropical Diseases (NTDs) refer to any of 17 diseases that affect hundreds of millions of people, typically in the developing regions of Africa, Asia, and the Americas. They are not uncommon, but many are not popularly known. Furthermore, since they affect primarily poor regions of the world, there is little to no interest shown by the pharmaceutical industry in developing therapy. There are no vaccines for any of these diseases, and drugs, if effective, are decades old and fraught with side-effects. These diseases are chronic and debilitating, and create a burdensome public health issue in tropical regions. Dr. James McKerrow has committed the majority of his career to researching the organisms that cause a number of these diseases. He is taking a novel approach to drug development by initiating an end-to-end process, originating from the identification of a successful treatment compound and culminating in the development of a widely-available successful treatment.

Current research projects can be organized into three categories:

• The traditional approach to drug development begins in "libraries," collections of thousands or millions of small chemical molecules that are the first step in the drug development process. Dr. McKerrow and his team are establishing a facility capable of screening large numbers of compounds, similar to the capabilities of large-scale pharmaceutical companies, against the organisms that generate NTD's.

• Even when hundreds of thousands of small molecules are screened, there is still the possibility that solutions will not be identified. In these cases, researchers must search "chemical space" beyond the established libraries -- that place is mother nature. Dr. McKerrow has capitalized on his proximity to the Scripps Institution of Oceanography by utilizing natural products extracted directly from natural environments and marine ecosystems. Dr. McKerrow is collecting molecules in a "natural" library of compounds that can be screened against NTD-causing organisms. Using a large variety of natural products in the drug development process has a secondary benefit -- increased protection interests for natural environments. There is an escalation in pressure to protect natural tropical environments (coral reefs, rainforests) when it is recognized that those environments may hold the cure to regional diseases.

• In a unique approach, Dr. McKerrow is working to develop a "translational drug pipeline." This process would link the discovery research stage, which usually occurs at universities or research labs, with the physical development of the drug in usable quantities that can be administered directly to patients. Steps in this process include identifying the biological target (a molecule or enzyme) for a particular disease. Dr. McKerrow is making strides to collect all of these processes under one roof at UCSD. Whereas many pharmaceutical companies will outsource stages of the drug production process, the consolidation of the end-to-end process is novel and interesting, and allows for more control and oversight.