An inexpensive nail medication available without a prescription has been discovered to effectively treat a severe and debilitating condition known as flesh-eating disease.

A low-cost and readily available medication commonly used for treating fungal nail infections has been discovered to effectively combat a severe disease that causes tissue and bone destruction, prevalent in Africa, Asia, and the Americas.

Experts are optimistic that this discovery will provide a glimmer of hope for the many individuals who have been neglected for years and may be at risk for amputations if their condition is not addressed.

The outcomes of the medical experiment in Sudan for a novel remedy for mycetoma have revealed that the oral medication fosravuconazole has an efficacy rate of up to 85% and does not have any adverse effects.

Dr Borna Nyaoke, the head of mycetoma at the Drugs for Neglected Diseases Initiative (DNDi) – which coordinated the trial with the Mycetoma Research Center (MRC) in Sudan’s capital, Khartoum, and the Japanese pharmaceutical company Eisai – labelled the discovery “momentous”.

She expressed great enthusiasm, stating that it will bring about significant change.

A man with a damaged foot walks with a crutch as other patients wait on a bench at a clinic

Mycetoma is a persistent infection caused by specific bacteria and fungi, and is included in the World Health Organization’s list of 20 overlooked tropical diseases. The global prevalence of cases is unknown, but Sudan and Mexico have reported the highest rates.

The primary impact of this condition is on young adults living in low-income rural regions. Children comprise approximately 20-25% of all patients with mycetoma. A significant number of individuals contract this infection through puncture wounds from thorns while walking without shoes.

If not addressed, it can be fatal. The negative perception surrounding the illness can have adverse effects on mental well-being.

Currently, mycetoma is managed with the medication itraconazole, which should be consumed with meals four times daily for a duration of one year and may cause various adverse effects. This treatment is also costly, amounting to approximately $2,000 (£1,600) per patient per year. Additionally, it is not accessible in all regions where the condition is prevalent.

Nyaoke stated that Fosravuconazole, a medication currently utilized for treating fungal nail infections, can be consumed once a week for 12 months without needing to eat. In areas where obtaining two full meals daily is a challenge, this is considered beneficial. The updated treatment is anticipated to be significantly more affordable.

Unfortunately, despite the positive results seen in trials conducted in Sudan, the ongoing conflict in the country has hindered progress in combating the disease. In April, Sudan was thrown into turmoil as clashes erupted between the Sudanese military, under the command of General Abdel Fattah al-Burhan, and the Rapid Support Forces, led by rival Mohamed Hamdan Dagalo, also known as Hemedti.

The only specialized center for mycetoma in the world, known as the MRC in Khartoum, that also serves as a reference laboratory for various medical institutions, has been forced to shut down.

A man on crutches with one leg enters the gate to a clinic as others stand around in the shade of trees

Nyaoke stated that the regulatory authority in Sudan seems prepared to authorize the drug for use throughout the country, however, the timing of the decision is uncertain.

According to Ahmed Fahal, a professor of surgery at Khartoum University and the creator of the center, the conflict in Sudan has had significant effects on the country and the mycetoma center, as well as its patients. The war has disrupted their work and caused staff to flee and experience trauma. Overall, the war has caused a setback for the center.

Fahal plans to establish two additional facilities in regions of the country that are not impacted by conflict. He expressed his determination to resume operations and carry on with our current efforts.