Although diarrhea can be prevented and treated with solutions available today, researchers are studying and developing new treatments to ease diarrhea symptoms, prevent dehydration, and protect children from long-term harm. There are still things we do not understand—such as the long-term impact of diarrhea—that research could help illuminate, thereby helping us discover the most effective interventions. This research is particularly important for children living in low-resource settings who lack access to drug treatments for specific diarrheal pathogens.
Though we already have a lot of the tools needed to defeat diarrheal disease, new research and innovations could help save even more lives and prevent lifelong harm.
There are very few drug treatments for specific diarrheal pathogens. In low-resource settings, diarrhea is often inappropriately treated with antibiotics that are ineffective against anything not caused by bacteria (i.e., anything viral or parasitic). Compounding the problem, indiscriminate antibiotic use can lead to bacterial resistance and deadlier pathogens.
New drug treatments to complement existing solutions—like oral rehydration solution (ORS) and zinc—are urgently needed. The work underway is promising. For example, iOWH032 is an investigational new drug for secretory diarrhea with potential to treat cholera and enterotoxigenic Escherichia coli (ETEC). This new drug could be the first synthetic drug of its kind designed to reduce fluid loss.
Additionally, scientists are at work to develop new prevention and treatment tools to combat the Cryptosporidium parasite, a significant problem for young children in low-resource settings. Currently, therapeutic options for Cryptosporidium are limited, with only one available drug, nitazoxanide, which is not approved for children under 1 year of age and has limited efficacy in malnourished children. A promising portfolio of drug candidates against Cryptosporidium is currently under evaluation.
Research and development on new vaccines and improved forms of the current portfolio of diarrheal vaccines is another exciting frontier. Building upon the global success of current rotavirus vaccines, new and reformulated candidates will help optimize effectiveness, impact, access, and affordability of rotavirus vaccines. Research and development of vaccines against other diarrheal pathogens that do not currently have vaccines – including ETEC, Shigella, and norovirus – has the potential to save many additional lives.
New drug treatments could have a profound impact on saving lives and alleviating the burden of diarrhea’s long-term effects. Research and development of new tools to stop diarrhea will play a crucial role in accelerating an end to the global crisis.
Advances in epidemiological data and research methods are opening new doors to develop treatments against top causes of moderate-to-severe diarrhea, such as Cryptosporidium and cholera. Additionally, research on the gut microbiome, immune system, and gut dysfunction barrier present promising opportunities to test and develop new interventions to prevent and/or reverse stunting.