[Public Health] Saving Lives in India

For Richard Poché, founder and president of Genesis Laboratories, sister company of Scimetrics/Kaput products, working in pest control goes far beyond providing the pest control industry with innovative product offerings — it’s about using Genesis Labs’ knowledge and skills to help save lives around the world.

“It began while in the Peace Corps. My wife Linda and I were volunteers in Niger, Africa,” said Poché. “An outbreak of Lassa fever, a rodent-borne disease, resulted in the deaths of African and German friends.”

Since that time, Poché has worked on Lyme disease, plague, hantavirus, sleeping sickness, typhus, cutaneous leishmaniasis in the Middle East and North Africa, and visceral leishmaniasis (VL) in Asia and Africa. Much of this research has been conducted since the Pochés started Genesis Labs more than 21 years ago. Genesis Labs’ current work takes place in India’s Bihar State. With a grant from the Bill & Melinda Gates Foundation, Genesis Labs is involved in efforts to control the sand fly vector of VL, a disease that has had a devastating impact on the region. It attacks the body’s organs and without an extended period of treatment is almost always fatal. VL usually attacks the poorest of the poor for whom a long hospital stay is not an easy option. The reservoir host of visceral leishmaniasis is human. Sand flies will take blood meals from infected people and then transmit the disease by biting other humans. Poché believes that Genesis Labs — having previously developed and tested systemic flea control products in the region — can make a difference. They had previously received grants from the U.S. Department of Defense to begin product development on systemic baits to control the sand fly vector of cutaneous leishmaniasis, which is impacting U.S. troops in the Middle East.

So, in 2009, Genesis Labs presented a proposal to the Bill & Melinda Gates Foundation for the purpose of conducting research on its ideas for using systemic products to control flies that feed on blood of livestock, and as feed-throughs to kill larvae in the feces. Gates funded the three-year project in 2009.

THE NEED IS GREAT.
Bihar State is impoverished, leaving residents more susceptible to infected sand flies, and thus visceral leishmaniasis. The hot climate for eight months of the year forces most rural residents to move their beds outside at night.

“It’s common to see many families living in grass homes — in extreme heat and cold — with no means for vector control against sand flies and mosquitoes,” Poché said. “Some people have bed nets, but the heat is so intense that 95% of the rural population does not use the nets. Plus, sand flies are so small they can squeeze through conventional mosquito netting. Those most susceptible are malnourished children. “To truly conquer Kala-azar, one has to address the poverty issue,” Poché said. “Nitish Kumar, chief minister of Bihar, is making great strides in this direction.”

Still, advances can be made through research and product usage. Genesis Labs has set up a lab in Patna, Bihar’s capitol city, which is equipped with 12 scientists, American and Indian, conducting research on sand flies, conducting efficacy testing on sand flies, and working closely with local vector control authorities and private companies.

RELIEF EFFORTS.
Genesis Laboratories’ research in India involves:

• Long-term sand fly monitoring in villages, at different sites within villages as well as homes, cattle sheds and vegetation
• Screening IGRs and insecticides as systemic and feed-through products to reduce adult sand flies and larvae
• Screening animal drugs that may control adult biting flies, and monitoring the distribution, and infection rates of rural Indians for VL

Poché notes, “The work is fulfilling but very rigorous. A normal week for the team is 12 to 14 to even 16 hour days with one day off when that is possible.”

Genesis Labs scientists and Indian counterparts travel from site to site to collect sand fly data, examine cattle and other livestock, and take milk, blood and fecal samples. Poché adds, “The villagers who have so little are so generous. There is never a stop in the villages (each of six) where we are not offered a meal or tea or both. The research team returns to the Patna at night for safety; we don’t allow them to stay in the endemic areas over night.” Travel time is approximately 2 ½ hours each way.

 In Patna, Genesis Labs maintains two labs, including one for analytical chemistry and sand fly breeding. Since numerous bioassays are conducted with adult and larval sand flies, the colony has to hatch out about 1,000 sand flies each day. Genesis Labs has subcontracted an Indian company to help with this segment of the research. “We also have a second lab where we conduct most of the larval bioassay research, along with PCR equipment for sand fly blood meal analysis,” Poché said. “That way we can know the source of the animal or human from which female sand flies are feeding in a given area.” He added, “We also look at tissues, such as the spleen from goats and poultry slaughtered in local markets in search of flies infected with Leishmania donovani. Our scientists in the field normally do a 4- to 6-month tour then come back to Colorado for rest and to eat beef which is not available in Patna.”

SHORT- & LONG-TERM GOALS.
The hope is that the work Genesis Labs, along with its Indian counterparts, is doing, will reduce sand fly populations, thus reducing cases of VL. Genesis Labs is encouraged by early results, including data showing a 70% decrease in sand fly numbers in a controlled pilot study conducted last fall. Also, data collected on weekly sand fly abundance will greatly contribute to control efforts in the future, namely, heading off the dramatic increase in sand flies before the large peaks begin in October, April and July each year.

The larger goal is to register several products for sand fly control that will be affordable to a rural population that exists on only $400 per year, per household. The Gates Foundation will play a major role in helping to ensure manufacturing and sales, and that the distribution of control products gets to the people who need them. An agreement between Genesis Labs and a large Indian agrochemical company has been signed to help meet these goals. Genesis Labs will serve as their conduit in making sure it happens.

In the meantime, Richard,  often accompanied by wife Linda, head back to India each month or two to monitor progress, begin new research projects, and meet with Indian counterparts and government officials and work with the villagers. During 2010, nine such trips were completed.

“We are trying to enter into contractual arrangements with several animal health companies in India to manufacture products and provide them on a steady basis,” Poché said. Part of the Gates Foundation arrangement (termed Global Access Policy) is that the products have to be made available —and at affordable prices — to India and other countries where visceral leishmaniasis is present.

Genesis Labs staff will remain in India until the end of 2011 unless more funding is available and the project is extended.
Poché added, “Our staff in India and our support staff involved in many other projects in the U.S. and elsewhere, are exceptional. This kind of work grabs you.”  

While promising products in development and encouraging results from the site monitoring are reasons for optimism, Poché said one of the most rewarding aspects has been developing friendships with Indian staff and the people in the villages. “The staff members we hired to aid in helping us in each village have become good friends. We have managed to assist many with other health problems, as well as VL. The people are amazing. The have so little, but when we come into the village, we are surrounded and there is much laughter and teasing. We have been able to provide reading and prescription glasses (Donated by the Lyons Club of Ft. Collins, Colo.), books and shoes for the children, and milk cows to widows for added income.” 
 

Other Projects
Genesis Labs prides itself on being skilled at solving problems. “We have many new products in mind to both increase the health of livestock, plus control parasites,” Poché said.
 
Genesis Labs will be assisting with another leishmaniasis project in Ethiopia beginning later this year, by sharing technology they’ve developed for India.

 
The author is Internet editor of PCT and can be contacted at bharbison@giemedia.com