Compressing the Timelines for Development and Delivery: Accelerating Access to Triple-Drug Therapy to Eliminate Lymphatic Filariasis

The traditional timeline for a new innovation in public health to move from initial proof of concept to introduction into national programs is sequential and can take decades. Here, we discuss the development of a new drug therapy for lymphatic filariasis (LF) to help progress toward elimination as a public health problem and how this process was accelerated by a group of partners working together. This article documents the way that these partners worked together and made decisions that made it possible to accelerate the process of the development and introduction of the triple-drug therapy involving ivermectin, diethylcarbamazine, and albendazole (IDA). The partners were able to condense the development timeline from the first clinical efficacy data to delivery in a country program for the triple-drug therapy from a projected ∼28 years to less than 5 years while maintaining all of the safety standards. The approach required understanding stakeholders, their roles, need for data to inform decisions, and then looking at timelines focused on prioritizing activities that inform decision-making. This process relied on a close engagement of all stakeholders and good communication. Through this exercise, additional early data review points were added to study designs, studies were run in parallel not sequentially, and a plan put in place to engage all stakeholders necessary for adoption and uptake throughout the process, so they were prepared to make decisions as data became available. This process could provide some insights into how global health can work together in new ways to accelerate the availability of interventions and strategies to promote health and well-being.