Endpoint – Research and development for elimination of NTDs

Endpoint – Research and development for elimination of NTDs

October 2025 – March 2028

Two women sitting outdoors sorting leafy greens into bowls, with one holding a baby, outside a home with washing hanging on a line.

The challenge

Lymphatic filariasis and onchocerciasis are neglected tropical diseases (NTDs) that continue to cause disability, stigma and significant social and economic hardship in affected communities. Although decades of elimination efforts have made substantial progress, important gaps remain in the tools available to diagnose infection, monitor transmission and effectively treat the adult parasites that sustain disease and support persons affected.

For lymphatic filariasis, existing diagnostic methods can be invasive, require night-time blood collection and skilled personnel, and can be difficult to implement at scale in community settings.

For onchocerciasis, mass drug administration with ivermectin (an antiparasitic anthelmintic medicine), has been central to reducing disease and transmission, but it does not kill adult worms- meaning treatment must be repeated over decades. Doxycycline, an antibiotic, is a proven curative strategy for onchocerciasis, but its long duration course and contraindications in children and during pregnancy present challenges to its scalable implementation as an alternative strategy to ivermectin.

There is therefore an urgent need for new, practical and scalable approaches that can improve diagnosis and surveillance of lymphatic filariasis and provide shorter course, affordable treatments capable of targeting adult worms in onchocerciasis, whilst supporting individuals and communities to minimise the devastating impacts of these diseases.

About the project

ENDPOINT is a UK aid-funded product development partnership coordinated by LSTM working with the Infection Innovation Consortium (iiCON) and partners in Cameroon, Germany, Nepal and Switzerland.

It is designed to accelerate the elimination of filarial neglected tropical diseases by developing, validating and de-risking innovative diagnostic and therapeutic solutions for lymphatic filariasis and onchocerciasis. The programme brings together a portfolio of complementary projects spanning novel diagnostics, repurposed medicines and new chemical entities. By combining cutting-edge technologies with strong in-country partnerships, ENDPOINT aims to generate high-quality evidence, support the development of scalable solutions that are acceptable to individuals and communities, and strengthen national research and development capacity.

The programme comprises three interconnected areas of product development:

  1. The development and evaluation of a non-invasive, wearable microwave biosensor for lymphatic filariasis diagnosis and surveillance in Nepal being delivered through the iiTECH team within iiCON, LSTM and TLMN
  2. The clinical development of a shorter-course treatment for onchocerciasis in Cameroon through repurposing the oral antibiotic fusidic acid, alone or in combination with albendazole, complementing the EDCTP-funded FAME study.
  3. The early preclinical development of a new class of fast-acting anti-Wolbachia drug candidates in the UK, with potential applications in the treatment or prevention of onchocerciasis, lymphatic filariasis and veterinary zoonotic filariasis.

Alongside product development, ENDPOINT will assess the acceptability, usability and perceived value of these innovations among community members, healthcare workers, policymakers and other relevant stakeholders, while identifying the health-system, policy, regulatory, and implementation factors that will influence their future uptake.

Together, these activities aim to advance promising innovations towards more acceptable, accessible, effective and scalable tools for filarial disease elimination, while strengthening the capacity of countries to develop and adopt solutions that meet their own health priorities.

Our strategies and approaches

ENDPOINT adopts an integrated strategy that combines technological innovation, clinical research, social science, community engagement, market access planning and research uptake to accelerate the development, adoption and scale-up of new tools for filarial NTD elimination:

  • Innovative product development: Applying cutting-edge technologies, including microwave spectroscopy developed through the iiTECH team, to deliver low-cost, point-of-care diagnostics, alongside repurposing existing antibiotics and advancing novel anti-Wolbachia compounds. Promising products will be advanced across the development pipeline, from early laboratory validation through clinical evaluation and towards regulatory readiness and higher technology readiness levels (TRLs), while reducing development risks and supporting futureinvestment by Product Development Partnerships and industry.
  • Country-led partnerships: Working closely with ministries of health, national research institutions, healthcare providers and communities in endemic countries to co-design, test and refine products that respond to local needs, national priorities and programme realities.
  • Community and health system acceptability: Engaging with communities and health-system stakeholders to understand local and cultural perspectives on the acceptability of innovative products, ensuring they are appropriate for the people who will use them and feasible for health systems to deliver.
  • Research uptake and policy engagement: Maintaining continuous engagement with policymakers, implementers, communities and people affected by NTDs throughout the research process, using evidence and stakeholder insights to inform policy dialogue, implementation planning and future national and global guidance, and to support timely and equitable uptake of successful innovations.
  • Market access: Embedding business development, affordability and market access analyses, alongside an understanding of regulatory pathways and requirements, to support the future clinical development, and to identify potential barriers to adoption and scale-up of promising diagnostic and drug candidates.

 

Our impact

ENDPOINT aims to deliver lasting scientific, public health and societal impact by accelerating the development and uptake of innovative diagnostics and treatments that can help reduce the burden of filarial neglected tropical diseases and support progress towards elimination.

A key potential impact is improved lymphatic filariasis surveillance and programme decision-making. Through the development and preliminary evaluation of a lightweight, wearable lymphatic filariasis-sensor, ENDPOINT will explore a rapid, non-invasive approach to detecting transmissible lymphatic filariasis infection in real-world settings. By reducing reliance on night-time blood collection and repeated finger-prick testing, the technology has the potential to make testing more accessible and acceptable, strengthen community participation, and improve the feasibility of surveillance, including decisions around stopping treatment and transitioning to post-treatment surveillance.

The acceptability and research uptake studies accompanying the FAME clinical trial will help bridge clinical evidence and real-world implementation. If fusidic acid proves safe and effective, the trial could provide evidence for a potentially shorter and more practical treatment option for onchocerciasis, while identifying the most promising dose, duration and combination for further clinical development. The studies will explore how participants and communities understand and experience the treatment, alongside community, healthcare provider and policymaker perspectives, helping to ensure future approaches reflect local needs, health-system realities and elimination priorities. By examining policy, regulatory, financing, procurement and delivery pathways, the research will identify potential barriers, enabling factors and system-readiness requirements, generating actionable, context-specific recommendations to support the equitable and sustainable uptake of fusidic acid and future anti-Wolbachia treatments.

ENDPOINT will also contribute to the early development of a new class of fast-acting anti-Wolbachia drug candidates, with potential applications across human and veterinary filarial diseases. In the longer term, these candidates could contribute to shorter-course treatment approaches and potentially expand treatment options for populations that are currently underserved by existing therapies.

Across the programme, ENDPOINT will strengthen research and development platforms and clinical trial capacity in endemic countries, while generating evidence to support future policy and implementation decisions. Over time, successful innovations could help reduce the health, economic and social burden of filarial NTDs on affected communities, improve programme efficiency and contribute to more equitable and sustainable progress towards the WHO 2030 NTD Roadmap targets.

Our partners

ENDPOINT is a UK aid-funded product development partnership coordinated by LSTM working with the Infection Innovation Consortium (iiCON) and partners in Cameroon, Germany, Nepal and Switzerland.

This collaborative, cross-disciplinary global health research programme brings together research leaders, laboratory parasitologists, engineers, clinical trial specialists, statisticians, social scientists, knowledge exchange specialists, market access advisors, programme managers, finance managers and administrators. By integrating expertise across the research, clinical, technical, commercial and operational domains, the programme is designed to maximise the potential impact, uptake and sustainability of the research.

Our team at LSTM

 

Related projects

A hand holding a petri dish filled with Cameroonian blackflies the vectors for onchocerciasis.

FAME (Fusidic Acid Macrofilaricide Evaluation)