Global action against neglected tropical diseases

16 July 2008

The WHO Strategic and Technical Advisory Group on Neglected Tropical Diseases (STAG-NTD) has released a report of its recommendations to the World Health Organization (WHO) on action to take over neglected tropical diseases resulting from its meeting in April [1]. Urgent requirements include surveillance and diagnostic techniques.

Neglected tropical diseases are a group of disabling chronic infections that cause disability, impaired childhood growth and development, adverse pregnancy outcomes, and reduced economic productivity.

Most of the neglected diseases are caused by parasites that thrive in impoverished settings, where water supply, sanitation, and housing are poor. Apart from this strong link to poverty, the diseases form a group because they permanently deform and disable large numbers of poor people, trapping them in poverty.

The neglected tropical diseases include three soil-transmitted helminthiasis (ascariasis, hookworm infections, and trichuriasis), lymphatic filariasis, onchocerciasis, dracunculiasis (guinea-worm disease), schistosomiasis, Chagas’ disease, human African trypanosomiasis, leishmaniasis, Buruli ulcer, leprosy, and trachoma. An expanded list could include dengue fever, the treponematoses, leptospirosis, strongyloidiasis, foodborne trematodiases, cysticercosis, and scabies, as well as other tropical infections.

Worldwide, an estimated 1.2 billion people — one sixth of the world’s population — are affected by one or more of these diseases. Recent evidence of their severe impact on socioeconomic development has spurred unprecedented commitment to reduce this burden. Control of these diseases is now considered part of the global drive to reduce poverty.

The STAG-NTD report gives four high priority themes for controlling neglected tropical disease:

  • a framework for mobilising resources for expanded control of neglected tropical diseases, including: 
    • Assisting governments of NTD endemic countries to integrate NTD control into national health systems;
    • Scaling up preventive chemotherapy as a public health intervention with special emphasis on least developed countries;
    • Establishment of a flexible fund dedicated for NTD control to which governments can apply for support for NTD control through WHO;
    • Expansion of relationships and sharing of information with the pharmaceutical industry to ensure the supply of sufficient quality drugs for control programmes; and
    • Closer collaboration with partners to ensure the continuation of a robust supply of resources and delivery of interventions in line with government plans.
  • health economics research: a critical understanding of the direct and indirect costs of the NTDs including snake bites, their prevention, control and treatment is essential for secure policy formulation, resource allocation and advocacy.
  • Dengue fever: this is one of the world’s fast growing and rapidly spreading infectious diseases
  • NTD surveillance: must be strengthened to support expanding NTD prevention and control activities. WHO is urged to assist NTD endemic countries with technology transfer and capacity building for:
    1. infection and disease distribution;
    2. diagnostic techniques;
    3. vector distribution;
    4. intervention and impact monitoring and evaluation;
    5. pharmacovigilance; and
    6. serious adverse events.

A joint report by WHO and the Carter Center [2] prepared following the STAG-NTD meeting says: "Despite the magnitude of suffering represented by these numbers, affected populations have low visibility and little political voice. This translates into a low profile for NTDs when public health priorities and health budgets are set.

"NTD control represents a largely untapped development opportunity to alleviate poverty in the world’s poorest populations, and therefore has a direct impact on the achievement of the Millennium Development Goals. This potential is further underscored by the availability of effective low-cost tools, proven control strategies, a high return on investment, and a solid track record of success."

WHO Director-General, Dr Margaret Chan said in her address to the Sixty-first World Health Assembly in May 2008: "We now see a whole spectrum of opportunities that have converged in a most harmonious way. Safe and powerful drugs are being donated or made available at very low cost. Integrated approaches have been devised for tackling several diseases at once.

"A strategy of mass preventive chemotherapy, aimed at reaching all at risk, rivals the protective power of immunization. Research continues to document the improvements in poverty reduction and economic productivity when these diseases are controlled. A perfect rainbow really can end in a pot of gold.

"With a comparatively modest, time-limited financial push, many of these diseases can be controlled by 2015. Some can even be eliminated by that date. In this regard, let me thank the government of the United States of America for its commitment of funds to control the neglected tropical diseases. I hope many other countries will show a similar commitment. If we can bring these diseases under control, that will be a contribution to poverty alleviation on a truly grand scale.

"As you know, we are on the brink of eradicating guinea-worm disease, and funds are being secured to ensure this happens."

References

1. Report of the WHO Strategic and Technical Advisory Group (STAG-NTD) (Held in Geneva, Switzerland 17-18 April 2008)
www.who.int/neglected_diseases/STAGReport_july_08_ok.pdf

2. The report Integrated Control of the Neglected Tropical Diseases. A neglected Opportunity Ripe for Action. A Paper jointly prepared by WHO and the Carter Center. May 2008
www.who.int/neglected_diseases/NTD_integrated_control.pdf

Further information

WHO website for neglected tropical diseases
www.who.int/neglected_diseases/en/index.html

Global Plan to Combat Neglected Tropical Diseases 2008-2115
http://whqlibdoc.who.int/hq/2007/WHO_CDS_NTD_2007.3_eng.pdf (English)
http://whqlibdoc.who.int/hq/2007/WHO_CDS_NTD_2007.3_fre.pdf (French)

 

To top