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 . 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
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
- 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
- infection and disease distribution;
- diagnostic techniques;
- vector distribution;
- intervention and impact monitoring and evaluation;
- pharmacovigilance; and
- serious adverse events.
A joint report by WHO and the Carter Center  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."
1. Report of the WHO Strategic and Technical Advisory Group (STAG-NTD)
(Held in Geneva, Switzerland 17-18 April 2008)
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
WHO website for neglected tropical
Global Plan to Combat Neglected Tropical Diseases 2008-2115