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Neglected Tropical Diseases: Looking Toward 2030

OCT 18, 2016 | NICOLA M. PARRY, BVSC, MRCVS, MSC, DIPACVP
In an article published in The Lancet, David H. Molyneux, DSc, from the University of Liverpool, United Kingdom, and colleagues review progress since 2010 in the area of neglected tropical diseases (NTDs).
 
NTDs are communicable diseases that are mostly neglected by the scientific and public-health community. They are typically chronic and insidious in how they present, and in how they manifest clinically.
 
The NTDs comprise viral diseases (including rabies, Dengue and Dengue hemorrhagic fever, protozoan infections (including leishmaniasis, Chagas' disease, and African trypanosomiasis), helminthiases (including schistosomiasis, ascariasis, hookworm infections, trichuriasis, lymphatic filariasis, onchocerciasis, and dracunculiasis), and bacterial infections (including trachoma, Buruli ulcer, leprosy, and yaws)). Many people suffer from multiple infections.
 
According to Professor Molyneux and colleagues, these diseases exclusively affect the poorest populations, occurring mostly in rural areas of low-income countries where they cause significant human suffering with debilitating consequences. Indeed, studies have estimated that NTDs result in 56 million disability-adjusted life years (DALYs) lost annually. And the annual mortality from NTDs is suspected to be around 350,000.
 
Because of the importance of these diseases, the World Health Organization (WHO) plays a critical role in developing strategies to address them. “Substantial progress in control and elimination has been achieved and policy momentum has been generated through continued bilateral, philanthropic, and nongovernmental development organisation (NGDO) support, and donations of drugs from pharmaceutical companies,” the authors note.
 
WHO has defined implementation targets for the control, elimination, or eradication of 17 NTDs by 2020—commonly referred to as the WHO Roadmap. This was endorsed by member states in a World Health Assembly Resolution in 2013. The Sustainable Development Goals (SDGs) were introduced in early 2016 and have been adopted by the United Nations. These goals comprise a set of 17 global targets that define and guide international efforts to end extreme poverty, fight inequality and injustice, and create a healthier environment by 2030—a global pledge to ‘leave no one behind’. Universal Health Coverage is critical to improving essential services, such as water and sanitation, and working towards control and elimination of NTDs.
 
Over the past 10 years, global attention and investment in NTDs has increased. However, although drug availability is no longer an obstacle to achieving universal health coverage for most NTDs, these diseases remain a chronic pandemic in the poorest communities in countries in which they are endemic.
 
The research agenda has identified the need for affordable products (such as new drugs, insecticides, and diagnostics), tools to improve delivery of existing products, evaluation of the efficacy of current treatments, and investigation of combinations of products already known to be effective.
 
However, progress toward reaching the 2020 WHO Roadmap targets has been sporadic, in particular, because resources assigned to control NTDs remain insufficient. Although about $300 million of annual funding is allocated to attain Roadmap goals, the WHO estimates that double this amount is needed—or, as much as ten times this amount if vector control is also taken into consideration.
 
“Further progress will be driven by commitment of countries to contribute to the relatively small costs of delivery—estimated at 1-3% of national health budgets—to ensure access to donated products with a calculated annual value of $2-3 billion,” the authors conclude.
 
 Dr. Parry graduated from the University of Liverpool, England in 1997 and is a board-certified veterinary pathologist. After 13 years working in academia, she founded Midwest Veterinary Pathology, LLC where she now works as a private consultant. She is passionate about veterinary education and serves on the Indiana Veterinary Medical Association’s Continuing Education Committee. She regularly writes continuing education articles for veterinary organizations and journals, and has also served on the American College of Veterinary Pathologists’ Examination Committee and Education Committee. 
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