UN outlines strategies to combat neglected tropical diseases
The United Nations health agency today unveiled a report detailing ways to combat a group of chronic infectious diseases, found almost exclusively in very poor populations, and which are increasingly being overcome through generous donations of drugs by the international pharmaceutical industry.
The report, “Working to overcome the global impact of neglected tropical diseases,” released by the UN World Health Organization (WHO), covers 17 neglected tropical diseases that thrive in poor environments, where housing is substandard, living surroundings are contaminated with filth, and disease-spreading insects and animals abound.
“These are debilitating, sometimes horrific diseases that are often accepted as part of the misery of being poor,” says Margaret Chan, WHO Director-General.
“The strategies set out in this report are a breakthrough. If implemented widely, they can substantially reduce the disease burden, breaking a cycle of infection, disability and lost opportunities that keep people in poverty,” Ms. Chan stated.
At the launch of the report in Geneva, several pharmaceutical firms made additional commitments to continue donating drugs to fight some of the diseases.
Novartis renewed its commitment to donate an unlimited supply of multi-drug therapy and loose clofazimine to treat leprosy and its complications.
GlaxoSmithKline announced a new five- year commitment to expand it donation of albendazole through WHO to treat school-age children for soil transmitted helminthiases in Africa. The donation is in addition to the company’s current donation for lymphatic filariasis (elephantiasis) treatments.
Sanofi-aventis, for its part, agreed to renew its support for the WHO programme against sleeping sickness elimination and support for Buruli ulcer, Chagas disease (American trypanosomiasis) and leishmaniasis for the next five years.
In addition, Bayer started discussions with WHO on how to evolve their current commitment to fight African sleeping sickness and Chagas disease, while EISAI committed to work towards the global elimination of lymphatic filariasis by providing diethylcarbamazine (DEC).
Johnson&Johnson announced last week that it is expanding its donation of mebendazole to supply up to 200 million treatments per year for tackling intestinal worms in children.
The consequences of untreated, long-term infection of some of the tropical diseases vary. They include blindness, disfiguring scars and ulcers, severe pain, limb deformities, impaired mental and physical development, and damage to internal organs.
Worldwide, the diseases are endemic in 149 countries and territories, and impair the lives of at least one billion people.
In Afghanistan, where an outbreak of cutaneous leishmaniasis has been reported in Herat province, WHO and the health ministry used the launch of the report as an opportunity to raise awareness about and advocate for neglected diseases in the country, with special emphasis on the disease.
In the capital, Kabul, commonly considered the “world capital” of cutaneous leishmaniasis, the number of new reported cases dramatically rose from the estimated yearly figure of 17,000 to 65,000 in 2009, mainly among women and girls, according to WHO.
“Existing interventions, including safe, simple and effective medicines, are having an impact. By expanding coverage, we can actually prevent many of these diseases. This is a first-time opportunity for some very ancient diseases,” said Ms. Chan.
According to the report, activities undertaken to mitigate the impact of the neglected tropical diseases so far are producing unprecedented results. Treatment with preventive chemotherapy reached 670 million people in 2008 alone. Guinea worm disease will be the first disease eradicated by health education and behaviour change.
Reported cases of sleeping sickness have dropped to their lowest level in 50 years, and elephantiasis is targeted for elimination as a public health problem by 2020.
The report also recognizes the challenges that lie ahead and the opportunities to alleviate the suffering of people in disease-endemic countries. Delivery systems, for example, need to be strengthened.
“The use of the primary school platform to treat millions of children for schistosomiasis and helminthiasis in Africa is a perfect example. It provides opportunities to broaden health education, thereby ensuring healthier future generations,” said Lorenzo Savioli, Director of the WHO Department of Control of Neglected Tropical Diseases.
The report also notes that better coordination is needed with veterinary public health as an essential element of controlling diseases that are transmitted from animals to humans. For example, every year, tens of thousands of human deaths occur from rabies, usually contracted from dogs. An estimated 95 per cent of cases occur in Asia and Africa and up to 60 per cent of cases are in children under the age of 15.
Among the neglected tropical diseases are Buruli ulcer disease (Mycobacterium ulcerans infection), Chagas disease (American trypanosomiasis), dengue, dracunculiasis (guinea-worm disease), human African trypanosomiasis (sleeping sickness), leishmaniasis, leprosy (Hansen disease), lymphatic filariasis (elephantiasis), onchocerciasis (river blindness) and rabies.