Bringing Tropical Diseases Out of the Shadows

By Jean-Jacques Bernatas

Much of the media attention and a substantial slice of pharmaceutical research funding focuses on the fight against HIV/AIDS and other high profile infectious diseases. 

The need to combat these public health threats is of course critically important, but there are a host of other diseases which largely fall under the public radar, even as they have a major, debilitating impact on the lives of the poor in developing countries, including Asia and the Pacific.

What I’m talking about here are so-called ‘neglected tropical diseases’ like sleeping sickness, soil-transmitted worm infections, elephantiasis, river blindness, bilharzia and many others.

These diseases are frequently ignored for a number of reasons. They pose no threat to developed countries, are typically not epidemic-prone, and are not preventable with vaccines, so attract little interest from drug companies. As a result, they draw little media attention. 

However they are a major cause of disability in many poor communities, making it even harder to break the cycle of poverty, with sufferers stigmatized and often unable to work, putting a severe strain on families.  They can also leave sufferers vulnerable to other debilitating illnesses like tuberculosis.

The statistics tell a grim story. According to the World Health Organization (WHO), 12 of these tropical diseases cause up to 534,000 deaths a year. They are also responsible for huge losses in ‘disability adjusted life years’ – or years lost due to ill-health, disability or early death. 

To bring these health threats out of the shadows, WHO has drawn up a list of 17 mostly neglected tropical diseases, and in May 2013 its policy-setting World Health Assembly endorsed a battle plan to fight them. 

The WHO Global Plan to Combat Neglected Tropical Diseases embraces several key principles. That countries should have ‘ownership’ of control programs; that programs should be integrated into primary health care services; that interventions should be stepped up to meet targets for disease reduction and eradication; and that development partners should provide support. 

The strategy for reducing and eradicating diseases incorporates a number of approaches. They include expanding preventive chemotherapy; intensified case detection and case management; improved vector control; appropriate veterinary health measures; and the provision of safe water and improved sanitation and hygiene. The main priority is on better case detection and management, which ―when circumstances dictate― could include large scale drug treatment.

While improved water, sanitation and hygiene is often viewed as a secondary or last stage step, it is a crucial one in the case of soil-transmitted helminthiasis (worm infections). A recent academic study found that improving water quality and hygiene standards has a major impact in controlling these infections, particularly in school settings. 

As such any successful drive to eliminate this disease must involve close inter-sectoral cooperation amongst the health, environment, water and sanitation, and education sectors. This interagency approach will need to be extended to include the agriculture and animal health sectors in the case of the other tropical diseases. 

The WHO plan, along with a greater collective effort amongst sectoral agencies, will be a major step forward in the fight against these tropical diseases. In turn, it will help break the vicious cycle of poverty in some of the world’s poorest communities, including many here in Asia and the Pacific.