I am currently preparing a lecture to give a group of internal medicine residents on the basics of global health. As I am reviewing the literature, it occurs to me that of the many health issues addressed in common global health literature, the one that even most physicians don’t know much about is the neglected tropical diseases (NTDs) appropriately named since I can barely recollect spending a few minutes on any of the 7 most common NTDs. Yet the impact of the NTDs is so striking that I feel it should be highlighted in my talk on global health.
The issue of NTDs are compelling for a few reasons – they mostly affect the world’s ultra-poor (those who live on less than $1-2 / day), they are chronic and disabling which means they have significant impact on determinants of health such as economics and education and despite the overwhelming prevalence and impact, NTDs receive relatively little political attention nor financial commitment because they don’t kill, they only disable so they don’t get counted when dollars spent are measured against lives saved.
According to the WHO “Although medically diverse, neglected tropical diseases share features that allow them to persist in conditions of poverty, where they cluster and frequently overlap. Over 1 billion people – one sixth of the world’s population – suffer from one or more neglected tropical diseases.” Whether your concern is education, poverty or health, treating NTDs has the potential to make a huge difference according to these facts published by the Global Network for NTDs:
- Deworming is the single most cost-effective means of improving school attendance
- Controlling intestinal worms will help to avoid 16 million cases of mental retardation and 200 million years of lost primary schooling among children in developing countries
- In Kenya, deworming could raise per-capita earning by 30%
- Controlling lymphatic filariasis in India would add $1.5 billion to the country’s annual GNP
Despite the huge impact of treating these diseases, it appears that the NTDs are not a priority of the Millenium Development Goals – they might be considered as part of the “other diseases” under Goal 6, but without specific targets, the focus will remain on the already-famous trio (HIV, Tb and Malaria). There are international partnerships (this reference is for you Dr. Grepin 🙂 that bring hope to those of us concerned about these forgotten diseases. I will do my part by taking the opportunity next week, as I speak with future internists and potential leaders in the field of community and public health, to remind them of the importance of NTDs.
It will be interesting to see if attention will be brought to the NTDs as progress is being made towards meeting the MDGs since poverty alleviation is a major priority. NTDs and poverty are clearly intertwined – an implication that will hopefully bring NTDs into the spotlight – if not before the 2015 deadline of the MDGs, then perhaps in the aftermath of the deadline when the world is searching for another cause to rally behind.