WHO urges affected countries to scale up their investment in tackling 17 neglected tropical diseases in order to improve the health and well-being of more than 1.5 billion people. This investment would represent as little as 0.1% of current domestic expenditure on health in affected low and middle income countries for the period 2015-2030.
Neglected tropical diseases cause blindness, disfigurement, permanent disability and death, particularly among the poor. WHO’s new report, “Investing to overcome the impact of neglected tropical diseases”, outlines an investment case and essential package of interventions for these diseases.
“Increased investments by national governments can alleviate human misery, distribute economic gains more evenly and free masses of people long trapped in poverty,” says WHO Director-General Dr Margaret Chan.
The report highlights progress made in recent years, largely attributed to a scale-up of control interventions in reaching the poorest. For example, in 2012 alone, more than 800 million people were treated for at least one neglected tropical disease. In 2014 there were just 126 cases reported of Dracunculiasis (guinea-worm disease), compared to almost 1800 in 2010 and 3.5 million in the mid-1980s. Eradication of this disease is achievable with continued effort and investment.
Need for increased domestic investment targets
The report sets specific investment targets for many of the 17 diseases. It stresses that countries must make firm and sustainable budgetary commitments if they are to meet WHO targets and accelerate progress.
- An annual investment of US$ 2.9 billion until 2020 (including vector control), is required to reach targets set in 2012 in the WHO Roadmap for 2015-2020.
- For the following 10 years (2021-2030), investment requirements will drop to US$ 1.6 billion per year. Annual investments will continue to decrease as diseases are reduced or eliminated.
- This adds up to a total investment of US$ 34 billion (over 16 years) and excludes cost of donated medicines and other in-kind contributions.
- By 2017, the number of people receiving preventive treatment for at least one of the diseases should reach 1.5 billion. As diseases are reduced or eliminated, the number of people needing and receiving treatment will obviously fall. Early detection of some neglected tropical diseases will allow more children to continue school and adults to work while reducing the costs associated with treating more advanced forms of these diseases.
- Moving towards universal health coverage will ensure that all people have access to preventive and curative health services for neglected tropical diseases without the risk of financial hardship when paying for them.
In the face of climate change countries need to strengthen their ability to anticipate and meet new challenges in terms of vector ecology and management. Diseases spread by insects are on the move because of rapid and unplanned urbanization, population movement and environmental change. Dengue is one of them: it is now present in more than 150 countries.
“Some of the neglected tropical diseases are no longer strictly tropical,” says Dr Dirk Engels, Director of the WHO Control of Neglected Tropical Diseases Department. “The potential for spread provides yet another strong argument for making the needed investments – while ramping up research and development efforts – to bring all these diseases under control and eliminate as many of them as rapidly as possible.”
Many countries have recognized the importance and cost effectiveness of investing in preventing and treating neglected tropical diseases. More than 70 countries are already implementing or ready to kick off national plans for accelerated control.
Recent advances in combating neglected tropical diseases
- In 2013, Colombia became the first country where WHO verified the elimination of river blindness (onchocerciasis), followed by Ecuador in 2014.
- Bangladesh and Nepal are poised to eliminate visceral leishmaniasis as a public-health problem by the end of 2015.
- The number of new cases of sleeping sickness (human African trypanosomiasis) has dropped to fewer than 10 000 annually and this for the first time in 30 years with 6 314 cases reported in 2013.
- In 2009 approximately 30% of children in need of preventive treatment for soil-transmitted helminthiases were receiving it. Reaching 50% of children with this treatment by end 2015 is achievable.
Listed below is a short description of the 17 neglected tropical diseases.
Dengue: A mosquito-borne infection causing flu-like illness that may develop into severe dengue and cause lethal complications.
Rabies: A preventable viral disease transmitted to humans through the bites of infected dogs that is invariably fatal once symptoms develop.
Trachoma: A chlamydial infection transmitted through direct contact with infectious eye or nasal discharge, or through indirect contact with unsafe living conditions and hygiene practices, which left untreated causes irreversible corneal opacities and blindness.
Buruli ulcer: A debilitating mycobacterial skin infection causing severe destruction of the skin, bone and soft tissue.
Yaws: A chronic bacterial infection affecting mainly the skin and bone.
Leprosy: A complex disease caused by infection mainly of the skin, peripheral nerves, mucosa of the upper respiratory tract and eyes.
Chagas disease: A life-threatening illness transmitted to humans through contact with vector insects (triatomine bugs), ingestion of contaminated food, infected blood transfusions, congenital transmission, organ transplantation or laboratory accidents.
Human African trypanosomiasis (sleeping sickness): A parasitic infection spread by the bites of tsetse flies that is almost 100% fatal without prompt diagnosis and treatment to prevent the parasites invading the central nervous system.
Leishmaniases: Disease transmitted through the bites of infected female sandflies that in its most severe (visceral) form attacks the internal organs and in its most prevalent (cutaneous) form causes face ulcers, disfiguring scars and disability.
Taeniasis and neurocysticercosis: An infection caused by adult tapeworms in human intestines. Cysticercosis results when humans ingest tapeworm eggs that develop as larvae in tissues.
Dracunculiasis (guinea-worm disease): A nematode infection transmitted exclusively by drinking-water contaminated with parasite-infected water fleas.
Echinococcosis: Infection caused by the larval stages of tapeworms forming pathogenic cysts in humans and transmitted when ingesting eggs most commonly shed in faeces of dogs and wild animals.
Foodborne trematodiases: Infection acquired by consuming fish, vegetables and crustaceans contaminated with larval parasites. Clonorchiasis, opisthorchiasis and fascioliasis are the main diseases.
Lymphatic filariasis: Infection transmitted by mosquitoes causing abnormal enlargement of limbs and genitals from adult worms inhabiting and reproducing in the lymphatic system.
Onchocerciasis (river blindness): Infection transmitted by the bite of infected blackflies causing severe itching and eye lesions as the adult worm produces larvae and leading to visual impairment and permanent blindness.
Schistosomiasis: Trematode infections transmitted when larval forms released by freshwater snails penetrate human skin during contact with infested water.
Soil-transmitted helminthiases: Nematode infections transmitted through soil contaminated by human faeces causing anaemia, vitamin A deficiency, stunted growth, malnutrition, intestinal obstruction and impaired development.