Neglected Tropical Diseases "NTDs"

It is uncommon for those who live in developed countries to hear about someone who is suffering from elephantiasis, river blindness, snail fever, trachoma, round worm, whip worm or hook worm infections. However; these Neglected Tropical Diseases (NTDs) are considered a major threat affecting the bottom billion of people who are stuck in poverty traps, lack of education, and lack of health benefits.

Setting priorities to deal with such threats is a challenging condition. It is an issue of the developing world that, from the point of view of many, is not affecting those in the upper sector. Globally, dependence on DALYs as an estimate of the global burden of these diseases as a criterion for priority settings towards these neglected diseases is somehow misleading. According to (WHO, 2004) report, the DALYs burden due to neglected tropical diseases was estimated to be only 4% of the total due to infections diseases. Based on that, it is not considered a global health priority to be taken into consideration in relation to other global diseases that has higher DALYs. Is this completely accurate? Actually, it is not! Depending on Global DALYs for this kind of diseases is not precise because of the associated “hidden” co-morbidities such as anemia, diarrhea, weight loss and others. Besides, the associated co-infections such as malaria may mask the original problem of NTDs.

Although it is an ethical responsibility, modern world in the era of globalization, deal with health issues in poor areas from an economic point of view. Accordingly, it is worth to highlight that many heath interventions in the developing world have high rankings of cost benefit ratio. Based on that, cost effective interventions, that entails fixed cost to be spread over high number of people, should be prioritized. This cost effective approach will combine both health gain along with economic benefits by applying the vertical interventions (SPHC) in the form of massive chemotherapy or school based programs. Such approach might convince policy makers and economic powers to invest in this sector based on the return of their investments in the form of preserving global human capital, increasing productivity, lowering child mortalities with consequent lowering fertility rates hence increasing investments in low number of individuals.

Such neglected diseases, along with their associated co-morbidities and co-infections, are currently localized in certain geographic poor areas. However, there is a global risk of transmission, loss of global productivity, and increasing non cost effective interventions in the future if the problem is not paid attention to in the current time. Therefore; targeting this global threat is neither exclusive personal nor national responsibilities. It is an ethical, economic and political obligation of the developed world which should be an integral part of the global health improvement and poverty reduction strategies.

Reference:

Canning D. Priority setting and the 'neglected' tropical diseases. Trans R Soc Trop Med Hyg. 2006 Jun;100(6):499-504.