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Health Affairs, 28, no. 6 (2009):
1688-1690
doi: 10.1377/hlthaff.28.6.1688 © 2009 by Project HOPE |
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Neglected Diseases |
PROLOGUE
Tropical Diseases: The Price Of Neglect
Over the past two decades, the "big three" diseases—HIV/AIDS, malaria, and tuberculosis—have occupied most of the global health spotlight. As millions have sickened and died, international donors and affected countries have channeled tens of billions of dollars toward these diseases’ prevention and treatment. Although few would dispute the wisdom of fighting these plagues, an unfortunate side effect has been limited attention to another class of infectious diseases that are arguably just as devastating. Small wonder they are referred to as "neglected" tropical diseases (NTDs), the topic of the cluster of papers that follow.
Caused by a variety of parasites, bacteria, and other microbes and transmitted in various ways, these diseases (see Exhibit 1
) have one major trait in common: They affect mostly poor people, most often in the poorest countries. These papers explore the scope of the problem, the cost to affected societies, and the terrible price paid by victims in disability and death. There is discussion of the potential and limitations of available modes of prevention, such as insect control and water sanitation. Treatment, including mass drug administration, has been sufficiently successful that there is a reasonable prospect of eliminating some of these conditions, such as leprosy, trachoma, and onchocerciasis, or river blindness. Some conditions, such as onchocerciasis in West Africa and schistosomiasis in Egypt, are on the verge of elimination. Multiple public-private partnerships have been behind many of these initiatives, many of them incorporating drug donations and stepped-up research from global pharmaceutical and biotechnology companies.
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Still, as these papers make clear, basic scientific research on these diseases has been inadequate. There is a clear need to jump-start more research and development in rich countries, and a great deal of potential for innovation among drug and biotech companies in emerging economies as well. Policy proposals are set forth, admittedly by principals of the very companies that could benefit from the tax credits and other measures proposed. Then again, if new modes of prevention and treatment can be found, benefit would accrue also to the tens of millions who are still blinded, mutilated, cognitively impaired, or otherwise devastated by these dreadful conditions as old as humankind.
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