The first WHO report on neglected tropical diseases: a way forward?

Recently, the World Health Organization (WHO) released a breakthrough document: the first report on neglected tropical diseases, entitled Working to overcome the global impact of neglected tropical diseases. According to the report, it is now possible to significantly reduce the debilitating impact of 17 neglected tropical diseases that thrive in 149 countries worldwide, almost exclusively in impoverished settings where housing is substandard, living environments are unsanitary and often contaminated and disease-carrying insects and animals are aplenty.

WHO director-general Dr Margaret Chan said in her opening statement at the launch of the report that often, these diseases were “accepted as part of the misery of being poor” although they did not need to be so, and that the strategies outlined by the report could substantially reduce disease burdens and break infection cycles if implemented widely.

The launch of this report is a significant development towards redirecting the international community’s attention towards neglected infectious diseases in a world where HIV/AIDS, malaria and tuberculosis (TB) are often perceived as the three greatest health problems affecting the global poor  (i.e. the United Nations Millennium Development Goals lists the eradication of the three aforementioned diseases as one of its goals, but neglected tropical diseases are not included). This report effectively recognizes the impact of neglected tropical diseases on a global scale and reaffirms the WHO’s commitment to tackling them. Additionally, several multinational pharmaceutical companies have also pledged an excess of USD 150mil towards their long-term commitment to the elimination of neglected infectious diseases through generous drug donations and renewed cooperative efforts with the WHO.

The report states that existing interventions undertaken to mitigate the impact of diseases such as dengue, leprosy and lymphatic filariasis have produced unprecedented results. However, the WHO also recognizes that challenges remain, including the need for stronger delivery systems, the lack of public health coordination with veterinary public health systems in order to better manage and control vector-borne diseases, and the need for public health systems to better respond to changing disease patterns that occur as a result of climate change and environmental factors.

The report itself has proven to be a pioneering document; it is the first of its kind to acknowledge the severe global impact of neglected tropical diseases and to call for a concerted effort among national governments, the private sector, the research profession and foundations towards their control and management (the WHO hopes that some diseases will be ‘completely controlled’ by 2015).

However, structural interventions and developments need to accompany these renewed international commitments to NTDs. Limited capabilities of poor and developing countries to provide access to adequate treatment and prevention programs exacerbate the suffering of those affected. Despite the serious consequences of these diseases, there remains little incentive for pharmaceutical industries to invest in developing new or better drugs for a market that cannot afford them. It remains questionable if the 2015 target will be successfully achieved without parallel developments in medical research and drug development, public health systems (national and international), economic growth and infrastructure in the countries most adversely affected by NTDs.