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NEGLECTED TROPICAL DISEASE

Published: 21st Feb, 2020

Context:

The first-ever edition of "World Neglected Tropical Diseases Day"(World NTD Day) is launched on 30 January 2020. This initiative brings together various civil society organisations, community leaders, global health experts and policymakers working in the field of NTDs.

They share a bold ambition: #BeatNTDs. For good. For all, a goal fully supported by the Institute of Tropical Medicine (ITM) in Antwerp. 

  • As part of the 2030 Sustainable Development Goals, several countries have joined the World Health Organisation (WHO) to roll out new targets for controlling five of 20 Neglected Tropical Diseases (NTDs) by year-end.
  • The challenge to combat NTDs, estimated to affect around 1.7 billion people in 149 countries, mostly poor population, involves considerable resources, coordination, awareness programmes and getting people and communities to co-operate.
  • The aim of the NTDs programme is to get millions of poor out of the cycle of poverty and disease.
  • These diseases may be acute or chronic, disabling, disfiguring and stigmatizing and some may cause death or contribute to causing death.
  • They impair children’s physical and cognitive growth, promote poverty and as many of the drugs used in the treatment are toxic, they are difficult to administer.
  • During the Sustainable Development Goals event ‘Future Forward 2020: Building A Momentum for Inclusion And Elimination’, which is being held in India, ten diseases will be targeted.
  • Of these five - Bilharzia (schistosomiasis); Blinding trachoma; Elephantiasis (lymphatic filariasis); Intestinal worms (soil-transmitted helminths); River blindness (onchocerciasis) - are being targeted through mass drug administration (MDA) or treatment of all people living in high-risk areas for treatment and reducing risks of transmission.
  • The other five NTDs - Chagas disease; Guinea worm disease; Leprosy; Sleeping sickness and Visceral leishmaniasis or Kala Azar (KA) - are being targeted through innovative and intensified disease management (IDM), including individual diagnosis and treatment (a surgery where needed), care, and rehabilitation of infected individuals.
  • For the first time, global funding for neglected disease R&D grew for three consecutive years, reaching a record high of more than US$4.05 billion in 2018.
  • This is according to the 12th annual G-FINDER report, which has been launched recently in Brussels by Policy Cures Research.
  • Across all LMIC funders - including India - investments remain well above pre-2017 levels. In keeping with trends from previous years, India ($66m, 70%), South Africa ($13m, 14%) and Brazil ($12m, 12%) comprised 96% of funding from LMICs.
  • The Indian government is the fourth largest funder for research and development into neglected tropical diseases.
  • The top public funding agencies into R&D on neglected diseases in India are the ICMR, the Department of Biotechnology (DBT), the Council of Scientific & Industrial Research (CSIR) and Biotechnology Industry Research Assistance Council (BIRAC)
  • The "big three" neglected diseases - HIV/AIDS, malaria and tuberculosis - saw increased investments, even as their global share dropped marginally to 69% ($2.79b) in 2018.
  • Other diseases, such as hepatitis C (up to $30m) and bacterial pneumonia and meningitis (up to $16m) also saw significant bumps in funding.
  • The annual G-FINDER report provides policy-makers, donors, researchers, and industry with a comprehensive analysis of global investment into research and development (R&D) of new products to prevent, diagnose, control, or cure neglected diseases in developing countries. 
  • The survey looks at funding for a number of diseases like trachoma, Buruli ulcer, rheumatic fever, meningitis, leptospirosis and also for HIV/AIDS, malaria, TB, dengue, hepatitis C and leprosy.
  • It examines funding from government sources, philanthropies, private sector funding and other types of organizations.
  • In India’s case, the first and most important challenge will be to continue good surveillance to determine whether these diseases remain in previously endemic areas, and to continue advocacy to ensure that political commitment remains strong and that these diseases continue to be granted the importance they deserve within the context of national health strategies.
  • Lack of resources: In global terms, the resources required are not so substantial, but in the poorest areas of some of the poorest countries of the region, finding adequate resources is an enormous challenge.
  • Population, poverty & malnutrition: India’s massive population, widespread poverty and malnutrition still present challenges in controlling neglected diseases.
  • Lack of knowledge: Another major challenge is diagnostics. Many common NTDs lack rapid tests that can be done at the primary care. For example, there is a clear need for sensitive rapid diagnostic tests for schistosomiasis.
  • Gaps in treatment: There are also gaps in treatment. For example, India has the potential to eradicate Guinea worm, spread by contaminated water – yet this disease has never had a diagnostic, vaccine or medical solution. Onchocerciasis(also called river blindness), on the other hand, is treatable. Yet it can take years to cure people of this blinding disease, years of unnecessary suffering and disability.
  • Global climate change: Global climate change is causing new challenges in addressing and combating neglected tropical diseases throughout the world. 
  • Lack of R&D: Stagnant resources limit our chances to fill critical gaps in NTD Research & Development.
  • Other factors: They are also increasing because of war, and political instability, and are now widespread wherever human populations are under threat.
  1. What are Neglected Tropical Diseases? Discuss the recent initiatives taken at the global level.
  2. Discuss the progress and challenges for Neglected Tropical Diseases.
  3. Neglected Tropical Diseases have garnered greater attention from the global government, spurred on by growing recognition of their potential threat to the achievement of the Sustainable Development Goals (SDGs). What opportunities does the new international policy environment offer for NTDs?
  4. In recent years, India has made huge progress in the health sector. Still, it lacks in eradicating neglected tropical diseases. Comment
  5. Neglected tropical diseases (NTDs) have long been overlooked in the global health agenda. Discuss the recent changes in policies at the global level.
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