NEGLECTEDTROPICALDISEASES

Dr. Rajesh Karyakarte MD

Professor and Head,
Department of Microbiology,
Government Medical College,
Akola-444001

Neglected Tropical Diseases (NTDs) are the most common diseases of the worlds poor. These
diseases disable and debilitate one in six people worldwide, including half a billion children.
Most of the NTDs are ancient and have plagued humanity for centuries. These diseases gradually
disappeared from large parts of the world as living conditions and hygiene improved.
In 2007, WHO launched a Global Plan to Combat Neglected Tropical Diseases 20082015,
with a vision of a world free of neglected tropical diseases and zoonoses. This global plan caused the
development of regional plans leading to growing awareness of NTDs and the suffering they cause. The
first WHO report on neglected tropical diseases, Working to overcome the global impact of neglected
tropical diseases was released in the year 2010 by the WHO Department of Control of Neglected
Tropical Diseases.
The 17 NTDs profiled in the first WHO report on neglected tropical diseases affect populations
whose lives are affected by poverty (Table). Although this report is confined to 17 NTDs, some comprise
separate infections and thus separate diseases: for example, soil-transmitted helminthiases comprise
three separate infections and therefore three separate diseases. There are 149 countries and territories
where NTDs are endemic, at least 100 of which are endemic for 2 or more diseases, and 30 countries
that are endemic for 6 or more (for details refer to the WHO report).
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Table: Neglected tropical diseases in the world today (First WHO report on neglected tropical diseases,
2010)

Parasitic
Chagas disease (American trypanosomiasis)
Cysticercosis
Dracunculiasis (guinea-worm disease)
Echinococcosis
Human African trypanosomiasis (sleeping sickness)
Leishmaniasis
Lymphatic filariasis (elephantiasis)
Schistosomiasis (bilharziasis)
Onchocerciasis (river blindness)
Foodborne trematode infections
Soil-transmitted helminthiasis
Bacterial
Trachoma
Buruli ulcer (Mycobacterium ulcerans infection)
Leprosy (Hansen disease)
Endemic treponematoses
Viral
Dengue
Rabies

The Second WHO Report on NTDs, Sustaining the Drive to Overcome the Global Impact of
Neglected Tropical Diseases was published in 2013. This report highlights the following (for details
refer to the WHO report):
1. The World is moving towards eradicating dracunculiasis However; operational challenges
remain in Chad, Ethiopia, Mali and South Sudan. It is estimated that eradication of the disease
will yield a 29% increase in economic returns for the agricultural sector of countries where the
disease is no longer endemic.
2. WHO aims at eradicating yaws by 2020. A new strategy of treating the entire community with a
single dose of oral azithromycin instead of intramuscular benzathine benzylpenicillin has
brightened this prospect. A study in Papua New Guinea, published in January 2012, helped in
framing this WHOs new Morges Strategy.
3. This report emphasizes the need for national programmes to continue developing a culture of
integrated and coordinated planning and programme management to enable programmes to
scale up effectively and encourage commitment from governments.
4. As mentioned in the First report the second report also emphasizes that to surmount neglected
tropical diseases, five public-health strategies are essential: (i) preventive chemotherapy; (ii)
innovative and intensified disease-management; (iii) vector control and pesticide management;
(iv) safe drinking water, basic sanitation and hygiene services, and education; and (v) veterinary
public-health services.
5. Universal coverage of prevention and control interventions for neglected tropical diseases
depends critically on strong and efficient health systems, access to essential medicines of
assured quality at affordable prices, a well-trained and motivated work force, as well as the
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involvement of sectors other than health, including finance, education, agriculture and
veterinary public health, water and sanitation, and environmental management.
6. Obstacles and risks to implementation of preventive programs are as diverse as the diseases
themselves. Natural disasters and human conflicts result in the displacement of millions of
people, and disrupt public-health interventions and disease surveillance.
7. A focus on vectors or intermediate hosts of the infectious agents is also essential. For example,
in 2012, dengue was ranked as the most important mosquito-borne viral disease with an
epidemic potential in the world. The global incidence of dengue has increased 30-fold during
the past 50 years, as our approach has been reactive instead of one that depends on
implementation of sustainable preventive measures that are guided by entomological and
epidemiological surveillance.
8. Specific, innovative and intensified management approaches, tailored individually for each
disease are required. For example, dengue, Chagas disease, lymphatic filariasis, the
Leishmaniasis and onchocerciasis vector control remains key to reducing transmission.
9. Sufficient human-resources (both technical and managerial) are required to combat NTDs.
WHOs new Working Group on Capacity Strengthening has been active in this regards since
December 2012.
10. Notwithstanding global economic constraints, more support from Member States and their
partners are required for preventing, diagnosing and controlling NTDs.

NTDs perpetuate a cycle of poverty that continues from generation to generation. Eradication of NTDs
is essential in our quest of eradicating poverty.