17 January 2013

Africa: Preventing Tropical Diseases Good Bargain in Development

Washington — Investments in the control and elimination of debilitating illnesses known as neglected tropical diseases are one of the best bargains in health care and development, the Washington-based Hudson Institute reports.

The best approach to combating infectious tropical diseases is through mass dispensation of a combination of four inexpensive medications and by providing access to clean drinking water and sanitation, Hudson says in Social and Economic Review on Neglected Tropical Diseases, produced in partnership with the Sabin Vaccine Institute's Global Network for Neglected Tropical Diseases. The solution includes removing bodies of stagnant water and piles of refuse where disease-carrying rodents and insects breed, it states.

The report summarizes input from academics, health care professionals and corporate representatives and concentrates on seven of the most prevalent tropical parasitic and bacterial diseases called Neglected Tropical Diseases (NTDs) -- Chagas' disease; river blindness; trachoma; guinea-worm disease; and soil transmitted hookworm, roundworm and whipworm. It recommends integrating NTDs into global development and health agendas, with increased funding.

The report notes that controlling the diseases also contributes to the Millennium Development Goal (MDG) of combating HIV/AIDS and other diseases. In 2000, 189 nations agreed to the eight MDGs that target freeing people from extreme poverty by 2015.

According to the report, NTDs infect 1.4 billion people worldwide, most of whom live in poverty. A half-billion of the infected are children.

The diseases cause malnutrition and anemia, pregnancy complications, blindness, disfigurement and -- among children -- delays in physical and cognitive growth. While not causing immediate death, the illnesses lead to disability and decreased birth weight, school attendance, worker productivity, agricultural outputs and quality of life, the report states. They "take away any chance that families have of lifting themselves out of poverty," the Global Network says in an online video.

Despite their prevalence, the diseases are often categorized as "other diseases" in the global development agenda and do not attract the same amount of attention as the better-known diseases of HIV/AIDS, malaria and tuberculosis, the report says.

The report notes the importance of public-private partnerships among drug companies, multilateral funding agencies and affected communities. It calls for more efforts to make companies that are potential donors aware of the existence of the diseases and of the need for things like vehicles to deliver the drugs and storage facilities to hold them until they can be distributed, said Ellen Agler, president of END Fund, which is dedicated to neglected tropical diseases.

The report praises the U.S. Agency for International Development's integrated approach with host-country governments to combat NTDs. The approach has been effective in significantly reducing the cost of treatment per person by using mass distribution of drugs that have been mainly donated by pharmaceutical firms. USAID started its NTD program in 2006.

Hudson found that in recent years 28 countries have reported controlling or eliminating at least one NTD with single doses of medicine given one to three times a year and costing on average 50 cents a dose.

Not living with any NTD means that children can learn more in school and parents can work more hours. They therefore earn more wages and pay more taxes, which benefits governments, Harvard professor Michael Kremer said in a January 17 discussion of the report at Hudson.

"Given the disproportionate impact of NTDs on the poorest of the poor, sustainability efforts in developing countries will falter unless NTDs are fought with integrated MDA [mass drug administration] programs through long-term, public-private partnerships," the report states.

The Hudson Institute report is available on the organization's website.

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