Waging war on tropical diseases may be key to U.S. foreign policy

Jan 27 2009

Stating that neglected tropical diseases (NTDs) not only promote poverty but also destabilize communities, former Health and Human Services Secretary Tommy Thompson and Sabin Vaccine Institute President Peter Hotez call upon the public-health and foreign-policy communities to embrace medical diplomacy and NTD control as a means to combat terrorism in an article published January 27 in the open-access journal PLoS Neglected Tropical Diseases.

In "Waging Peace through Neglected Tropical Disease Control: A US Foreign Policy for the Bottom Billion," Thompson and Hotez make a strong case for the new U.S. presidential administration to engage in medical diplomacy as a critical piece of its foreign policy agenda. Defining medical diplomacy as "the winning of hearts and minds of people in the Middle East, Asia, Africa, and elsewhere by exporting medical care, expertise, and personnel to help those who need it most," the authors say that strengthening U.S. efforts to eliminate NTDs would help end the cycle of poverty in areas of conflict and promote peace and economic prosperity.

The authors cite recent scientific analysis of the adverse impact of NTDs on agricultural productivity, education, future wage earnings, and the health of mothers and children in low-income countries, demonstrating the "multiple and intimate connections between pervasive NTDs and conflict." They note that many nations that are considered diplomatic "hot spots" for the United States exhibit high rates of NTDs, with up to 50% of their populations suffering from one or more NTD.

"As the most common afflictions in the world's areas of conflict and strife, and among the most common bases for diminished agricultural productivity, food insecurity, ignorance, and community destabilization, NTDs represent an obvious target for medical diplomacy," says Hotez, President of the Sabin Vaccine Institute, Distinguished Research Professor and Walter G. Ross Professor & Chair of Microbiology, Immunology, and Tropical Medicine at The George Washington University School of Medicine. "NTD control is also highly cost-effective, with treatment of the seven most common NTDs averaging a remarkable 50 cents per person, per year."

"Acts of compassion destroy the rhetoric of terrorists, and the world responds best to America when it provides medical humanitarian relief to the world's war-torn and poorest regions," says former Secretary Thompson, Global Ambassador of the Global Network for Neglected Tropical Diseases. "President [Barack] Obama and Secretary of State [Hillary] Clinton have a unique opportunity to engage in proven effective medical diplomacy strategies aimed at eliminating NTDs and fostering global prosperity and stability."

NTDs are devastating, debilitating, and deadly diseases that affect 1.4 billion people living on less than US$1.25 a day. Control or elimination of several NTDs, including ascariasis, trichuriasis, lymphatic filariasis, trachoma, and onchocerciasis, can be achieved for a fraction of the cost of treatment for HIV/AIDS or tuberculosis. The authors note that, "in practical terms, this means that the entire at-risk populations of war-torn areas and areas of conflict in sub-Saharan Africa could be treated for one year at roughly the cost of one or two F/A-18 Hornet fighter jets."