WHO marching toward extraordinary progress against neglected tropical diseases, report reveals

Since 2007, the World Health Organization (WHO) has been reporting outstanding success in dealing with neglected tropical diseases (NTDs) with 1 billion people estimated to have received treatments in 2015.

“WHO has observed record-breaking progress towards bringing ancient scourges like sleeping sickness and elephantiasis to their knees,” said WHO Director-General, Dr Margaret Chan. “Over the past 10 years, millions of people have been rescued from disability and poverty, thanks to one of the most effective global partnerships in modern public health.”

The report, Integrating Neglected Tropical Diseases in Global Health and Development, revealed the role of political support, liberal donations of medicines, and development in living environments in leading to a continued expansion of disease control programs in countries where these diseases are widespread.

A group of partners across the globe met and agreed to deal with NTDs jointly in 2007. Since then, a mix of local and international partners have worked together with health ministries in distributing quality drugs and providing care and long-term management to people in countries where the diseases are most prevalent.

The partners approved of a WHO NTD roadmap in 2012 with a commitment to offer additional support and resources to eradicate ten of the most common NTDs.

The major accomplishments in 2015 include treating 1 billion people for at least 1 neglected tropical disease. Out of this, 114 million were treated for onchocerciasis (river blindness), while 62% required the treatment, providing preventive treatment for lymphatic filariasis (elephantiasis) for 556 million people.

Oman, Morocco, and Mexico has eradicated public health problem of Trachoma, the top infectious cause of blindness in the world. Throughout the world, more than 185,000 patients underwent trichiasis surgery for trachoma and more than 50 million people received antibiotic medicines.

The target to eliminate visceral leishmaniasis was met 100% in the districts of Nepal, 97% of subdistricts in Bangladesh, and 82% in the subdistricts of India.

Compared with 37,000 cases of human African trypanosomiasis (sleeping sickness) reported in 1999, the year 2015 witnessed well under 3,000 cases.

The target for the region of the Americas to eradicate rabies in humans by 2015 was almost met, as only 12 humans were reported to have died due to rabies.

In 2016, only 25 human cases of Guinea-worm disease was reported which made it easy to eradicate the disease.

The report emphasized the need to improve action in other areas.

“Further gains in the fight against neglected tropical diseases will depend on wider progress towards the Sustainable Development Goals,” said Dr Dirk Engels, Director of the Department of Control of Neglected Tropical Diseases.

WHO predicted that 2.4 billion people still need to get basic sanitation facilities such as toilets and latrines. The key is to meet the global target for sanitation and water as more than 650 million people continue to use untreated sources of water for drinking purposes.

The recent outburst of zika virus disease and its related complications have become a global concern, revitalizing efforts to improvise vector control. The World Health Assembly will evaluate the proposals for a new Global Vectorl control response this year in the month of May. To promote veterinary public health there are also bright prospects for prioritizing cross-sectoral collaboration.

The WHO NTD Roadmap, which instituted goals and milestones for the global control, elimination, and eradication of many of these diseases, is celebrating its 5th anniversary on 19 April 2017 and the report. Integrating neglected tropical diseases in global health and development, will be released the same day at the Global Partners’ Meeting on NTDs in Geneva.

Ministers from health departments, representatives from industry, partners, and a host of well-known personalities, including philanthropists, donors, and stakeholders will attend the meeting that will celebrate the 10-year multistakeholder efforts to “Collaborate. Accelerate. Eliminate.”

Further information on neglected tropical diseases

Neglected tropical diseases blind, mutilate, disfigure, and weaken millions of people in poor living conditions.

Previously, the NTDs that were widely spread are now limited to tropical and subtropical regions where water is not safe, and hygiene and sanitation are inadequate. Those living in poor housing conditions, in remote rural areas, urban slums, or conflict zones are at greater threat.

Of the countries and territories reporting the presence of NTDs, more than 70% are from low or lower middle income economies

Below is a short description of NTDs:

• Dengue: mosquito-borne viral infection causing a severe flu-like illness and, sometimes, causing a potentially lethal complication called severe dengue.
• Rabies: viral disease transmitted to humans through infected dog bites. Invariably fatal once symptoms develop.
• Trachoma: caused by infection with the bacterium Chlamydia trachomatis; infection is transmitted through direct contact with eye or nasal discharge. Causes irreversible corneal opacities and blindness.
• Buruli ulcer: chronic debilitating disease caused by mycobacterium ulcerans; debilitating skin infection causing severe destruction of the skin, bone, and soft tissue.
• Yaws: a chronic disfiguring and debilitating childhood infectious disease caused by Treponema Pallidum subspecies pertenue.
• Leprosy: caused by a bacillus, mycobacterium leprae, which affects the skin, the peripheral nerves, mucosa of the upper respiratory tract, and the eyes; curable and, if untreated, can cause progressive and permanent damage to the skin, nerves, limbs, and eyes.
• Chagas disease: the insect vector is a triatomine bug that carries the parasite trypanosoma cruzi, which causes the disease; curable if treatment is initiated soon after infection. In the chronic phase, antiparasitic treatment can also prevent or curb disease progression. Chronically infected people develop cardiac alterations and develop digestive, neurological, or mixed alterations that may require specific treatment.
• Human African trypanosomiasis (sleeping sickness): parasitic infection spread by bites of the tsetse fly. The disease develops rapidly and invades the central nervous system.
• Leishmaniases: transmitted through the bite of infected female phlebotomine sandfly—a tiny, 2–3 mm long insect vector.  In its most severe (visceral) form, it attacks the internal organs. The most prevalent (cutaneous) form causes face ulcers, disfiguring scars, and disability.
• Taeniasis and neurocysticercosis: humans can also develop cysticercosis with tapeworm larvae (cysticerci) in the muscles, skin, eyes, and the central nervous system with possible devastating effects on health. Symptoms include severe headache, blindness, convulsions, and epileptic seizures and can be fatal.
• Dracunculiasis (guinea-worm disease): nematode infection transmitted by drinking water contaminated with parasite-infected water fleas, causing intensely painful edema, blister, and ulcer accompanied by fever, nausea, and vomiting.
• Echinococcosis:  parasitic disease caused by tapeworms of the genus echinococcus. Humans are infected through ingestion of parasite eggs in contaminated food, water, or soil or through direct contact with animal hosts.
• Foodborne trematodiasis: people become infected by eating raw fish, crustaceans, or vegetables that harbor the parasite larvae.
• Lymphatic filariasis: impairs the lymphatic system and can lead to the abnormal enlargement of body parts, causing pain, severe disability, and social stigma.
• Mycetoma:  chronic, progressively destructive morbid inflammatory disease usually of the foot, but any part of the body can be affected. Infection is most probably acquired by traumatic inoculation of certain fungi or ‎bacteria into the subcutaneous tissue.
• Onchocerciasis (river blindness): caused by the parasitic worm onchocerca volvulus and is transmitted to humans through exposure to repeated bites of infected blackflies of the genus Simulium. Symptoms include severe itching, disfiguring skin conditions, and visual impairment, including permanent blindness
• Schistosomiasis: infection is acquired when people come into contact with freshwater infested with the larval forms (cercariae) of parasitic blood flukes, known as schistosomes.
• Soil-transmitted helminthiases:  infections are caused by different species of parasitic worms and transmitted by eggs present in human feces, which contaminate the soil in areas where sanitation is poor.