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Preventing tropical diseases

Winning the fight against neglected Tropical Diseases The World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) have recently identified a set of diseases as 'targets of opportunity' in the effort to improve global health, while creating more vigorous economies and a better quality of life in some of the world's poorest countries. While now found in the U.S. and other developed countries only in travelers, missionaries, peace corps volunteers and the like, these diseases have burdened humanity since the beginning of recorded history. Mostly unknown and with hard-to- pronounce names, all six of the following diseases are being targeted for control or elimination due to remarkable scientific breakthroughs and unprecedented corporate philanthropy; indeed three of these diseases - trachoma in Morocco, river blindness in the Americas and leprosy worldwide - already represent near successes. 'Targets of Opportunity' o Leprosy o Lymphatic filariasis (elephantiasis) o Onchocerciasis (river blindness) o Schistosomiasis o Soil-transmitted helminths (intestinal parasites) o Trachoma o Generally non-fatal, but base diseases of poverty that cause enormous chronic disability and suffering as well as greater susceptibility to other often fatal diseases o Over 50 million future years of disability-free life lost (or, in comparative terms, over half of the global disease burden from HIV/AIDS) o Endemic in over 100 of the poorest countries in Africa, Asia and Latin America - most often with multiple diseases affecting any given community o Over 3 billion children, women and men at risk o Over 350 million people already disabled or severely impaired, with many more infected o Tremendous costs for medical treatments that drain resource-scarce health systems o Equally high social and economic toll, as physical incapacitation limits school attendance and impairs work productivity, at a cost of over $10 billion annually o Tools exist to diagnose, treat and, in some cases, prevent/eliminate the diseases o Low or no-cost medicines, with four major pharmaceutical companies (GlaxoSmithKline, Merck & Co., Inc., Novartis, and Pfizer) providing unprecedented amounts of donated drugs as well as cash support o Annual or periodic treatment intervals (much like immunizations) that lend themselves to community-based delivery and offer opportunities to combine treatments for greater health impact and cost efficiencies o Costs per treatment that range from a few cents to a few dollars per person o Ongoing research to improve existing tools and enhance cost analysis o Political will and desire in the endemic countries to get rid of the diseases o Public-private partnerships to provide support at local, national and international levels Leprosy, also known as Hansen's disease, is a chronic bacterial disease that affects the skin and nerves of infected individuals. In the past, nerve damage and complications from disease progression led to deformities of the face and limbs. Fortunately, patients now can be cured with a few months of antibiotic treatment. American Leprosy Missions, in conjunction with the International Federation of Anti-Leprosy Associations (ILEP), works toward a world without leprosy by providing medical care for people around the world with leprosy. Lymphatic filariasis (LF) is a mosquito- borne parasitic disease that damages the lymphatic system. It can result in incapacitation or disfiguration from swollen limbs and breasts (lymphedema) and genitals (hydrocele) or swollen limbs with thickened, hard, rough skin (elephantiasis). LF prevents the afflicted from experiencing a normal working and social life, furthering the cycle of poverty. However, treatment of individuals in endemic areas with anti-parasitic drugs annually for at least five years can break. Onchocerciasis, also known as river blindness, is caused by a parasitic worm and is transmitted to humans by bites from black flies. People that fish, bathe or collect water in fast flowing rivers where these flies breed are at risk of infection. The disease causes intense itching, disfiguring skin diseases called leopard or lizard skin, and eye lesions that can result in blindness. A single, annual dose of Mectizan™ has been found to reduce parasite transmission and have a beneficial effect on symptoms and clinical manifestations due to onchocerciasis. It relieves the intense itching from the disease, and it clears microfilariae from the eye, thus halting the progression towards blindness except in very advanced cases. The African Program for Onchocerciasis Control consists of 19 countries working to fight river blindness using community-directed treatment with Mectizan™. The Onchocerciasis Elimination Program for the Americas aims to eliminate morbidity and interrupt transmission of river blindness in six endemic countries in the Americas. Schistosomiasis, also known as Bilharzia, is caused by a blood-borne fluke which uses freshwater snails as an intermediate host. The disease can progress from the first symptom, blood in urine, to anemia and impaired growth and development in children, to the life-threatening conditions of bladder cancer, kidney malfunction or liver and spleen complications. Control can be achieved by treating infected people with praziquantel and providing adequate disposal of feces and urine. The Schistosomiasis Control Initiative (SCI) works to treat those at high risk in Sub-Saharan Africa. Soil transmitted helminths (STH), including roundworm, whipworm and hookworm, are transmitted through contact with feces or unclean water. STH cause anemia, vitamin A deficiency, stunting, malnutrition, and intestinal obstruction. In some areas, 90% of children are infected - impairing their ability to develop and learn. Without treatment, these infections erode th