RESUMEN
The history of the neglected tropical disease movement is seen through the lens of authors who worked during the last 4 decades in different roles and in different settings, from Western-based laboratories to clinical roles in endemic countries and in critical policy roles in the World Health Organization (WHO). The authors seek to identify key players from the introduction of the word 'neglected' by the late Kenneth Warren in his Rockefeller Foundation-supported Great Neglected Diseases of Mankind movement through to the more recent developments after the London Declaration of 2012. The role of the various actors-endemic countries, major pharmaceutical companies, the WHO, non-government development organizations, bilateral donors and academia-are discussed. The critical events and decisions are highlighted that were essential enabling factors in creating a viable and successful movement and with a resultant massive global public health and antipoverty impact. The importance of advocacy is emphasized in creating the momentum to establish a globally recognized public health 'brand' as a target in the United Nations Sustainable Development Goals.
Asunto(s)
Medicina Tropical , Salud Global , Humanos , Londres , Enfermedades Desatendidas , Salud Pública , Organización Mundial de la SaludRESUMEN
Strongyloides stercoralis is a soil-transmitted helminth, but it has a unique life cycle that can be completed in the human host, in a process known as autoinfection. Worldwide, the burden of disease is substantial (300 to 400 million infections). Strongyloidiasis is mainly prevalent in the tropics and subtropics, but there is as yet no global public health strategy for controlling the parasite.
Asunto(s)
Gastroenterología , Strongyloides stercoralis , Estrongiloidiasis , Animales , Humanos , Estrongiloidiasis/diagnóstico , Estrongiloidiasis/tratamiento farmacológicoRESUMEN
Schistosomiasis, one of the 17 neglected tropical diseases listed by the World Health Organization, presents a substantial public health and economic burden. Of the 261 million people requiring preventive chemotherapy for schistosomiasis in 2013, 92% of them lived in sub-Saharan Africa and only 12.7% received preventive chemotherapy. Moreover, in 2010, the WHO reported that schistosomiasis mortality could be as high as 280 000 per year in Africa alone.In May 2012 delegates to the sixty-fifth World Health Assembly adopted resolution WHA65.21 that called for the elimination of schistosomiasis, and foresees the regular treatment of at least 75% of school age children in at-risk areas. The resolution urged member states to intensify schistosomiasis control programmes and to initiate elimination campaigns where possible.Despite this, in June 2015, schistosomiasis was indicated to have the lowest level of preventive chemotherapy implementation in the spectrum of neglected tropical diseases. It was also highlighted as the disease most lacking in progress. This is perhaps unsurprising, given that it was also the only NTD with access to drug donations but without a coalition of stakeholders that collaborates to boost commitment and implementation.As a consequence, and to ensure that the WHO NTDs Roadmap Targets of 2012 and World Health Assembly Resolution WHA65.21 are met, the Global Schistosomiasis Alliance (GSA) has been set up. Diverse and representative, the GSA aims to be a partnership of endemic countries, academic and research institutions, international development agencies and foundations, international organizations, non-governmental development organizations, private sector companies and advocacy and resource mobilisation partners. Ultimately, the GSA calls for a partnership to work for the benefit of endemic countries by addressing health inequity and rural poverty.
Asunto(s)
Disparidades en Atención de Salud/estadística & datos numéricos , Pobreza/estadística & datos numéricos , Esquistosomiasis/epidemiología , Esquistosomiasis/prevención & control , África del Sur del Sahara/epidemiología , Erradicación de la Enfermedad/organización & administración , Enfermedades Endémicas , Salud Global , Humanos , Prevalencia , Salud Pública/métodos , Población Rural , Esquistosomiasis/economía , Esquistosomiasis/mortalidad , Factores Socioeconómicos , Clima Tropical , Organización Mundial de la SaludRESUMEN
The concept of neglected tropical diseases (NTDs) emerged more than a decade ago and has been recognised as a valid way to categorise diseases that affect the poorest individuals. Substantial progress in control and elimination has been achieved and policy momentum has been generated through continued bilateral, philanthropic, and non-governmental development organisation (NGDO) support, and donations of drugs from pharmaceutical companies. WHO has defined a Roadmap to reach 2020 targets, which was endorsed by member states in a World Health Assembly Resolution in 2013. NTDs have been included within the Sustainable Development Goal targets and are a crucial component of universal health coverage, conceptualised as "leaving no one behind". WHO reported that more than 1 billion people in 88 countries have benefited from preventive chemotherapy in 2014. The research agenda has defined the need for affordable products (diagnostics, drugs and insecticides). However challenges such as insecurity and weak health systems continue to prevail in the poorest countries, inhibiting progress in scaling up and also in achieving Roadmap goals.
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Cooperación Internacional , Enfermedades Desatendidas/prevención & control , Pandemias/prevención & control , Medicina Tropical , Enfermedad Crónica , Humanos , Enfermedades Desatendidas/epidemiología , Práctica de Salud Pública , InvestigaciónAsunto(s)
Liderazgo , Enfermedades Desatendidas/prevención & control , Organización Mundial de la Salud , Erradicación de la Enfermedad , Dracunculiasis/prevención & control , Infecciones por Uncinaria/prevención & control , Humanos , Cooperación Internacional , Esquistosomiasis Urinaria/prevención & control , Medicina TropicalRESUMEN
In 2001, the World Health Assembly (WHA) passed the landmark WHA 54.19 resolution for global scale-up of mass administration of anthelmintic drugs for morbidity control of schistosomiasis and soil-transmitted helminthiasis, which affect more than 1·5 billion of the world's poorest people. Since then, more than a decade of research and experience has yielded crucial knowledge on the control and elimination of these helminthiases. However, the global strategy has remained largely unchanged since the original 2001 WHA resolution and associated WHO guidelines on preventive chemotherapy. In this Personal View, we highlight recent advances that, taken together, support a call to revise the global strategy and guidelines for preventive chemotherapy and complementary interventions against schistosomiasis and soil-transmitted helminthiasis. These advances include the development of guidance that is specific to goals of morbidity control and elimination of transmission. We quantify the result of forgoing this opportunity by computing the yearly disease burden, mortality, and lost economic productivity associated with maintaining the status quo. Without change, we estimate that the population of sub-Saharan Africa will probably lose 2·3 million disability-adjusted life-years and US$3·5 billion of economic productivity every year, which is comparable to recent acute epidemics, including the 2014 Ebola and 2015 Zika epidemics. We propose that the time is now to strengthen the global strategy to address the substantial disease burden of schistosomiasis and soil-transmitted helminthiasis.
Asunto(s)
Antihelmínticos/uso terapéutico , Salud Global/economía , Guías como Asunto , Helmintiasis/tratamiento farmacológico , Esquistosomiasis/epidemiología , África del Sur del Sahara/epidemiología , Salud Global/normas , Helmintiasis/prevención & control , Helmintiasis/transmisión , Humanos , Morbilidad , Años de Vida Ajustados por Calidad de Vida , Esquistosomiasis/tratamiento farmacológico , Esquistosomiasis/economía , Esquistosomiasis/prevención & control , SueloAsunto(s)
Antihelmínticos/uso terapéutico , Accesibilidad a los Servicios de Salud , Internacionalidad , Estrongiloidiasis/diagnóstico , Estrongiloidiasis/prevención & control , Adulto , Comunicación , Femenino , Humanos , Ivermectina/uso terapéutico , Masculino , Factores de Riesgo , Estrongiloidiasis/tratamiento farmacológicoAsunto(s)
Antihelmínticos/uso terapéutico , Sesgo , Control de Enfermedades Transmisibles/métodos , Toma de Decisiones , Métodos Epidemiológicos , Helmintiasis/tratamiento farmacológico , Helmintiasis/epidemiología , Parasitosis Intestinales/tratamiento farmacológico , Parasitosis Intestinales/epidemiología , Animales , Conducta Cooperativa , Helmintiasis/prevención & control , Humanos , Parasitosis Intestinales/prevención & controlAsunto(s)
Dengue/prevención & control , Brotes de Enfermedades/estadística & datos numéricos , Vectores de Enfermedades , Salud Global , Resistencia a los Insecticidas/efectos de los fármacos , Enfermedades Desatendidas/parasitología , Animales , Culicidae/parasitología , Dengue/epidemiología , Dengue/transmisión , Brotes de Enfermedades/prevención & control , Humanos , Insectos Vectores , Región Mediterránea/epidemiologíaAsunto(s)
Enfermedades Transmisibles , Enfermedades Desatendidas , Medicina Tropical , Humanos , IndonesiaRESUMEN
BACKGROUND: A mathematical model based on the Markov methodology to predict the change in prevalence of soil-transmitted helminth (STH) infections during public health control activities is not available, but would be an extremely efficient planning tool. METHOD: We used the parasitological data collected during a deworming and iron supplementation programme for women of child-bearing age conducted in Vietnam between 2006 and 2011 to develop a Markov transition probability model. The transition probabilities were calculated from the observed changes in prevalence in the different classes of intensity for each STH species during the first year of intervention. The model was then developed and used to estimate the prevalence in year 2, 3, 4 and 5 for each STH species and for 'any STH infection'. The prevalence predicted by the model was then compared with the prevalence observed at different times during programme implementation. RESULTS: The comparison between the model-predicted prevalence and the observed prevalence proved a good fit of the model. CONCLUSIONS: We consider the Markov transition probability model to be a promising method of predicting changes in STH prevalence during control efforts. Further research to validate the model with observed data in different geographical and epidemiological settings is suggested to refine the prediction model.
Asunto(s)
Helmintiasis/epidemiología , Helmintos/parasitología , Suelo/parasitología , Adolescente , Adulto , Animales , Femenino , Predicción , Helmintiasis/parasitología , Helmintiasis/transmisión , Humanos , Estudios Longitudinales , Cadenas de Markov , Persona de Mediana Edad , Prevalencia , Microbiología del Suelo , Vietnam , Adulto JovenRESUMEN
Huge increases in funding for international health over the past two decades have led to a proliferation of donors, partnerships, and health organisations. Over the same period, the global burden of non-communicable diseases has increased absolutely and relative to communicable diseases. In this changing landscape, national programmes for the control of HIV/AIDS, tuberculosis, malaria, and neglected tropical diseases must be reinforced and adapted for three reasons: the global burden of these communicable diseases remains enormous, disease control programmes have an integral and supporting role in developing health systems, and the health benefits of these control programmes go beyond the containment of specific infections. WHO's traditional role in promoting communicable disease control programmes must also adapt to new circumstances. Among a multiplicity of actors, WHO's task is to enhance its normative role as convenor, coordinator, monitor, and standard-setter, fostering greater coherence in global health.