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What are Neglected Tropical Diseases (NTDs)

Neglected tropical diseases (NTDs) comprise of 14 parasitic and bacterial infections (http://www.who.int/neglected_diseases/diseases/en/). They are the most common afflictions of humankind. The seven most prevalent (ascariasis, hookworm, trichuriasis, lymphatic filariasis (LF), onchocerciasis, schistosomiasis, and trachoma) affect over one billion individuals, one sixth of the world population. Ninety percent of the disease burden of NTDs is in Africa with the majority of the infected polyparasitised with two or more NTDs. NTDs are widespread, and yet very easy and inexpensive to treat. Children are the most vulnerable.

They are named neglected because these diseases persist exclusively in the poorest and the most marginalized communities, and have been largely eliminated and thus forgotten in wealthier places. The diseases thrive in places with unsafe water, poor sanitation, and limited access to basic health care. Despite the severe pain and life-long disabilities they cause, these diseases are often less visible and given a low priority alongside high mortality diseases.
NTDs blind, debilitate, deform, or maim. Severe impairments occur after years of virtually silent infection. From initial infection the parasites multiply and migrate through the body and mature and accumulate in tissues, internal organs, the eyes or the lymphatic system. Some destroy the skin and subcutaneous tissue. If left undetected and untreated the damage is irreversible.

NTDs cause human misery due to the stigma, deformities, chronic and debilitating pain they cause. NTDs permanently curtail human potential and cause an enormous economic burden for endemic countries. In children they impair growth and cognitive development thus reducing the child’s ability to learn and benefit from attending school. In adults they significantly reduce their economic productivity, thereby anchoring millions of people in poverty.

In the context of poverty, calculations indicate that the control or elimination of these diseases produces an economic rate of return of 15-30%, unlocking the potential for enormous social and economic development, the road out of poverty.

Why are they neglected?

  • They are not highly visible because they do not kill large numbers of people (approx. 500,000 deaths annually). NTDs have to compete with more visible diseases like HIV/AID, tuberculosis, and malaria with higher mortality rates and attract more attention nationally and internationally;
  • They do not cause explosive outbreaks that attract public and media attention;
  • They do not travel internationally so don’t affect wealthy nations;
  • Affect the poorest of the poor so there is no incentive for the development of new diagnostic tools, drugs and vaccines for diseases with a market that cannot pay;
  • They cause enormous misery but do not kill large numbers of people.
  • Endemic countries have limited resources to invest in health and competition for funds is fierce.
  • The stigma associated with debilitating and deforming diseases makes the afflicted reluctant to seek care.

Summary

  • Around half of the world’s population is at risk from these NTDs.
  • NTDs are controllable and potentially can be eliminated using safe and effective drugs, many of which are donated for free or can be purchased for a minimal cost.
  • NTDs are diseases of poverty and maintain people in poverty.
  • A body of scientific evidence indicates that the control of NTDs would greatly reduce the morbidity and mortality of malaria and tuberculosis and reduce the transmission of HIV/AIDS.
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© Schistosomiasis Control Initiative 2008

Department of Infectious Disease Epidemiology
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