Neglected tropical diseases, neglecting neglect

Neglected tropical diseases (NTDs) are a group of approximately 20 diseases that cause serious illness for over 1.7 billion people living in the world’s poorest and most marginalized communities.

NTDs impair physical and cognitive development, contribute to maternal and child morbidity and death, and limit productivity. (CDC – Neglected Tropical Diseases-, 2021).

These diseases not only cause blindness or disability, but also deformities in people, depriving them of their health, opportunities to stay in school and to work. In the worst case, those affected can lose their lives. Some examples of NTD include dracunculiasis (guinea worm disease), lymphatic filariasis (elephantiasis), onchocerciasis (river blindness), schistosomiasis (bilharzia), soil-transmitted helminths (STH) (ie. (i.e. Ascaris, hookworm and whipworm), and Trachoma (granular conjunctivitis). According to research, trachoma is the leading infectious cause of blindness worldwide. NTDs tend to thrive in resource-poor regions of the world, where water quality, sanitation and access to health care are poor.

Have you ever wondered why they are called “overlooked”? your hypothesis is not far from being valid. This is simply because they mainly afflict the poor of the world and since time immemorial have not received as much attention as other diseases. For example, they are not seen as a priority market for pharmaceutical manufacturers or as a health risk for developed countries. Again, the majority of people infected with so-called NTDs are poor and marginalized populations, with low visibility and little political voice. These populations suffer in silence with no one to defend them.

Their socio-economic impact leaves a lot to be desired. NTDs, like all other long-term illnesses, have a devastating effect on the individual, the family, the community and the nation as a whole. They result in a vicious double cycle MTN-Poverty and Poverty-MTN. It just means that NTDs can lead to poverty and vice versa.

The poor farmer who earns his living mainly from agriculture may be deprived of this livelihood after contracting NTD. Family members spend productive hours caring for bedridden patients with disregard for their activities of daily living (ADLs). And that can throw the family into abject poverty. In addition, the costs of treatment, mainly in the long term, can inflict further economic hardship on populations already struggling to live on less than $ 1 per day.

The greatest danger of NTDs is their effect on achieving the much anticipated Universal Health Coverage (UHC). For UHC to be successful, coverage and prevention of NTDs is inevitable. Achieving UHC is colossally dependent on mitigation of NTDs. Better yet, NTDs are the main drivers and determinants of achieving UHC. Again, it is incongruous to talk about achieving the Sustainable Development Goals (SDGs) by 2030 without plans to tackle NTDs. A quick glance at the 17 SDGs shows the inclusion of factors such as health and well-being, poverty, personal and environmental hygiene which are the fuel for the spread and development of NTDs.

Nevertheless, NTDs are largely preventable. The majority of them can be avoided even without any vaccine. Routine personal and environmental hygiene practices such as; the use of clean water, the hygienic handling of food, as well as the proper management and disposal of waste can prevent water-borne and water-borne diseases such as trachoma, guinea worm disease, schistosomiasis and helminthiasis transmitted by the soil.

Mass spraying of insecticide into vector breeding areas is also useful in eliminating vector-borne NTDs, especially those spread by worms, flies and mosquitoes. For example, eliminating areas of standing water, where mosquitoes like to breed, will decrease the risk of mosquito-borne diseases, or sleeping under an insecticide-treated mosquito net will reduce the possibility of fly-borne diseases.

Educating populations at risk and making them aware of the threat is also an important step in preventing NTDs. Travelers to places where insect-borne NTDs are prevalent should wear protective clothing, use insect repellant, and sleep under a treated mosquito net.

It is important to note that social interventions targeting poor and marginalized people could break the poverty-NTD and NTD-poverty chain. Providing adequate potable water for domestic consumption by people in rural and remote areas is another step in the right direction.