The publication of the Global Burden of Disease Study 2010 (GBD 2010) and the accompanying collection of Lancet articles in December 2012 provided the most comprehensive attempt to quantify the burden of almost 300 diseases, injuries, and risk factors, including neglected tropical diseases (NTDs). The disability-adjusted life year (DALY), the metric used in the GBD 2010, is a tool which may be used to assess and compare the relative impact of a number of diseases locally and globally. Read the whole article here
Since the founding of PLOS Neglected Tropical Diseases more than six years ago, I have written about the interface between disease and geopolitics. The neglected tropical diseases (NTDs) are the world’s most common infections of people living in poverty. Where they are widespread in affected communities and nations, NTDs can be highly destabilizing and ultimately may promote conflict and affect international and foreign policy. Many of the published papers in this area were recently re-organized in a PLOS “Geopolitics of Neglected Tropical Diseases” collection that was posted on our website in the fall of 2012, coinciding with the start of our sixth anniversary. From this information, a number of new and interesting findings emerged about the populations who are most vulnerable to the NTDs, including the extreme poor who live in the large, middle-income countries and even some wealthy countries (such as the United States) that comprise the Group of Twenty (G20) countries, as well as selected Aboriginal populations. Together, the PLOS “Geopolitics of Neglected Tropical Diseases” collection and the G20 analyses identified more than a dozen areas of the world that repeatedly show up as ones where NTDs disproportionately affect the poorest people living at the margins. Here, I summarize what I view as ten of the worst global “hotspots” where NTDs predominate. They represent regions of the world that will require special emphasis for NTD control and elimination if we still aspire to meet Millennium Development Goals (MDGs) and targets by 2015; they are regions that may need to be highlighted again as we consider post-MDG aspirations and new Sustainable Development Goals (SDGs).
Despite an enormous population and growing economy, the nation of Indonesia has some of the world’s highest concentrations of neglected tropical diseases (NTDs). These NTDs may thwart future national growth and recent gains. Yet, Indonesia and its Ministry of Health, together with the World Health Organization (WHO), have embarked on an ambitious effort to quickly assemble a health and scientific infrastructure suitable for eliminating its NTDs.
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Although Aboriginal people make up a small percentage of the worlds population, they are disproportionately affected by poverty and neglected tropical diseases (NTDs). Unless prioritized, Aboriginal populations may be the last to receive access to essential medicines as part of global NTD elimination efforts. Poverty, especially rural poverty, and its associated poor housing and sanitation, environmental degradation, inadequate or improper nutrition, forced migrations, and lack of access to health care, combine and synergize to create a number of adverse health consequences for Aboriginal populations.
In 2005 India, Nepal, and Bangladesh signed a landmark agreement to eliminate visceral leishmaniasis in South Asia. There is an exciting opportunity for India and China to also engage in international science diplomacy for controlling or eliminating the major neglected tropical diseases in their two countries, and thereby reducing the global NTD burden by up to 40% or more.
My visits to Shanghai and the Chinese National Institute of Parasitic Diseases (IPD) began almost 20 years ago in the winter of 1994. I was eager to work at the IPD – then a component of the Chinese Academy of Preventive Medicine (CAPM) later the Chinese Center for Disease Control and Prevention (CCDC) –- following their publication of an extraordinary parasite epidemiology study of incredible magnitude that may never be repeated. Beginning late in the 1980s and into the early 1990s Chinese parasitologists conducted fecal examinations on almost 1.5 million people across all provinces. The study first published in the English biomedical literature in the Southeast Asian Journal of Tropical Medicine and Public Health found that hundreds of millions of Chinese were infected with soil-transmitted helminths (STHs), including 194 million people with hookworm infection (‘hookworm’). Most of these infections were south of the Yangtze River, cutting across all of the southern provinces from East to West, and I felt the IPD was an ideal institute to begin the co-development of a prototype human hookworm vaccine.