How neglected tropical diseases reduce the quality of life in Africa

Tuesday March 3 2015

A municipal council worker dispenses insecticide using a fogging machine during a dengue prevention spraying in Kuala Lumpur in February 20114. East Africa has a high burden of the neglected tropical diseases. AFP PHOTO | MOHD RASFAN

A municipal council worker dispenses insecticide using a fogging machine during a dengue prevention spraying in Kuala Lumpur in February 20114. East Africa has a high burden of the neglected tropical diseases. AFP PHOTO | MOHD RASFAN 

By CHRISTABEL LIGAMI, TEA Special Correspondent

One in six people in the world suffers from neglected tropical diseases (NTDs), says a UN report.

Neglected Tropical Diseases (any one of 17 parasitic and bacterial infections including dengue fever, leprosy and sleeping sickness) are seen as precursors to such widely known diseases as malaria and tuberculosis.

In addition to the above, there are rabies, trachoma, buruli ulcer, yaws, Chagas, leishmaniases, taeniasis, Guinea-worm disease, echinococcosis, foodborne trematodiases, lymphatic filariasis, river blindness, schistosomiasis, and soil-transmitted helminthiase.

Of the 1.5 billion people affected by NTDs, the majority live in sub-Saharan Africa.

Kenya, Uganda and Tanzania are among the 10 countries in African with the highest burden of the diseases.

Thirty million of the 168 million people requiring preventive for schistosomiasis in Africa are in the three East African countries.

Dengue fever, the report says, affects about 390 million people every year, and is particularly prevalent on the East African coast of Kenya, Tanzania, Somalia, Eritrea and Djibouti.

“Outbreaks are becoming more frequent in Tanzania where multiple virus serotypes co-circulate and where the disease is probably expanding its geographical reach,” says the report.

According to Rosemary Sang, head of the arbovirology laboratory of the centre for virus research at Kenya Medical Research Institute (Kemri), NTDs are considered “neglected,” because they are treatable, yet the money and resources are not available in many developing nations. Instead, it is up to agencies and networks to get the necessary information and treatment to the people.

“Compared with malaria for example, they receive little funding or attention from national governments and medical and donor communities despite the vast numbers of people affected,” said Dr Sang.

“They disable and trap the poor in a cycle of poverty by undercutting adults’ ability to work productively and take care of their families,” she added.

These diseases thrive where people live in extreme poverty with poor sanitation and little access to healthcare — usually in remote rural areas, urban slums or conflict zones — and disproportionately affect women and children.

“A few of the diseases, including rabies and anthrax, kill relatively quickly, but the majority infect people for several years and are more likely to maim than kill. These include river blindness, sleeping sickness, elephantiasis, Chagas disease, guinea-worm disease and leprosy,” said Dr Sang.  

However, the good news is that there is growing awareness internationally, and an increased focus on eliminating the diseases.

“Effective advocacy must continue, but we also need effective implementation and this means more research embracing mapping and surveillance,” said Dr Sang.

The UN report states that progress has been made in combating certain NTDs in recent years. For example there were only 126 cases of Dracunculiasis, or guinea-worm disease, reported in 2014, compared with nearly 1,800 in 2010 and 3.5 million during the mid 1980s.

“Eradication of this disease is achievable with continued effort and investment,” the report says.

The UN organisation also cites the elimination of river blindness, a parasitic infection that causes itching, bumps under the skin and potential loss of sight.

According to the WHO, there are cheap treatments available for several of the diseases including yaws, roundworm, hookworm and whipworm infections, elephantiasis, river blindness, bilharzia and trachoma; moreover pharmaceutical companies have donated large doses free of charge. But new treatments need to be developed in case drug resistance occurs, health experts say.  

Some diseases still have no specific treatment, including dengue fever which affects millions every year. Others have only expensive treatments that are difficult to manage where early treatment is vital to avoid disability or death.  

The main challenge with producing new drugs, WHO says, is the cost. Pharmaceutical companies spend millions of dollars to find and test a new drug and there is little financial incentive to produce new drugs for people who cannot afford to buy them.

While agencies like the World Bank and the UN are working to fight the spread of these diseases, their efforts are spread thin over a number of areas.

“Increased investments by national governments can alleviate human misery, distribute economic gains more evenly and free people long trapped in poverty,” said WHO director-general Margaret Chan.

To better fight NTDs, the WHO has called on developing countries to invest $1 per person per year to battle the diseases until 2030, which it says would represent as little as 0.1 per cent of current national health spending of the developing countries affected by NTDs.

In 2012, the WHO published a roadmap that set ambitious targets to curb many NTDs. These targets were endorsed by donor governments, leaders of countries where the diseases are endemic, pharmaceutical companies and NGOs in the London Declaration 2012.