Neglected diseases

Combating tropical diseases: What is still missing

LONDON, 30 January 2012 –  The Gates Foundation-hosted conference held in London today, ‘Uniting To Combat Tropical Diseases’, draws attention to devastating tropical illnesses that have been neglected for too long. However, the ambitious goals to eliminate or control ten neglected tropical diseases will only be credible when some critical remaining gaps are filled, according to the international medical humanitarian organisation Médecins Sans Frontières (MSF).

“Though we are delighted that the World Health Organisation, donors and development agencies are finally drawing attention to neglected tropical diseases (NTDs), we are concerned that challenges for some of these diseases are being glossed over,” said Daniel Berman, Deputy Director of MSF’s Access Campaign. “Expanded drug donations from the pharmaceutical industry will be part of the solution, but it is not possible to eliminate and control diseases such as Chagas, kala azar or sleeping sickness without increased support for programmes to identify and treat patients and increased investment for new and better diagnostic tests and medicines.” 

For diseases like these to be sustainably eliminated, new diagnostics and treatments must be developed that can be used by healthcare workers with basic training in remote areas. For example, staging sleeping sickness still requires a painful lumbar puncture and there is not yet an oral treatment. Injections and intravenous drips are required, which are unsuited to basic clinics in rural areas and also difficult and painful for patients.

Not only the drugs but also the healthcare programmes themselves suffer from chronic under-funding. If DFID, USAID, WHO and other external actors are going to champion elimination of these diseases, they will need to address the critical need to scale up programmes and invest in strengthening surveillance systems. At present there are still ‘blind spots’, areas where NTDs like sleeping sickness are likely to be prevalent but insecurity and lack of funding mean people go undiagnosed and untreated.

“All the talk about ambitious goals and elimination will not make a difference unless we put our full support behind national control programmes and national health systems in countries where the disease is endemic,” says Dr Andreas Lindner, a member of MSF’s inter-regional mobile sleeping sickness team, working to combat this neglected disease in countries like Chad and Central African Republic. “We have to realise that, ultimately, it is the national control programmes – and not MSF, or any other organisation – that will get this disease under control, and they need all the support and cooperation they can get.”

By putting so much emphasis on drug donations, MSF is concerned that strategies for eliminating these diseases are at risk of being influenced by what products companies are offering. The commitments outlined by Gilead, Novartis and other companies reflect the policies of the companies, but do not necessarily reflect public health priorities.