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Tackling the Neglected: Attention for Tropical Diseases

Author: Jared Sawyer

        If we are willing to spend $10 on Nyquil for a night’s reprieve from a stuffy nose, then why not spend less than $1 a year to prevent lymphatic filariasis or soil-transmitted helminthiasis? Or, what about schistosomiasis, onchocerciasis, or maybe trachoma? Then again, why waste a dollar on these long-named diseases you have never heard of?

        This is the problem that plagues these neglected tropical diseases. These unfamiliar diseases remain unheard of to us Americans, but are overbearingly common in tropical countries where over a billion people[1] are disabled and disfigured annually due to these neglected diseases.

        Lymphatic filariasis (better known, but still not known well as, elephantiasis) is a parasitic disease that is rarely fatal. Nevertheless, those who develop symptoms are faced with painful and disfiguring swellings in the arms, legs, or genitals.[2] Following the pain and permanent disability comes horrid social stigma tied to the visible physical disfigurations created. A quick, although disturbing, Google image search will demonstrate why these disfigurations are so ostracizing. Yet, while billions get spent on social stigmatizing issues such as acne, little is spent on the debilitating effects of lymphatic filariasis.   

        Soil-transmitted helminthiasis includes roundworms, whipworms, and most famously, hookworms. Around 1.5 billion people or roughly 20% of the world’s population are currently impacted by these worms. However, these infections are not equally distributed around the world, but rather, most of the infections reside in the developing tropical and subtropical world.[3]

        These parasitic worm diseases are also rarely fatal. The more common symptoms include anemia, lack of energy, and stunted growth and cognitive development.[4] These symptoms are specifically devastating for the 267 million preschool-age children and the 568 million school-age children at risk of infection from these worms.[5]

        The scariest part of neglected diseases like lymphatic filariasis or soil-transmitted helminthiasis is how easy they can be solved and even eradicated. Simple strategies such as educating about the importance of peeling and cooking of vegetables, avoiding walking barefoot, and not using night soil (otherwise known as excrement used for fertilizer), can prevent infection.[6] Nonetheless, in the areas where these neglected tropical diseases are prevalent, education may not be useful; these recommendations may be impossible to realistically implement. There are populations without access to water to wash their vegetables, without shoes to wear, or without access to proper fertilizer.

        The good news is that there is an even easier solution available: mass drug administration. Not only does the preventative cure already exist, it costs no more than $0.64 annually per person to treat both lymphatic filariasis and soil-transmitted helminthiasis. [7] For under a dollar, or the cost of about one tenth of a bottle of Nyquil, a successful preventative and curative measure can be taken against these neglected tropical diseases. Even better, the cure, a mixture of albendazole and diethylcarbamazine, comes in pill form, making them easy to mass distribute and administer.

       Hope is not lost.There has been past success in eradicating neglected tropical diseases. For example, Dracunculiasis was a parasitic worm disease that affected around 3.5 million people in the mid-1980s.[8] Due to an effective prevention campaign, only 25 human cases were reported last year.[9] Turns out that when the World Health Organization (WHO) and the United States Centers for Diseases Control and Prevention (CDC) formulate and implement a strategy together, neglected tropical diseases can get eradicated.

        So, what are we waiting for? If we can solve these terrible diseases so easily, why haven’t we? The problem is that most of the people who are impacted are those without voices. The poor from the most destitute areas are the ones who get knocked down and further impoverished by these neglected diseases. In opposition, those with voices push for resources and money to funnel toward the more profitable diseases we regularly hear about. Why spend money abroad when we cannot solve our issues back home?

        Beyond the screaming from my moral and ethical compasses, factually, these neglected tropical diseases are simply not confined to the tropics Approximately 12 million Americans are affected. Over 2.5 million African-Americans are infected with toxocariasis, and around 300,000, mostly Hispanic-Americans, are affected by American Trypanosomiasis.[10]  These primarily low income voiceless communities are being devastated by these diseases without help and without attention. To make matters worse, due to the pervasive lack of attention, the current absence of viable diagnostic tests and sufficient education commonly leads health care providers to either misidentify or fail to recognize the disease.

Neglecting these tropical diseases is no longer a viable strategy due to any notion that it does not affect us. Neglecting them is now synonymous with neglecting the disenfranchised.

Nevertheless, diseases like cancer take the whole stage while diseases both easier and cheaper to solve are ignored. This is not the fault of private industry. What money is there for making cheap cures for those without the money to buy them? Rather, this is a problem of attention. It is increasingly hard to gain momentum for solutions to problems that are unheard of. The first step here is to generate a new wave of easily accessible and persuasive information about these neglected diseases. Only when these neglected tropical diseases reach the limelight can impetus be achieved for solutions. It is time to tackle the neglected.

 

[1] http://www.who.int/neglected_diseases/diseases/en/

[2] http://www.who.int/mediacentre/factsheets/fs102/en/

[3] http://www.who.int/mediacentre/factsheets/fs366/en/

[4] WHO, ibid.

[5] WHO, ibid.

[6] https://www.cdc.gov/parasites/hookworm/prevent.html

[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3205627/

[8] http://www.who.int/mediacentre/factsheets/fs359/en/

[9] WHO, ibid.

[10] http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0003012

 

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