No time for neglect

A race to kill nasty tropical diseases

International

If the world does not significantly step up its efforts in 2017, it will miss deadlines for stamping out some of the planet’s nastiest diseases. In 2012 the World Health Organisation (WHO), drug companies and myriad donors and NGOs promised to control, eliminate or eradicate ten “neglected tropical diseases” by 2020. These conditions, which include bilharzia, river blindness and Guinea worm, may not kill but they disable, stunt and stigmatise.

A number of countries have succeeded in eliminating trachoma (an infection that causes blindness), lymphatic filariasis (also known as elephantiasis because of the swollen limbs the parasite causes) and onchocerciasis (river blindness). More such successes are expected in the year ahead: Laos, Vietnam and Ghana for trachoma elimination, for example, as well as Togo, Tonga and Egypt for lymphatic filariasis. Cases of human African trypanosomiasis (sleeping sickness) are at an all-time low. Nepal, Bangladesh and India are on track to eliminate visceral leishmaniasis, which affects the spleen, liver and bone marrow.

But the eradication of Guinea worm has suffered a setback, with an outbreak of infections in dogs in Chad in 2015-16. There aren’t enough drugs to scale up the programme to combat schistosomiasis (bilharzia). Money is all too often in short supply, as is political will. Security worries are hampering progress in a number of areas, such as Yemen, Ethiopia and South Sudan.

Previous disease-eradication efforts show that the last mile is always the hardest. A lot is at stake. These neglected tropical diseases disproportionately affect the poor; they cause lifelong suffering and cost billions in lost productivity. Their control and elimination would be a huge public-health achievement, and a victory in the fight against poverty.

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