Neglected tropical diseases 2003–2013: A decade of continued progress
From vision to reality
Ten years ago, the first historic Berlin meeting initiated changes in WHO’s approach to tackling tropical diseases.
The event, on 10 December 2003, convened experts from many sectors to review existing challenges and devise new ways to address the public-health needs of neglected populations – from a human rights, economic and global perspective.
The outcome of the intense discussions that followed until 2005 resulted in a paradigm shift. This strategic change involved moving away from a traditional disease-centred approach to one responding to the specific health needs of marginalized communities.
The Berlin meeting set the scene for WHO to translate the new approach into policy, and to provide effective and comprehensive solutions to some of the health problems of poor populations.
With the creation of WHO’s Department of Control of Neglected Tropical Diseases in 2005, bold measures were taken to develop a strategic framework for tackling these diseases in a coordinated and integrated way.
WHO’s approach to overcoming the 17 neglected tropical diseases that thrive mainly among poor populations and frustrate the achievement of the health-related United Nations Millennium Development Goals relies on five public health strategies:
- preventive chemotherapy – the large-scale delivery of single-dose, quality-assured medicines, either alone or in combination, provided free of charge and at regular intervals to prevent selected diseases;
- innovative and intensified disease management – controlling through case management the diseases that are difficult to diagnose and treat, and which in most cases trigger severe clinical manifestations and complications;
- vector control and pesticide management – the safe and judicious management of public-health pesticides to achieve vector control through integrated vector management;
- safe drinking-water, basic sanitation and hygiene services, and education – the prioritization of improved sanitation combined with the delivery of preventive chemotherapy and health education to sustain reductions in prevalence of many of these diseases;
- zoonotic disease management – the application of veterinary sciences and interventions to protect and improve human health (also referred to as veterinary public health).
Over the years, WHO has accumulated evidence to show that the burden caused by these diseases can be effectively controlled and, in some cases, eliminated or even eradicated.
A meeting of WHO’s global partners on neglected tropical diseases in Geneva in 2007 marked a turning point: it resulted in increased commitment and engagement from Member States of endemic countries and the pharmaceutical industry, and in expanded collaboration among partners.
In October 2010, WHO published its first report on neglected tropical diseases, highlighting their adverse impacts on health and the successes of Member States in overcoming them through collaboration with the private sector and other partners. These initial successes have led to increased donations of essential medicines by industry, enabling countries to scale up interventions.
In January 2012, WHO published a roadmap for implementation detailing its vision for prevention, control, elimination and eradication. Inspired by this roadmap, a community of partners comprising heads of global health organizations, donors, politicians and pharmaceutical industry leaders endorsed the London Declaration on Neglected Tropical Diseases at a meeting in London, United Kingdom.
The roadmap makes clear that prevention and control of neglected tropical diseases form an integral part of universal health coverage, which prioritizes the public-health needs of poor people and delivers interventions through appropriate technology at sustainable cost.
In January 2013, WHO published its second report on neglected tropical diseases, which outlines the unprecedented progress made since 2010 through renewed momentum that has shifted the world closer to eliminating many of these conditions.
In May 2013, the World Health Assembly adopted a comprehensive resolution on all 17 neglected tropical diseases, urging Member States to inter alia:
- ensure country ownership of prevention, control, elimination and eradication programmes;
- expand and implement interventions and advocate for predictable, long-term international financing for activities related to control and capacity strengthening;
- integrate control programmes into primary health-care services and existing programmes;
- ensure optimal programme management and implementation;
- achieve and maintain universal access to interventions and reach the targets of the roadmap.
Of the 17 neglected tropical diseases, two are targeted for eradication (dracunculiasis by 2015 and yaws by 2020) and four for elimination (blinding trachoma, human African trypanosomiasis, leprosy and lymphatic filariasis by 2020).
WHO is currently estimating the costs associated with expansion of implementation activities in order to anticipate the funding that will be needed to achieve the roadmap’s targets.
1Buruli ulcer disease, Chagas disease, taeniasis/cysticercosis, dengue, dracunculiasis (guinea-worm disease), echinococcosis, endemic treponematoses, foodborne trematodiases, human African trypanosomiasis (sleeping sickness), the Leishmaniases, leprosy, lymphatic filariasis, onchocerciasis (river blindness), rabies, schistosomiasis (bilharzia), trachoma and soil-transmitted helminthiases.