Neglected Tropical Diseases Hidden and silent : Key problems

1
Neglected Tropical Diseases Hidden and silent
Key problems

• Complacency, lack of information and commitment
• The poor, with little political voice, suffer
  most
• Not perceived as a threat to western society
• Incapacitating more than killing
• Low profile in public health priorities
• Negative image, complicated names and complex
  strategies

2
Global distribution the burden divides the world
in two
.
Approximately 1 billion people are affected by
more than one of NTDs
3

• Large scale interventions
• Lymphatic filariasis
• Leprosy
• Onchocerciasis
• Schistosomiasis
• Helminthiasis
• Trachoma
• Yaws

Rapid Impact Interventions Improving access

• Case management and development of new tools
• Human African trypanosomiasis
• Chagas diseases
• Buruli ulcer
• Leishmaniasis

Focused interventions Improving innovation
4
The importance of the Right to health for the
control of NTDs

• Advocacy Participation of Paul Hunt in two
  international meetings on NTDs, and several
  meetings in WHO. Goodwill Ambassador Mr Sasakawa
• Help scientific community to focus thinking on
  strategies adapted to the local reality Berlin
  and Bangalore
• Assessment at country level...Mission report in
  Uganda
• Specific recommendations to Governments, private
  sector, NGOs and international community
• If integrated into policies, programmes and
  projects, the right to health helps to ensure
  that they are evidence-based, robust,
  sustainable, equitable and meaningful to those
  living in poverty.
• Key role of the civil society, NGOs and people
  affected by NTDs

5
The case of Leprosy
Leprosy is considered shameful and people hid
their symptoms for fear of ostracism despite free
and effective multidrug treatment.
6
Leprosy situation in 2008

• Between 1985 and 2008, more than 15 million cases
  have been cured with MDT. The number of persons
  registered for treatment fell from 5.4 million in
  1985 to 250 000 in 2008.
• Global case detection continues to fall every
  year
• Only 3 countries remain with prevalence rates
  above 1 per 10,000 population (1985 122
  countries) Brazil, Nepal and Timor Leste)

7
Registered prevalence by WHO Region in 2007 and
2008, and change
Region Prevalence at beginning of 2007 Prevalence at beginning of 2008 change from 2007 to 2008
Africa 29 548 30 055 1.71
Americas 64 715 49 388 -23.68
East Mediterranean 3 986 4 240 6.37
South East Asia 116 663 120 967 3.69
Western Pacific 9 805 8 152 -16.86
World 224 717 212 802 -5.30
Patients registered for treatment, excluding
Europe
8
New case detection by WHO Region in 2006 and
2007, and change
Region Cases detected during 2006 Cases detected during 2007 change from 2006 to 2007
Africa 34 480 31 037 - 9.99
Americas 47 612 41 978 - 11.83
East Mediterranean 3 261 4 091 25.45
South East Asia 174 118 171 552 - 1.47
Western Pacific 6 190 5 867 - 4.20
World 265 661 254 525 - 4.19
excluding Europe
9
Milestones in MDT treatment

• Multidrug therapy (MDT) recommended as a standard
  treatment for leprosy by WHO in 1982, contains
  rifampicin, clofazimine and dapsone
• 1986 only 5 of registered patients on MDT
• 1991 World Health Assembly resolution to
  eliminate leprosy as a public health problem
• 1995 WHO started global supply of high quality
  MDT free of cost
• 1998 onwards 100 of registered cases on MDT

10
MDT changes the face of leprosy

• Highly effective - cures patients in 6