Professor David Molyneux in his presidential address to the Royal Society of Tropical Medicine and Hygiene challenges international health policymakers to radically reassess global health priorities to focus on neglected tropical diseases. Published today online in Transactions of the Royal Society of Tropical Medicine and Hygiene, Professor Molyneux’s address called for the world to target leprosy, elephantiasis, trachoma, river blindness, worm diseases and bilharzia (schistosomiasis), where treatments and cures are already available for minimal cost.
There is a vast discrepancy between the significant funds the world allocates to combat the “big three” infectious diseases – AIDS, tuberculosis, and malaria – and other tropical diseases, which can often be treated or prevented for often as low as 25 pence per person per year. The availability of excellent free or very cheap drugs, the proven success of the interventions, and the willingness of both countries and external donors to contribute make these diseases the low hanging fruit of disease control.
“If aliens came down to Earth, they would likely think that AIDS, TB, and malaria are the only diseases that affected the world’s poor,” said Professor Molyneux, a Professor at the Liverpool School of Tropical Medicine and President of the Royal Society of Tropical Medicine and Hygiene. “The interventions being promoted must address the fundamental public health problems that the world’s poor are facing.”
Currently, at least 1 billion people are not accessing quality health products which could make a real improvement to their well-being, productivity, nutrition, and educational performance. Meanwhile, the incidence of HIV, TB and malaria is not declining, despite infusions of significant sums, and there is unlikely to be a decline in incidence in the foreseeable future as research has yet to produce the new tools required to effectively address transmission.
In adopting the Millennium Development Goals, international policymakers committed to combating HIV/AIDS, malaria, and 'other diseases'. However, in practice, much of the international community’s efforts have been directed toward high tech end research that cannot be delivered by 2015. In contrast, by re-adjusting health goals to focus on implementing tools that are already available, public health programmes can have significant impact immediately.
The “low hanging fruit” approach has been achieved in many different settings. Specifically, targeted programmes have achieved success by eliminating lymphatic filariasis in many countries including China, Sri Lanka, Thailand and Egypt; river blindness in 10 West African countries and removing leprosy as a public health problem in 93 of 100 affected countries. With more resources, as well as continued contributions by international health agencies and the pharmaceutical industry, the world can build upon these successful programmes and achieve lasting impact in improving health in the developing world. The burden of the neglected diseases is at least equivalent of malaria and TB and they affect the poorest billion. Professor Molyneux believes that if the international health community cannot address the problems of the billion poorest at such a very low cost with proven interventions the chances of us making an impact on the more complex problems is extremely limited.
Journal
Transactions of the Royal Society of Tropical Medicine and Hygiene