NTDs V.2.0: “Blue Marble Health”—Neglected Tropical Disease Control and Elimination in a Shifting Health Policy Landscape

Peter J Hotez,Stefanie Knopp

doi:10.1371/journal.pntd.0002570

Abstract

The concept of the neglected tropical diseases (NTDs) was established in the aftermath of the Millennium Development Goals. Here, we summarize the emergence of several new post-2010 global health documents and policies, and how they may alter the way we frame the world's major NTDs since they were first highlighted. These documents include a new Global Burden of Disease 2010 Study that identifies visceral leishmaniasis and food-borne trematode infections as priority diseases beyond the seven NTDs originally targeted by preventive chemotherapy, a London Declaration for access to essential medicines, and a 2013 World Health Assembly resolution on NTDs. Additional information highlights an emerging dengue fever pandemic. New United Nations resolutions on women and the non-communicable diseases (NCDs) have not yet embraced NTDs, which may actually be the most common afflictions of girls and women and represent a stealth cause of NCDs. NTDs also have important direct and collateral effects on HIV/AIDS and malaria, and there is now a robust evidence base and rationale for incorporating NTDs into the Global Fund to Fight AIDS, Tuberculosis, and Malaria. “Blue marble health” is an added concept that recognizes a paradoxical NTD disease burden among the poor living in G20 (Group of Twenty) and other wealthy countries, requiring these nations to take greater ownership for both disease control and research and development. As we advance past the year 2015, it will be essential to incorporate global NTD elimination into newly proposed Sustainable Development Goals.

Highlights

The conceptual framework of the neglected tropical diseases (NTDs) began to take shape in the first few years following the 2000 Millennium Development Goals (MDGs), which called for efforts to combat ‘‘other diseases’’ alongside HIV/AIDS and malaria (MDG 6)
It was recognized that a group of 13 or more parasitic and tropical infections have a number of common features including their chronicity and ability to cause long-term disabilities, especially among the extreme poor living in low- and middle-income countries [1,2,3,4,5]. Their public health importance was determined to be roughly equivalent to HIV/AIDS and malaria [3]
Critical to this framework was the concept of integrating control of at least seven of these NTDs—three soiltransmitted helminth infections, schistosomiasis, lymphatic filariasis (LF), onchocerciasis, and trachoma—through a low-cost ‘‘rapid impact package’’ of essential medicines mostly donated by the multinational pharmaceutical companies [1,2,3,4,5]

Summary

Introduction

The conceptual framework of the neglected tropical diseases (NTDs) began to take shape in the first few years following the 2000 Millennium Development Goals (MDGs), which called for efforts to combat ‘‘other diseases’’ alongside HIV/AIDS and malaria (MDG 6). It was recognized that a group of 13 or more parasitic and tropical infections have a number of common features including their chronicity and ability to cause long-term disabilities, especially among the extreme poor living in low- and middle-income countries [1,2,3,4,5]. Their public health importance (measured in disability-adjusted life years [DALYs]) was determined to be roughly equivalent to HIV/AIDS and malaria [3].

Indigenous None None

Hidden Links to the NonCommunicable Diseases

Total cases globally