Prevention, control, and elimination of neglected diseases in the Americas: pathways to integrated, inter-programmatic, inter-sectoral action for health and development.

John C Holveck,Mirta Roses Periago,Maria Teresa Cerqueira,John P Ehrenberg,Steven K Ault,Javier Vasquez,Rocio Rojas,Josefa Ippolito-Shepherd,Miguel A Genovese

doi:10.1186/1471-2458-7-6

Abstract

BackgroundIn the Latin America and Caribbean region over 210 million people live below the poverty line. These impoverished and marginalized populations are heavily burdened with neglected communicable diseases. These diseases continue to enact a toll, not only on families and communities, but on the economically constrained countries themselves.DiscussionAs national public health priorities, neglected communicable diseases typically maintain a low profile and are often left out when public health agendas are formulated. While many of the neglected diseases do not directly cause high rates of mortality, they contribute to an enormous rate of morbidity and a drastic reduction in income for the most poverty-stricken families and communities. The persistence of this "vicious cycle" between poverty and poor health demonstrates the importance of linking the activities of the health sector with those of other sectors such as education, housing, water and sanitation, labor, public works, transportation, agriculture, industry, and economic development.SummaryThe purpose of this paper is three fold. First, it focuses on a need for integrated "pro-poor" approaches and policies to be developed in order to more adequately address the multi-faceted nature of neglected diseases. This represents a move away from traditional disease-centered approaches to a holistic approach that looks at the overarching causes and mechanisms that influence the health and well being of communities. The second objective of the paper outlines the need for a specific strategy for addressing these diseases and offers several programmatic entry points in the context of broad public health measures involving multiple sectors. Finally, the paper presents several current Pan American Health Organization and other institutional initiatives that already document the importance of integrated, inter-programmatic, and inter-sectoral approaches. They provide the framework for a renewed effort toward the efficient use of resources and the development of a comprehensive integrated solution to neglected communicable diseases found in the context of poverty, and tailored to the needs of local communities.

Highlights

In the Latin America and Caribbean region over 210 million people live below the poverty line
The HIPA Program notes, "There is an urgent need for identifying innovative, and at the same time respectful and practical forms [of interaction] to work with the indigenous representatives and to show concrete results whose evidence can be reflected in the reduction of the disease and death in the indigenous communities
The persistence of the "vicious circle" between poverty and poor health demonstrates the importance of linking the activities of the health sector with those of other sectors such as education, housing, water and sanitation, labor, public works, transportation, agriculture, environment, and industry and using human rights norms and guidelines

Summary

Introduction

In the Latin America and Caribbean region over 210 million people live below the poverty line. These impoverished and marginalized populations are heavily burdened with neglected communicable diseases. These diseases continue to enact a toll, on families and communities, but on the economically constrained countries themselves. "Poverty goes beyond a lack of income It is multi-dimensional, encompassing economic, social, and governance perspectives. Markets and jobs are often difficult to access, because of low capabilities and geographical and social exclusion Limited education affects their ability to get jobs and to access information that could improve the quality of their lives. Due to inadequate nutrition and health services, further limits their prospects for work and from realizing their mental and physical potential [9]

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