Abstract
Dengue is currently listed as a “neglected tropical disease” (NTD). But is dengue still an NTD or not? Classifying dengue as an NTD may carry advantages, but is it justified? This review considers the criteria for the definition of an NTD, the current diverse lists of NTDs by different stakeholders, and the commonalities and differences of dengue with other NTDs. We also review the current research gaps and research activities and the adequacy of funding for dengue research and development (R&D) (2003–2013). NTD definitions have been developed to a higher precision since the early 2000s, with the following main features: NTDs are characterised as a) poverty related, b) endemic to the tropics and subtropics, c) lacking public health attention, d) having poor research funding and shortcomings in R&D, e) usually associated with high morbidity but low mortality, and f) often having no specific treatment available. Dengue meets most of these criteria, but not all. Although dengue predominantly affects resource-limited countries, it does not necessarily only target the poor and marginalised in those countries. Dengue increasingly attracts public health attention, and in some affected countries it is now a high profile disease. Research funding for dengue has increased exponentially in the past two decades, in particular in the area of dengue vaccine development. However, despite advances in dengue research, dengue epidemics are increasing in frequency and magnitude, and dengue is expanding to new areas. Specific treatment and a highly effective vaccine remain elusive. Major research gaps exist in the area of integrated surveillance and vector control. Hence, although dengue differs from many of the NTDs, it still meets important criteria commonly used for NTDs. The current need for increased R&D spending, shared by dengue and other NTDs, is perhaps the key reason why dengue should continue to be considered an NTD.
Highlights
The World Health Organization (WHO) classifies dengue as a neglected tropical disease (NTD)
For the purpose of this presentation, the data collection on the definitions has been limited to the process of defining NTDs as it has evolved over time at WHO and other key agencies
One of the earliest “official” definitions of NTDs emerged from a series of WHO cohosted meetings in 2003 and 2005, the “Berlin meetings” [5,6]
Summary
The World Health Organization (WHO) classifies dengue as a neglected tropical disease (NTD). For this aim we 1) review common definitions of NTDs, 2) review the lists of NTDs as defined by different agencies dealing with NTDs, 3) consider commonalities of NTDs and how dengue perhaps differs, 4) give a landscape analysis of the current research needs, reviewing ongoing areas of research, and 5) describe the changes to the dengue R&D funding over the past decade (2003–2013)—in an attempt to tackle the question, whether dengue is an NTD after all This is even more important in the light of the above-mentioned increased global public health importance of dengue. Because such a designation, or the lack thereof, might have implications for dengue control efforts, considering that other illnesses, such as malaria, have seen increased funding levels when treated in isolation or, as in the case of HIV and AIDS, malaria, and tuberculosis, when treated as the “big three.”. The lack thereof, might have implications for dengue control efforts, considering that other illnesses, such as malaria, have seen increased funding levels when treated in isolation or, as in the case of HIV and AIDS, malaria, and tuberculosis, when treated as the “big three.” This latter part will be dealt with in the discussion
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