World Neglected Tropical Diseases Day

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    Recently, the 74th World Health Assembly has declared 30th January as the World Neglected Tropical Diseases (NTD) Day.

    • It was attended by the officials from the World Health Organization (WHO), the World Bank, the Bill and Melinda Gates Foundation along with representatives from pharmaceutical industries and national governments, at London’s Royal College of Physicians.

    Key Highlights

    • The idea to recognise the day was proposed by the United Arab Emirates (UAE) and was adopted unanimously by the delegates.
    • The first World NTD Day was celebrated informally in 2020.
    • A major milestone in the movement to recognise the global burden of these diseases was the London Declaration on NTDs which was adopted on 30th January 2012.
    • The Assembly highlighted that the NTDs and their intricate interrelationships with poverty and ecological systems continue to cause devastating health, social and economic consequences.

    Significance

    • WHO notes that these diseases are central to human rights as they deal with issues related to poverty, discrimination and stigma as well as the right to health.
    • The recognition of the Day will further motivate everyone to work across sectors to implement the new road map, which aims to free over a billion people from NTDs by 2030.
    • Across health and development, world awareness days offer an annual opportunity to mobilize greater attention, action and investment on priority issues, particularly in the countries and communities most directly affected.
    • The Day brings together civil society advocates, community leaders, global health experts and policymakers working across the diverse NTD landscape, and unifies partners behind the common goal: to Face NTDs and #EndTheNeglect.

    New NTD Roadmap

    • The WHO’s new road map for 2021-2030 was launched on 28th January 2021.
    • It calls for three strategic shifts to end NTDs:
      • From measuring process to measuring impact.
      • From disease-specific planning and programming to collaborative work across sectors.
      • From externally driven agendas reliant to programmes that are country-owned and country-financed.

    Neglected Tropical Diseases

    • These are a diverse group of communicable diseases that are common in tropical and subtropical conditions in 149 countries.
      • These are most common among marginalised communities in the developing regions of Africa, Asia and the Americas.
      • NTDs threaten more than 1.7 billion people living in the poorest and most marginalized communities worldwide.
    • They are caused by a variety of pathogens such as viruses, bacteria, protozoa and parasitic worms.
    • Disease classified as NTD by WHO
      • Buruli ulcer, Chagas disease, Dengue and Chikungunya, Guinea worm disease, Echinococcosis, Foodborne trematodiases. Human African trypanosomiasis, Leishmaniasis, Leprosy, Lymphatic filariasis, Mycetoma, chromoblastomycosis and other deep mycoses, Onchocerciasis, Rabies, Scabies and other ectoparasites, Schistosomiasis, Soil-transmitted helminthiases, Snakebite envenoming, Taeniasis/Cysticercosis, Trachoma and Yaws.
    • These diseases generally receive less funding for research and treatment than diseases like tuberculosis, HIV-AIDS and malaria.
    • They are preventable and treatable.
    • Impacts
      • Several NTDs disproportionately affect children, girls and women and the elderly.
      • Some diseases with cutaneous manifestations (the so-called “skin NTDs”, which include cutaneous leishmaniasis and leprosy) are disfiguring, particularly for women, because they delay health-seeking behaviour, diagnosis and treatment. 
      • These diseases often leave visible scars, which have psychological, social and economic impacts that are amplified for women because of gender-based cultural norms and expectations.
      • Children infected with soil-transmitted helminthiases are nutritionally and physically impaired.
      • These diseases take away their health along with the chances of staying in school, earning a living, or even being accepted by their family or community.
    • Challenges in Elimination
      • For many NTDs, there are no vaccines or simple tests to ensure timely diagnosis and treatment, and treatments can be toxic, ineffective, and costly.
      • Lack of resources is the single most important roadblock that keeps countries from achieving the elimination of targeted diseases.
      • Where health systems are weak, as is often the case in remote and border areas, these diseases remain undiagnosed and untreated.
      • Preventing stigma and discrimination is a remaining challenge, which can lead families to discourage their relatives with disfiguring diseases from attending health services, along with the social displacement of people affected by NTDs.
    • Global Progress So Far
      • The global NTD partnership includes hundreds of organizations that support programme implementation and contribute to working with health ministries and communities.
      • With the right investments and actions, progress to contain NTDs is within reach.
      • Since 2012 alone, 33 countries have eliminated at least one NTD and the number is increasing in the positive direction.
      • The WHO South-East Asia Region has made good progress towards eliminating the targeted diseases from individual countries and decreasing their burden at a regional and global scale.

    Suggestions

    • Sustaining political commitment and providing adequate resources are of utmost importance, along with ensuring uninterrupted drug supplies and wider health service coverage, especially for currently underserved population groups.
    • Inter-country cooperation in terms of exchanging information, learning from each others’ experience and working together in border areas can be extremely useful, however, it does not always take place.
    • Resource mobilization, public–private partnerships and community mobilization are therefore important and must be prioritized.
    • Regular briefing of the media can increase community involvement in elimination programmes, reduce stigma and discrimination and highlight the need for resources with which to eliminate these diseases that have been neglected until now.
    • Effective surveillance and monitoring are urgently needed, together with an evaluation system for tracking progress on a regular basis.
    • Operational research is needed to generate evidence in support of the post-elimination strategy, including the integration of NTD control within primary health services.
    • Strengthening the integration of national disease control programmes within general health systems remains important.
    • Gender issues will require greater attention, particularly where women fear to attend health services because a specific diagnosis can cause them to be rejected by their families and communities.

    NTDs in India

    • India is home to the world’s largest absolute burden of at least 11 of these major NTDs.
    • NTDs are commonly seen to affect people living in poverty and hence, many people in India are afflicted by these diseases every year.
    • The most common NTDs in India: Lymphatic Filariasis, Visceral Leishmaniasis, Rabies, Leptospirosis, Dengue and Soil-Transmitted Helminth Infections (STH).
    • As per WHO data, India ranks number 1 in the number of cases for many major NTDs in the world.
    • However, India has made tremendous progress in controlling many such diseases.
      • Leprosy is no longer a public health concern in the country and mass treatment coverage has also been achieved for Filaria.
      • The Ministry of Health and Family Welfare has highlighted that India has already eliminated several other NTDs, including guinea worm, trachoma, and yaws.

    Elimination Efforts by Indian Government

    • India is implementing both oral administration of miltefosine and indoor residual spraying, has established intersectoral coordination with the National Rural Health Mission and with the housing development sector.
    • The National Rabies Control Programme provides vaccination to stray dogs and free vaccines through Government Hospitals all over the country.
      • It was established as the Integrated National Rabies Control Programme under the ‘One Health Approach’.
    • The National Vector Borne Disease Control Programme (NVBDCP), is a comprehensive programme for the prevention and control of vector-borne diseases.
    • The National Leprosy Eradication Programme was launched with the goal of elimination of leprosy as a public health problem.
    • The National Health Policy was established in 2017, setting an ambition to stimulate innovation to meet the health needs and ensure that new drugs are affordable for those who need them most.
      • However, it does not specifically tackle NTDs.
    • The National Policy on Treatment of Rare Diseases focuses on identifying and researching treatments for rare diseases and infectious NTDs.
    • NTD partners in India, Global Health Strategies (GHS), The Leprosy Mission Trust India (TLMTI) and National Centre for Promotion of Employment for Disabled People (NCPEDP), will adopt an integrated approach and support each other in undertaking several activities to galvanize visibility on the issue.

    India’s Global Contribution

    • India’s contribution to innovation for NTDs goes beyond its borders as millions of people outside the country rely on quality, affordable medicines produced in India to safeguard their health.
      • Over the past 20 years, one third of new drugs and two-thirds of new vaccines registered for NTDs have involved contributions from Indian scientific and industrial actors.
    • With a strong and growing scientific and industrial base, Indian research institutes, pharmaceutical companies, and public sector actors are making critical contributions to research and development (R&D) for drugs and other medical innovations needed to beat NTDs and advance patient-centred approaches to medical care for people in need.

    Source: DTE