[e-drug] "Neglected" diseases but unrecognised successes

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E-drug: "Neglected" diseases but unrecognised successes
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"Neglected" diseases but unrecognised successes- challenges and 
opportunities for infectious disease control
David H Molyneux
Published online July 13, 2004
Lymphatic Filariasis Support Centre, Liverpool School of Tropical 
Medicine, Pembroke Place, Liverpool L3 5QA
(Prof DH Molyneux)

[This article was published online by Lancet last week.  It is too 
big to post in full on e-drug but the first section is below. The 
full article can be accessed from the URL.  BS]
http://image.thelancet.com/extras/03art7073web.pdf

[Copied as fair use].

The Millennium Development Goals and a plethora of initiatives have 
focused on the control of HIV/AIDS, tuberculosis, and malaria. 
However, a large group of diseases has been confined to the "other 
diseases" category by health policy makers and politicians. These 
so-called neglected diseases are the viral, bacterial, and parasitic 
infections of the tropics (often vector borne), together with acute 
respiratory infections and diarrhoeal diseases of children.

  Despite the availability of cost-effective, stable, and successful 
control or elimination interventions, large numbers of the world's 
poorest people remain afflicted or are at risk from this group of 
diseases.

The focus of health policy makers on HIV/AIDS, tuberculosis, and 
malaria, as well as emerging or reemerging diseases causes funding 
for neglected diseases to be overlooked, with deleterious effects on 
the social and economic wellbeing of the poorest quintile of 
populations in the least developed and low-to-middle income 
countries.1

Several organisations, partnerships, and initiatives have been 
created to address the big three diseases-UNAIDS, International Aids 
Vaccine Initiative (IAVI), Roll Back Malaria, and Stop TB culminating 
in the establishment of The Global Fund to fight AIDS, Tuberculosis 
and Malaria. The Global Burden of Disease study, the establishment of 
International Development Targets and Millennium Development Goals, 
the development of public private partnerships2 and the 
Macroeconomics and Health Commission, however, have all emphasised 
the relationship between disease, poverty, and development.1 In 
parallel, financing mechanisms have moved towards sector wide 
approaches (SWAPs), with emphasis on country ownership and basket 
funding-ie, funding for broad health sector support rather than for 
individual projects and disease-specific interventions.

  I want to emphasise that long-term successes have been achieved for 
control of a group of disabling, debilitating, "neglected" diseases 
over the past three decades- Chagas' disease (caused by Trypanosoma 
cruzi),3 Guinea worm (Dracunculus medinensis)4 leprosy (Mycobacterium 
leprae),5 lymphatic filariasis (Wuchereria bancrofti and Brugia 
malayi),6 onchocerciasis (Onchocerca volvulus),7 poliomyelitis,8 and 
to a lesser degree the schistosomiases and geohelminths in schoolage 
children (usually 6-14 years). I will also contrast the control 
programmes, biological features, and funding patterns for HIV/AIDS, 
tuberculosis, and malaria, and emergent and reemergent killer 
diseases, with those of the chronic disabling diseases that have in 
the past had programmes for control, elimination, or eradication.
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