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Neglected Tropical Diseases Hidden and silent : Key problems

Neglected Tropical Diseases Hidden and silent : Key problems. Complacency, lack of information and commitment The poor, with little political voice, suffer most Not perceived as a threat to western society Incapacitating more than killing Low profile in public health priorities

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Neglected Tropical Diseases Hidden and silent : Key problems

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  1. Neglected Tropical DiseasesHidden and silent : Key problems • Complacency, lack of information and commitment • The poor, with little political voice, suffer most • Not perceived as a threat to western society • Incapacitating more than killing • Low profile in public health priorities • Negative image, complicated names and complex strategies

  2. Global distribution: the burden divides the world in two . Approximately 1 billion people are affected by more than one of NTDs

  3. Large scale interventions • Lymphatic filariasis • Leprosy • Onchocerciasis • Schistosomiasis • Helminthiasis • Trachoma • Yaws Rapid Impact Interventions Improving access • Case management and development of new tools • Human African trypanosomiasis • Chagas diseases • Buruli ulcer • Leishmaniasis Focused interventions Improving innovation

  4. The importance of the Right to health for the control of NTDs • Advocacy: Participation of Paul Hunt in two international meetings on NTDs, and several meetings in WHO. Goodwill Ambassador Mr Sasakawa • Help scientific community to focus thinking on strategies adapted to the local reality: Berlin and Bangalore • Assessment at country level...Mission report in Uganda • Specific recommendations to Governments, private sector, NGOs and international community • If integrated into policies, programmes and projects, the right to health helps to ensure that they are evidence-based, robust, sustainable, equitable and meaningful to those living in poverty. • Key role of the civil society, NGOs and people affected by NTDs

  5. The case of Leprosy Leprosy is considered shameful and people hid their symptoms for fear of ostracism despite free and effective multidrug treatment.

  6. Leprosy situation in 2008 • Between 1985 and 2008, more than 15 million cases have been cured with MDT. The number of persons registered for treatment fell from 5.4 million in 1985 to 250 000 in 2008. • Global case detection continues to fall every year • Only 3 countries remain with prevalence rates above 1 per 10,000 population (1985: 122 countries): Brazil, Nepal and Timor Leste)

  7. Registered prevalence by WHO Region in 2007 and 2008, and % change* * Patients registered for treatment, excluding Europe

  8. New case detection by WHO Region in 2006 and 2007, and % change* * excluding Europe

  9. Milestones in MDT treatment • Multidrug therapy (MDT) recommended as a standard treatment for leprosy by WHO in 1982, contains rifampicin, clofazimine and dapsone • 1986: only 5% of registered patients on MDT • 1991: World Health Assembly resolution to eliminate leprosy as a public health problem • 1995: WHO started global supply of high quality MDT free of cost • 1998 onwards : 100% of registered cases on MDT

  10. MDT changes the face of leprosy • Highly effective - cures patients in 6 – 12 months • Single MDT dose renders patient non-infectious • Best way to prevent disabilities through early cure • Treatment is safe with few side effects • No drug resistance following MDT has yet been reported • The numbers of relapses after treatment remains very low, at less than one case per 1,000 patients per year.

  11. But still a long way to go Stigma and discrimination are still present in developed and developing countries An estimated one million persons live with severe disabilities and are highly vulnerable Despite the medical progress and information, a significant number of countries have regulations aiming at isolating, limiting access to work, public transport, international travel, divorce

  12. Key features of a right to health approach to neglected diseases • Community participation • Fighting stigma and discrimination • Research and development • An integrated health system that is responsive to local priorities • Monitoring and accountability: monitor and hold to account national and international actors in the public and private sectors. The guiding question should be: have all duty-bearers done all they reasonably can to promote and protect the right to health of those suffering from, or vulnerable to, neglected diseases?

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