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The Neglected Tropical Diseases: a Challenge We Could Rise to – Will We?

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The Neglected Tropical Diseases: a Challenge We Could Rise to – Will We? The Neglected Tropical Diseases: A challenge we could rise to – will we? Report for the All-Party Parliamentary Group on Malaria and Neglected Tropical Diseases (APPMG) Using presentations made to the APPMG 2008/9 Chairman: Stephen O’Brien MP Vice-Chairmen: Dr Evan Harris MP, Lord Rea, David Drew MP Treasurer: Ashok Kumar MP Secretary: Eleanor Laing MP Coordinator: Susan Dykes Website: www.appmg-malaria.org.uk Contents Chairman’s Foreword House Of Commons Chairman’s Foreword iii The All-Party Parliamentary Group on Malaria and Neglected Tropical Diseases Acknowledgments v 1 Introduction: The Neglected Tropical Diseases 1 I am pleased to introduce and endorse the latest in our describing the suffering caused, and quantifying the 2 Group One – controlled by Mass Drug Administration 2 2 series of authoritative and influential reports: the All- burden of disease, which remarkably has been shown 3 Group Two – Case finding and treatment 3 7 Party Parliamentary Group on Malaria and Neglected to be as high as Malaria and TB in terms of “Disability 4 Group Three – Animal Zoonotic Diseases 4 9 Tropical Diseases (APPMG’s) Fifth Report entitled: Life Years” lost. They have described the complex 5 Lessons learnt from the Speakers 10 The Neglected Tropical Diseases: life cycles of the parasites which infect humans and sometimes their animals. They have stressed how 6 Conclusions and Recommendations of the APPMG 11 A challenge we could rise to – will we? these diseases affect the poorest of the poor who For the first time since the APPMG was established, cannot afford treatment, and they have described Annex 1 Summary of presentations 12 we focus our report outside the Malaria field. how the pharmaceutical industry have come to the During the last two years our meetings have been aid of these vulnerable populations by providing attended by more and more biomedical scientists, Bibliography 15 drugs free of charge. There is still a funding gap and particularly parasitologists, interested in the wider money is needed for new drug development for tropical health spectrum beyond Malaria. In particular some diseases. For other diseases funds are required Figures presentations by Sir Roy Anderson, Professor David for advocacy, for training, for drug distribution Molyneux, Dr. Lorenzo Savioli and Professor Alan Figure 1 Child with intestinal helminths 2 from the ports to the points of delivery, for health Fenwick convinced us to turn our attention to these Figure 2 Successful early deworming of children stimulates growth 2 education, for delivery through schools, health Neglected Tropical Diseases (NTDs), in addition to Figure 3 Coverage leaves a lot to be achieved 3 centres or community selected drug distributors, all our continuing work on Malaria. Figure 4 Worms from a child 3 and finally for monitoring and evaluation. Figure 5 Bloody urine caused by Schistosoma haematobium 3 The case for more investment in the control of However, the funding gap for all these activities is Figure 6 Advanced Schistosoma mansoni infection causes ascites 3 the NTDs has been promoted by a group of relatively smaller than the amounts required for Figure 7 Sighted children lead blind adults 4 international scientists who have each worked HIV/AIDs, TB and Malaria. Despite that smaller Figure 8 Lymphatic filariasis causes swelling of limbs 4 on individual diseases for many years, developing demand, filling that gap is still proving to be Figure 9 Lymphatic filariasis causes swelling of the scrotum 5 and validating tools for their control. Armed with problematic despite calls from the Commission Figure 10 Central African countries still need LF elimination programmes 5 proven strategies they have now combined their for Africa, the G8, the UN Secretary General and Figure 11 Flies cause chlamidia infection leading to trachoma 6 efforts to advocate how (not whether) we rid the WHO Secretary General and contributions Figure 12 Trachoma causes eye damage 6 the world of some of the NTDs, and how we from USAID and DFID. put in place control measures for other NTDs. Figure 13 Guinea worm infection 6 The massive numbers of people infected with NTDs As you read this report, you will be taken aback Figure 14 Man with leprosy 7 live mainly in sub-Saharan Africa, although there are at the unbelievably complicated life cycles and Figure 15 Cutaneous leishmaniasis 7 still infected populations in Asia, the Pacific, Central and the horrific and tragic consequences of these South America. Because NTDs are not necessarily infections mostly unknown in the Western world perceived as being responsible for the major burdens Tables – in children malnutrition and stunting of growth, of disease as they are not serious causes of death, Table 1 The NTDs 1 and later in life blindness, deformity, urinary tract they are nonetheless an integral cause of poverty Table 2 The Pharmaceutical company donations 10 and intestinal damage, swellings of limbs to gross preventing progress on the Millennium Development proportions, anaemia, and cancer. Goals. To achieve the MDGs, NTDs will need to The APPMG meetings during 2008 and 2009 have be controlled, and that control to be sustainable. If on several occasions been dedicated to NTDs. this can be achieved, a heavy burden on vulnerable Speakers have professionally presented the evidence economies will be removed. Chairman: Stephen O’Brien MP Vice-Chairmen: Dr Evan Harris MP, Lord Rea, David Drew MP Treasurer: Ashok Kumar MP Secretary: Eleanor Laing MP Coordinator: Susan Dykes Website: www.appmg-malaria.org.uk III Chairman’s Foreword Acknowledgements The APPMG would like to express its deep gratitude to Professor Alan Fenwick, Director of the Schistosomiasis Control, Initiative (SCI) Imperial College London, who has prepared the Report for the Group. Our grateful thanks go to all those who made presentations to the Group since the last report: House Of Commons The Group would also like to express its grateful thanks to GlaxoSmithKline which has kindly sponsored The All-Party Parliamentary Group on Malaria and Neglected Tropical Diseases the printing of this Report. Presentations on Neglected Tropical Diseases during 2008-09 • Professor Sir Roy Anderson, Rector, Imperial College, London The APPMG has played a major role in raising the In addition to all the contributors, the Officers • Professor Alan Fenwick, Director SCI, Imperial College, London awareness of NTDs. It has been heartening to see and Members of the APPMG are deeply grateful • Professor David Molyneux, Liverpool School of Tropical Medicine the group expand not only in its remit, but also in to Professor Alan Fenwick of the Schistosomiasis addressing a wider number of attendees as well as Control Initiative (SCI, Imperial College) for his • Professor Peter Piot, Director, Institute for Global Health at Imperial College London the variety of speakers and subjects. expertise and hard work in producing this report. • Professor Chris Whitty, Director of Research, DFID So the Group is now called the All-Party I commend this report and its recommendations • Chris Gilbert, Crown Agents Parliamentary Group on Malaria and Neglected to all those who, with us, are willing to learn about • John ‘Luc’ Lucas and Adam Flynn, Sumitomo Global Vector Control Tropical Diseases (retaining its abbreviation – infections which are common in the developing • Dr Jan Kolaczinski, NTD and Malaria Specialist, the Malaria Consortium APPMG). It remains a lively forum where, at world but which are often new to us. They infect • Dr John P Rumanu, MPH, MB.BS, Director General, Preventative Medicine, Ministry of Health, least monthly, new ideas, technologies, methods a high percentage of the world’s poor keeping Government of Southern Sudan and field work can be explained and debated them in poverty and making their lives a misery. • Dr Lorenzo Savioli, Director, NTDs WHO, Geneva, Switzerland from across the spectrum of all those involved For less than 50 pence per person per year it is • Dr Egon Weinmuller, Head of Corporate Affairs, BASF in the battle against Malaria and the NTDs. The awe-inspiring what could be achieved in treating all • Andy Wright, Director of the Lymphatic Filariasis Programme, GSK plc UK Government and the Opposition Parties are the people with these Neglected Tropical Diseases now all equally committed to Malaria control and – almost invariably the very poorest people on our • Ivan Lewis MP (previously) Parliamentary Under-Secretary at the Department of International Development) DFID has become one of the leading government planet and often hardest to reach too, across sub- departments in helping to bring tools to Saharan Africa, as well as across other equatorial • Prof. Michel Kazatchkine, Executive Director, the Global Fund communities who need them. We still maintain that continents. I urge all readers of this Report to use Many other organisations gave presentations during this period. They will all be acknowledged in the next we must control Malaria in the highest transmission it to join in the advocacy and campaign to alleviate Group’s Report on Malaria Control. areas of sub-Saharan Africa and eliminate the NTDs – it is do-able. Let us decide to act! disease country by country, as we all work together In addition, the Group would like to express its gratitude for the financial support it receives from The Malaria to ‘shrink the map’ of Malaria. It is vital that this Consortium and Medicines for Malaria Venture. political will is maintained to sustain the long term commitment required. However while this is being done our presenters have also shown that with a smaller and cost effective intervention of just 50 pence or less per person per year, many less lethal Stephen O’Brien MP tropical diseases could be eliminated or reduced in Chairman of the All-Party Parliamentary Group prevalence and intensity of infection. We must not on Malaria and Neglected Tropical Diseases forget them because their control would alleviate the suffering on many millions, improve their quality of life, and to school-aged children give them a healthier start to life.
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