The Politics of Priorities: NTDs – Neglected Tropical Diseases or Neglecting True Development?

Why NTDs are Neglected

Neglected Tropical Diseases (NTDs) have been less successful at attracting resources and attention mainly because they exist mostly in the poorest countries and most marginalized communities. They have been eradicated in the developed world and are now largely forgotten. Without this connection in suffering (like the one shared by HIV/AIDS and SARS), it is difficult to persuade developed countries to put money toward fighting NTDs. Persuasion is also difficult to do without a political voice, which the over 1 billion affected by NTDs do not really have. Additionally, some argue that though NTDs are chronic, because fatality is not imminent, they constitute a smaller share of the overall burden of disease. Thus, NTDs have a low profile and status in public health priorities.

Why NTDs Shouldn’t Be Neglected

NTDs place a significant burden on health systems, particularly because they are prolonged diseases1. Because people live with these diseases for extended periods of time, the core groups of 13 NTDs equals roughly 57 million DALYs—more than malaria and tuberculosis combined2. The interventions for NTDs are very inexpensive and effective. Thus, to maximize health benefits, especially on a fixed budget, the cost-effectiveness of NTD intervention creates a compelling case for increased resources in their direction3.

According to WHO’s Dr. Margaret Chan, NTDs express the link between health and development. In the interest of economic development, NTDs deserve more attention and resources. NTDs have a widespread effect beyond the health sector, especially on the labor market and productivity1. There is a vicious cycle of poverty and disease perpetuating one another. Because NTDs perpetuate poverty, economic development cannot be truly addressed without addressing these diseases4. The World Health Organization also highlights equity as being a fundamental principle of health development and cites the inability to pay as an unfair reason to deny access to life-saving interventions1.

As Dr. Chan calls NTDs “a symptom of poverty and disadvantage”, so, too, may they be a symptom of the developed world’s interest in maintaining the current power hierarchy. This is another possible explanation for why tropical diseases are neglected. Many forms of foreign aid do not do much to change the capacity of the recipient country. Addressing NTDs would change this capacity by breaking the poverty cycle and creating greater capacity for economic development. If donors, particularly bilateral, had true development as the motivation for aid, it would seem that they would maximize their money by focusing it on cost-effective interventions.

by: Carly Nasehi

1Chan, Dr Margaret. “Address to the WHO Global Partners Meeting on Neglected Tropical Diseases”. World Health Organization. Geneva, Switzerland. 19 April 2007. http://www.who.int/dg/speeches/2007/190407_ntds/en/index.html

2Hotez, PJ, Fenwick, A, Savioli, L, Molyneux, DH. (2009) “Rescuing the bottom billion through control of neglected tropical diseases.” Lancet 373: 1570-1575.

3Canning, D. (2006) “Priority setting and the ‘neglected’ tropical diseases.” Transactions of the Royal Society of Tropical Medicine and Hygiene 100: 499-504.

4Sachs, Jeffery and Hotez, Peter. “Fighting Tropical Diseases”. Science. 17 March 2006. Vol.  311 (no. 5767); pg. 1521. http://www.sciencemag.org/cgi/content/summary/311/5767/1521?etoc

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