Concerted Efforts to Control or Eliminate Neglected Tropical Diseases: How Much Health Will Be Gained?

Abstract

BackgroundThe London Declaration (2012) was formulated to support and focus the control and elimination of ten neglected tropical diseases (NTDs), with targets for 2020 as formulated by the WHO Roadmap. Five NTDs (lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminths and trachoma) are to be controlled by preventive chemotherapy (PCT), and four (Chagas’ disease, human African trypanosomiasis, leprosy and visceral leishmaniasis) by innovative and intensified disease management (IDM). Guinea worm, virtually eradicated, is not considered here. We aim to estimate the global health impact of meeting these targets in terms of averted morbidity, mortality, and disability adjusted life years (DALYs).MethodsThe Global Burden of Disease (GBD) 2010 study provides prevalence and burden estimates for all nine NTDs in 1990 and 2010, by country, age and sex, which were taken as the basis for our calculations. Estimates for other years were obtained by interpolating between 1990 (or the start-year of large-scale control efforts) and 2010, and further extrapolating until 2030, such that the 2020 targets were met. The NTD disease manifestations considered in the GBD study were analyzed as either reversible or irreversible. Health impacts were assessed by comparing the results of achieving the targets with the counterfactual, construed as the health burden had the 1990 (or 2010 if higher) situation continued unabated.Principle Findings/ConclusionsOur calculations show that meeting the targets will lead to about 600 million averted DALYs in the period 2011–2030, nearly equally distributed between PCT and IDM-NTDs, with the health gain amongst PCT-NTDs mostly (96%) due to averted disability and amongst IDM-NTDs largely (95%) from averted mortality. These health gains include about 150 million averted irreversible disease manifestations (e.g. blindness) and 5 million averted deaths. Control of soil-transmitted helminths accounts for one third of all averted DALYs. We conclude that the projected health impact of the London Declaration justifies the required efforts.

The cross-cutting contribution of the end of neglected tropical diseases to the sustainable development goals

“…However, the economic benefits estimated to have accrued during the first 8 years of the programme exceeded $24 billion. A 2016 study on health gains from NTD programmes has estimated if targets are met for nine NTDs, 600 million Disability Adjusted Life Years (DALYs) would be averted, which can be extrapolated to 2030, due largely to the decline in morbidity of NTDs treated by preventive chemotherapy [123]. However, this figure does not include gains in subtle morbidities through improved cognitive development and mental health and the analysis was restricted to only nine NTDs.…”

Visceral leishmaniasis: Spatiotemporal heterogeneity and drivers underlying the hotspots in Muzaffarpur, Bihar, India

“…In the rest of the world, where the disease is also zoonotic, the WHO target for VL control is 100% detection and treatment of VL cases [11]. It has been estimated that the global health and economic gains from reaching these WHO targets would be enormous [12]. Interventions against VL on the ISC are based on early detection and treatment of cases and vector control, mainly through indoor-residual spraying of insecticide (IRS) [5,11].…”

Guide posts for investment in primary health care and projected resource needs in 67 low-income and middle-income countries: a modelling study

“…Here, we present incremental outputs for 2020-30. Similar to the previously published SDG projections, we present estimates for eight groups of countries: three income categories and five additional country categories representing different degrees of health system maturity 18 NTDs, 19 and stillbirths avoided. 10…”