In the global health world, we often hear discussion of HIV/AIDS, malaria and tuberculosis – but what about the other diseases that fly under the radar? According to the Global Health Progress initiative, “More than one billion people around the world are afflicted with one or more neglected diseases, and this topic is of critical importance to US foreign aid and global health policy.”

The Tufts Center for the Study of Drug Development took on this issue of neglected diseases last Friday at their daylong event, “Neglected Diseases in the Developing World: Progress, Current Challenges and Promising Approaches.” Held in the Dirksen Senate Building, the event featured a distinguished group of speakers, including representatives from the Food and Drug Administration (FDA), National Institute of Health (NIH), Duke University, BIO Ventures for Global Health and the U.S. Agency for International Development (USAID).

Christopher Milner, Associated Director of the Tufts Center for Drug Development, started the morning by introducing Mary Moran, Director of the Health Policy Division of the George Institute. Ms. Moran spoke about the issue of obtaining global funding for research and development to treat neglected diseases. She explained that many countries and organizations are participating in the development of new neglected disease products, which is a welcome and relatively new phenomenon. However, there is a dire need, particularly during the economic crisis, for the broadening of funding efforts so that all diseases receive the attention they deserve.

Joshua Cohen of the Tufts University Center for the Study of Drug Development also took the floor to discuss progress in neglected disease drug development. Mr. Cohen emphasized that financial support for neglected disease research is very lopsided, with the majority of funding flowing into HIV/AIDS, malaria, and tuberculosis. He also stressed that a comprehensive approach to addressing neglected diseases should include not only effective drug development, but also attention to health infrastructure, affordability, and improved accessibility.

The morning ended with a panel discussion in which public and private sector experts discussed how to prioritize and facilitate the discovery and development of new medical products for neglected diseases. The panelists also highlighted public health impacts and current efforts to address this global threat.

The event provided a unique opportunity to hear leaders from a variety of fields share their views on both the progress and challenges surrounding the development and distribution of products for combating neglected diseases in the developing world.

-Robyn Mitchell, Hallie Tosher, & Jen Fraser

There’s an important editorial in the LA Times today about drug-resistant tuberculosis.

A couple of excerpts:

“A new survey by the World Health Organization shows that drug-resistant tuberculosis is even more widespread than had been feared — on average, it’s present in 5% of new TB cases. That’s 500,000 drug-resistant cases a year. If most Americans aren’t concerned by this, it’s because they don’t yet understand that drug-resistant tuberculosis is no longer a disease that threatens mainly HIV and AIDS patients and the Third World poor. It threatens us all. Worldwide, only 8% of TB cases occur in HIV/AIDS patients…

Even after the panic last year caused by Andrew Speaker, the jet-setting honeymooner found to have MDR TB, funding to stop the disease has lagged. The WHO, which gets its money from United Nations member states, estimates it needs $4.8 billion for global TB control. But despite increases in funding from the U.S., Britain and private donors, it still faces a $2.5-billion shortfall.

You can read the full piece here.

They say timing is everything. Fewer than 24 hours after my colleague David Molyneux’s call to action for increased attention to neglected tropical disease (NTD) control appeared on this blog, President Bush has unveiled a $350 million commitment to fight NTDs in Africa, Asia, and Latin America over the next five years.

This commitment represents a historic step forward in the US’s global health strategy, and a major victory for the NTD advocacy movement. I applaud President Bush for taking leadership on this issue and encouraging other G-8 members, as well as public and private partners and philanthropic foundations, to follow suit.

There is no doubt that the integrated control of NTDs (providing treatment for up to seven of the most common of these infections in one package) will have a rapid and long-lasting impact on almost every facet of life for the billions who have long suffered these debilitating and disabling infections in silence. Together with other effective health and sanitation strategies, NTD control has the potential to unlock economic and educational growth (not to mention improvements in physical and mental well-being) at never-before-seen levels throughout the developing world.

This is truly a cause for great hope. The President’s funding commitment, together with money from Bill and Melinda Gates and other partners such as Geneva Global, will cover almost half of the estimated NTD funding gap over the next seven years. If President Bush’s plea to other donors is successful, perhaps we will after all consign these diseases to history.

For more information on NTDs and to join the fight, visit the Global Network for Neglected Tropical Diseases.

-Dr. Peter Hotez is President of the Sabin Vaccine Institute and Executive Director of the Global Network for Neglected Tropical Diseases, based in Washington, DC

The rhetoric surrounding President Bush’s tour of Africa has certainly been inspirational, but is marked by a common and unfortunate omission. Amid a sea of hopeful images of economic growth, educational opportunity, and life-saving healthcare, the President – like so many other global leaders these days– has displayed an inability to recognize perhaps the most important background factor linking health, wealth, and education in the developing world. The factor I am referring to is the scourge of the neglected tropical diseases (NTDs), a hidden pandemic of the world’s poorest.

Though not killers on the scale of HIV/AIDS and malaria, the NTDs – a group of infections with names like ’schistosomiasis,’ ‘onchocerciasis,’ and ‘lymphatic filariasis’ that are a mouthful even for those of us who have made a career of fighting them – cause more disability and premature death in Africa than either malaria or tuberculosis, according to the World Health Organization. As a group, the NTDs are the most common infections of the world’s at least one billion poorest inhabitants, affecting 500 million in Africa (compared to 30 million for HIV). Simply put, no progress can be made in development without addressing these infections as well as the “big three” (HIV/AIDS, tuberculosis, and malaria) which so preoccupy politicians.

Even if you have traveled in the countries hardest hit by NTDs, you may not be familiar with them. They are hidden infections that thrive in the poorest rural and urban populations, often causing grotesquely swollen limbs, distended bellies full of worms, blindness, and mental retardation, all of which lead to severe social stigmatization. They leave adults unable to work, keep kids out of school, add to rates of infant death and low birth weight, and can speed up transmission of the HIV virus, all at alarming rates.

There is good news, however. A package of medications to treat seven of the most common NTDs is available for only 50 cents per person per year – an almost negligible price compared to treatment costs for other major infectious diseases (for example, $400 – 1200 per year to treat a case of HIV). Given this low cost and the hugely positive impacts of treatment, providing medication for NTDs is one of the single most cost-effective investments we can make with our international aid dollars.

While the President’s commitment to African health and development is admirable, we must be careful not to focus solely on the “big three” to the exclusion of other equally devastating diseases. Control of NTDs is within our grasp, and if we truly wish to invest in the future of African development, we must take action now.

For more information on NTDs or to join the fight, please visit the Global Network for Neglected Tropical Diseases.

-Professor David Molyneux, Director of the Lymphatic Filariasis Support Centre based at the Liverpool School of Tropical Medicine and current President of the Royal Society of Tropical Medicine and Hygiene