Neglected Infectious Diseases Integrated Approach
Neglected Infectious Diseases (NIDs) affect populations living in poor socio-economic conditions with low income and poor education. These groups often live in areas that lack access to basic services, such as clean drinking water and sanitation, and in areas with deteriorating environmental conditions and where barriers to access health services exist. As they share similar social and environmental factors, neglected infectious diseases frequently coexist in the same geographical areas.
NIDs are caused by several different microorganisms and most are chronic diseases with long lasting health effects that affect growth, physical and intellectual development, and learning ability, which in turn, leads to decreased labor productivity and the decreased to generate an adequate school absenteeism income. Some NIDs can also cause physical disfigurement leading to social stigma against the individual. All these conditions hamper progress and development of communities in affected countries. NIDs also undermine already precarious living standards, thus contributing to a cycle of poverty.
The WHO classifies 17 diseases under the neglected tropical diseases grouping.
The resolution Elimination of neglected diseases and other infections related to poverty, from PAHO’s Directing Council signed by Member States in October 2009, identifies 12 neglected infectious diseases with the aim of eliminating or significantly reducing their impact in LAC by the year 2015.
PAHO’s regional program for neglected infectious diseases has the direct co-responsibility of achieving the elimination or control of a set of diseases that can be targeted through preventive chemotherapy schistosomiasis, lymphatic filariasis, soil transmitted helminthiases, onchocerciasis and trachoma, interacting with other disease control programs such as Chagas disease, malaria, leishmaniasis and leprosy.
Impact of Neglected Infectious Diseases
More than a billion people worldwide suffer from at least one NID and the total burden of the NID group is 56.6 million of Disability Adjusted Life Years (DAYLs). This figure is only surpassed by some infectious diseases, lower respiratory infections, HIV/AIDS, and diarrheal disease. The disease burden of NIDs is greater than malaria, tuberculosis, and measles.
The NID disease burden in Latin America and the Caribbean is 8.8% of the global burden, about 5 million DAYLs, which is higher than the burden of HIV in the region. This important figure can be explained in the following context: in 2008, 40% of the estimated 556 million people in Latin America and the Caribbean lived under poverty, including an estimated 47 million people with a daily per capita income of less than US$1 and 74 million people with a daily per capita income less than US$2.
Read more about the NID Brochure:
Although Latin America is not the poorest region in the world, it is considered to be the one with the greatest inequality. Statistics show that the richest 10% of the population receives 48% of the income while the poorest 10% receives only 1.6%. In Latin America and the Caribbean, as of 2008, 7% of the population had no access to clean water (3% in urban areas and 21% in rural areas) while 21% of the population lacked access to basic sanitation (14% in urban areas and 45% in rural areas).
In Latin America and the Caribbean the soil transmitted helminthiases are widely disseminated (50 million children under 15 years old at risk of infection). Schistosomiasis can be found in areas of Brazil, St. Lucia, Suriname, and Venezuela (25 million people needing preventive chemotherapy); while lymphatic filariasis is found in areas of Brazil, Guyana, Haiti, and the Dominican Republic (13.4 million people needing preventive chemotherapy). Onchocerciasis is found in six countries: Brazil, Colombia, Ecuador, Guatemala, Mexico, and Venezuela (379,274 people living in areas at risk of infection). Finally, blinding trachoma can be found in Brazil, Colombia, Guatemala, and Mexico (50 million people at risk of infection). The NID brochure summarizes the status of these five diseases in Latin America and the Caribbean.
The Integrated Approach to Combat Neglected Infectious Diseases
PAHO’s regional program for neglected infectious diseases emphasizes the importance of an integrated approach for the control and elimination of these diseases. This integrated approach consists of both supporting actions within the health sector as well as from those of interested parties and stakeholders which are normally outside of the health sector. Within the health sector, the regional program promotes collaboration with health programs such as the Expanded Programme on Immunization (EPI), programs to control vector-borne diseases, and the Integrated Management of Childhood Illnesses (IMCI). The regional program also incorporates an intersectoral approach and promotes joint work in education, housing, development, water and sanitation, environment, and agriculture in order to modify the social and environmental determinants related to NIDs. In this context, PAHO provides technical cooperation for drafting and implementation of integrated plans of action to control or eliminate neglected diseases, as well as facilitating the donation of medicines and tools, and supporting mapping, surveillance, monitoring and evaluation.
Decreasing the disease burden of neglected infectious diseases in Latin America and the Caribbean will help improve the living conditions of affected populations, reduce poverty in the region, and help achieve the Millennium Development Goals.
Pan American Health Organization. Directing Council. Resolución CD 49. R19, ¨Elimination of neglected diseases and other infections related to poverty¨. 2 October 2009. [Accessed: 28 June 2011]
Savioli L. Neglected Tropical Disease Department, World Health Organization. [Accessed: 28 June 2011]
Hotez PJ, Molyneux DH, Fenwick A, Kumaresan J, Sachs SE, Sachs JD, Savioli L. Control of neglected tropical diseases. N Engl J Med. 2007; 357:1018-27.
Hotez PJ, Bottazzi ME, Franco-Paredes C, Ault SK, Roses-Periago M. The Neglected Tropical Diseases of Latin America and the Caribbean: A Review of Disease Burden and Distribution and a Roadmap for Control and Elimination. . PLOS Neglected Tropical Diseases 2008; 2: e300. [Accessed: 28 June 2011]
The World Bank. Inequality in Latin America & the Caribbean: Breaking with History? [Internet]. [Washington]. [Accessed: 28 de junio de 2010]
Pan American Health Organization. Health Situation in the Americas. Basic Indicators 2010. PAHO/HSD/HA/10.01
Schneider MC, Aguilera XP, Barbosa da Silva Junior J, Ault SK, Najera P, Martinez J, Requejo R, Nicholls RS, Yadon Z, Silva JC, Leanes LF, Roses Periago M. Elimination of Neglected Diseases in Latin America and the Caribbean: A Mapping of Selected Diseases. PLoS Negl Trop Dis 2011; 5: e964. doi:10.1371/journal.pntd.0000964 [Accessed: 28 June 2011]
Holveck JC, Ehrenberg JP, Ault SK, Rojas R, Vasquez J, Cerqueira MT, Ippolito-Sheperd J, Genovese MA, Roses Periago M. Prevention, control, and elimination of neglected diseases in the Americas: Pathways to integrated, inter-programmatic, inter-sectoral action for health and development. BMC Public Health 2007, 7:6. [Accessed: 28 June 2011]