Cash plea to fight Africa's forgotten diseases

Scientists have called for a more balanced approach in distributing the billions of dollars available for controlling tropical diseases. In a paper published on Tuesday, they said a focus by governments and charities on the big three tropical diseases—HIV, malaria and tuberculosis (TB)—has left millions of the poorest people in Africa without treatment for a range of illnesses.

The neglected diseases, which include schistosomiasis, river blindness, ascariasis, elephantiasis and trachoma, affect more than 750-million people and kill at least 500 000 every year.

Writing in the open-access journal Public Library of Science, Medicine, the researchers said treating all of these illnesses with a cocktail of four readily available drugs would cost less than 50 United States cents a person a year. They claimed that dealing with the forgotten diseases would reduce susceptibility to malaria and help to make socio-economic improvements for those in poverty, as well as save lives.

“We urge policymakers and health economists to recognise that although HIV, TB and malaria are the most serious problems facing health planners, other diseases exist that can be addressed at realistic cost with effective interventions,” said the researchers.
“Controlling Africa’s neglected diseases is one of the more convincing ways to make poverty history.”

In a briefing on Monday, authors David Molyneux, of the Liverpool School of Tropical Medicine, and Alan Fenwick, of Imperial College London, said their analysis showed that doctors could reach everyone in Africa who needed treating for $200-million a year. They want just a fraction of the $15-billion a year spent on malaria, HIV and TB to be diverted to the forgotten diseases.

Fenwick said: “Instead of 95% of money donated going to malaria, HIV and TB, it would only need to be 90% and we could do an awful lot of cost-effective treatment and help towards making poverty history.”

Molyneux added that the large amount of money spent on the big three diseases is not having such a large impact on the spread of those diseases. Only an estimated three million people out of 30-million infected with HIV are receiving anti-retroviral treatment.

“There are large needs out there which are not being addressed, and the focus of policymakers on HIV, TB and malaria is slightly distorting the realities of health in Africa and elsewhere,” he said.

The costs for treating the forgotten diseases are partly kept down because three of the four drugs that the researchers want to distribute—mectizan, albendazole and azithromax—would be donated by manufacturers Merck, GlaxoSmithKline and Pfizer respectively. Many of the countries where the most help is needed, including Tanzania, Uganda, Burkina Faso, Mali, Cameroon and Nigeria, have people in place to distribute drugs. The only element they lack is logistical support.

Molyneux said reducing the incidence of worms and parasites would help control more life-threatening diseases. People with intestinal worms are known to be nine times more likely to contract malaria because their immune systems are weakened by the lesser disease. He added that eradicating schistosomiasis would halve the incidence of malaria.

The researchers said that their cocktail of drugs would not get rid of parasitic infections, but would lift the burden of disease from poor communities and perhaps lay the foundations for future eradication. They pointed out that similar programmes had been successful elsewhere.

In China, 350-million people are now free of elephantiasis, while in Egypt the proportion of the population affected by schistosomiasis has been reduced from 20% to 2% over 15 years.—Guardian Unlimited Â

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