I first heard about the Access Campaign for neglected diseases during my MSF time, but over the past year these diseases have spawned intense philanthropic, governmental, and intergovernmental concern. Here's the basic problem as put forward by the WHO:
"At least 1 billion people — one sixth of the world’s population, or 1 person in 6 — suffer from one or more neglected tropical diseases (NTDs), such as Buruli ulcer, cholera, cysticercosis, dracunculiasis (guinea-worm disease), foodborne trematode infections (such as fascioliasis), hydatidosis, leishmaniasis, lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiasis, trachoma and trypanosomiasis, although there are other estimates that suggest the number could be much higher. Several of these diseases, and others such as dengue, are vector-borne. Often, those populations most affected are also the poorest and most vulnerable and are found mainly in tropical and subtropical areas of the world."
And yet, a great divergence exists in the availability and effectiveness of treatments for these diseases, many of which overlap both patient populations AND effective medications. Simultaneously, there's a global debate going on between the most effective institutional mechanism for overcoming these problems. But before we get to that, though, here are the diseases. Click on each to go to the WHO description:
:: Blinding trachoma
:: Buruli Ulcer
:: Cholera
:: Dengue/dengue haemorrhagic fever
:: Dracunculiasis (guinea-worm disease)* (see below)
:: Fascioliasis
:: Human African trypanosomiasis
:: Leishmaniasis
:: Leprosy
:: Lymphatic filariasis
:: Onchocerciasis
:: Schistosomiasis
:: Soil transmitted helmithiasis
:: Yaws
One thing to notice is that neither HIV, TB nor malaria are on this list. The original MSF Access Campaign included these latter three - but since the start of the campaign in 1999, much more attention has been paid them.
In the next few weeks, we'll spend some time describing the basics of each of these diseases, the latest literature, like this JAMA article and this NEJM piece, the intellectual property schism that may evolve out of this whole process and the interrelation between these diseases and poverty.
*Meanwhile, I'd like to highlight again one of the great public health accomplishments of our time, done without any medicines:
"Guinea worm disease, or dracunculiasis — Latin for "affliction with little dragons" — is a plague so ancient that it has been found in Egyptian mummies and has been proposed by some to have been the "fiery serpent" described in the Old Testament as torturing the Israelites in the desert. The global Dracunculiasis Eradication Program spearheaded by former President Jimmy Carter and the Carter Center has now reached its final stages (see graph). This accomplishment is unprecedented — the only disease previously eradicated was smallpox, not a parasitic disease — and it has been achieved through grassroots public health initiatives involving thousands of village volunteers." (Emphasis added)
Picture below from the NEJM article:
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