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15 2 The“Other Diseases” The Neglected Tropical Diseases Through more than $70 billion in overseas development assistance from the G8 countries, together with international cooperation implemented within the framework of the UN Millennial Development Goals, dramatic reductions have been achieved in child mortality (MDG 4), and in deaths from HIV/AIDS and malaria (MDG 6). Progress toward MDG 4 was achieved first and foremost through increased vaccine coverage and global access to new vaccines for pneumococcus and rotavirus, while MDG 6 gains occurred mostly through increased access to essential medicines (antiretroviral drugs and antimalarial drugs) and bed nets. As a consequence of these great reductions in the deaths and DALYs from communicable and infectious diseases, particularly in Africa, the Global Burden of Disease Study 2010 determined that for the first time ever the global disease burden of noncommunicable diseases (NCDs), especially cancer, cardiovascular diseases , chronic pulmonary diseases, diabetes, unipolar depression, and Alzheimer ’s disease, now exceeds infectious diseases and represents the world’s major causes of illness. In light of these findings, the global health community was quick to place new emphasis on the control of NCDs as the next “big wave.” Efforts to combat NCDs became especially urgent in the “Global South,” meaning Africa, Asia, and Latin America. In response, the UN General Assembly organized a high-­ level meeting in New York to review and assess a 2011 political declaration on the NCDs [1]. In parallel, a Lancet Commission on investing in health (led by former World Bank chief economist, United States secretary of the treasury, and Harvard president Larry Summers toHotez .indb 15 6/22/16 11:02 AM 16 Blue Marble Health gether with University of Washington professor Dean Jamison) was also established to formulate plans for the next 20 years. The Lancet Commission found that fiscal policies directed at taxation of tobacco, alcohol, and other harmful substances, as well as those focused on reducing subsidies for fossil fuels linked to air pollution, might one day represent some of the most powerful pro–public health forces [2]. However, I believe that the apparent rise of the NCDs at the expense of declining infectious diseases partly ignores a harsh reality presented by the third (and often forgotten) component of MDG 6, which unfortunately was named “other diseases.” In my previous book, Forgotten People, Forgotten Diseases [3], I explained how a group of these other diseases that I helped co-­brand as the NTDs [4] actually represents the most common afflictions of theworld’spoor.Ouroriginallistof13–14majorNTDs[5–7] was subsequently modified by the World Health Organization (WHO) to a list of 17 NTDs. However, our open access journal Public Library of Science Neglected Tropical Diseases (PLOS NTDs) has also shaped an expanded list that includes dozens more disease conditions. The GBD 2013 has recently derived new estimates for the number of people actually infected with the 17 NTDs (as currently defined by WHO), and these are shown in table 2.1 [8]. In aggregate, there are more than two billion cases of NTDs worldwide, representing the most common diseases of people living in poverty. The major features of each of the leading NTDs (listed in order of prevalence) can be described as follows: Ascariasis is the most common NTD and possibly the most common affliction of the poor. Transmitted by the ingestion of parasite eggs that are nearly ubiquitous in the dirt found in impoverished rural and urban areas, ascariasis is caused by the roundworm Ascaris lumbricoides, which lives in the small intestines of millions of children. Chronic infection with A. lumbricoides produces malnutrition, which in turn leads to physical and cognitive growth delays. The larval stages of A. lumbricoides also migrate through the lungs to cause wheezing and a clinical syndrome that resembles asthma. The parasite is highly sensitive to deworming medication—typically mebendazole or albendazole—but because NTDs are the most common diseases of the poor. Virtually every person on the planet living in extreme poverty is affected by at least one NTD. Hotez.indb 16 6/22/16 11:02 AM The“Other Diseases” 17 Table 2.1 GBD 2013 estimates of the 17 diseases considered by WHO as NTDs Rank Disease Prevalent cases in 2013 (in millions) Common name Major clinical features 1 Ascariasisa 804.4 Intestinal roundworm Malnutrition (soil transmitted) 2 Trichuriasisa 477.4 Whipworm Colitis (soil transmitted) 3 Hookworm diseasea 471.8 Hookworm infection Anemia (soil transmitted) 4 Schistosomiasis 290.6 Snail fever Chronic liver and renal disease; female genital schistosomiasis; cancer...

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Additional Information

ISBN
9781421420479
MARC Record
OCLC
956541522
Pages
224
Launched on MUSE
2016-08-15
Language
English
Open Access
No
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