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Neglected Tropical Diseases: Fighting Neglect
More than one billion people – one in seven of the world’s population - are affected by parasites and diseases that few have ever heard of. These wide-reaching, debilitating conditions are known as Neglected Tropical Diseases (NTDs).
While attention is being drawn towards some NTDs by donors and development agencies, a lot still needs to be done if the three most prominent – Chagas disease, sleeping sickness and kala azar (visceral leishmaniasis) – are to be truly controlled and eliminated.
Fighting Neglect report
Fighting Neglect, a Medecins Sans Frontieres/Doctors Without Borders (MSF) report released today, charts MSF's 25 years diagnosing and treating these three diseases which, if left untreated, are almost always fatal.
“These diseases are not a curse,” says Dr Unni Karunakara, MSF international president.
“While challenging, they are highly treatable and curable. Neglect can be overcome and millions of lives can be saved, but for that, we need political will: political will to pay for programmes that work and politicial will to develop better tools that will allow us to tackle these diseases more effectively.”
The report shows that diagnosis and treatment of these diseases is possible, but decades of inaction at the global level has left a deep void.
“What we have is a terrible cycle of neglect,” says Gemma Ortiz Genovese, MSF’s neglected diseases advisor. "Policy makers don’t focus on the neglected diseases because they claim there are not enough tools to adequately treat patients.
"Pharmaceutical companies don’t invest in research and development of new tools because these diseases mostly affect the poorest people in the world, who don’t represent a lucrative market. This cycle must be broken.”
NTDs mainly affect people in South Asia, Africa and Latin America, specifically those living in remote rural areas, urban slums or conflict zones.
Cycle of poverty
Beyond their negative impact on health, NTDs contribute to an ongoing cycle of poverty and stigma that leaves people unable to work, go to school or participate in family and community life.
At the recent World Health Assembly held in May 2012, the US and Europe blocked proposals for a new convention on financing research and development (R&D) for NTDs saying that other approaches might be possible.
However, none of these approaches prioritised the needs of patients in poor countries.
“For better diagnostics and medicines to be developed, we not only need more resources dedicated to innovation, but we have to seriously rethink the way R&D is conducted and ensure that innovation meets public health needs in developing countries,” says Judit Rius, manager of the MSF Access Campaign in the US.
“What we need is action, not lip service to tackle these killer diseases.”
Chagas is transmitted by an insect that lives in the walls and roofs of mud and straw houses, common among rural areas and poor urban slums in South America.
Millions of people with the disease, including those infected decades ago, go undetected and untreated. Without treatment, Chagas can eventually progress to fatally damaging the heart, nervous and digestive systems.
A test of cure for Chagas is missing: the simplification of tools and treatment are urgently needed to make their use in field conditions easier.
Leishmaniasis is a disease caused by a parasite that is spread by sand fly bites. In its most severe form, it is called visceral leishmaniasis or kala azar.
Kala azar attacks the immune system, causing prolonged fever and weakness. If untreated it is almost always fatal, but with effective treatment about 95 per cent of patients make a full recovery.
Since 1988, MSF have treated over 100,000 people with kala azar. We are still working on ways to manage it more effectively and affordably.
Human African Trypanosomiasis, more commonly known as sleeping sickness is a parasitic infection seen in sub-Saharan African and is transmitted by tsetse flies.
The parasite attacks the central nervous system, causing severe neurological disorders and will always lead to death if untreated.
MSF uses Nifurtimox-eflornithine combination therapy (NECT) to treat sleeping sickness, which is now the internationally recommended treatment. However, the drug formerly used to treat the disease – melarsoprol – is still in use by some. Being a derivative of arsenic, it can be as deadly as the disease itself.