An important part of TropIKA.net is our Profiles section in which Tatum Anderson interviews key figures working against the infectious diseases of poverty. We are delighted that our latest interviewee is Dr Awa-Marie Coll-Seck executive director of the Rollback Malaria Partnership (RBM). She plays a crucial role in coordinating the activities of the myriad of organizations now involved in international efforts to improve malaria control. One of the many new malaria initiatives is the Affordable Medicines Facility for malaria (AMFm). There is currently much debate, for example in a recent PLoS Medicine article, as to the merits of this scheme and how it might best be implemented.

Another recent Profile interviewee, Brian Greenwood, is probably best known for his work against malaria but in his long career in tropical medicine he has also focused on other diseases, among them is meningitis. We report on the launch of the African Meningococcal Carriage Consortium (MenAfriCar), to be headed by Professor Greenwood, which will make a concerted effort to understand the spread of meningococcal meningitis in Africa.

We also report good news on another disease that is predominantly an African problem – onchocerciasis (river blindness). Mass administration of the drug ivermectin kills the larvae of the parasite responsible but not the adult; repeat treatments (once or twice a year) are therefore given. It has been widely believed that communities living in areas endemic for the disease would need to be given these treatments indefinitely. However, a study in Mali and Senegal found that, after 15-17 years of mass drug administration with ivermectin, only a few people were still infected and treatment could safely be stopped. Ivermectin is not, however, an ideal drug. Many patients find it extremely unpleasant to take and parasite resistance to the drug has been reported. Research to find new ways to control river blindness that do not depend on ivermectin therefore remains important – see TropIKA.net news story on the latest meeting of the SCOOTT Consortium (Sustainable Control of Onchocerciasis today and Tomorrow).

Amongst the other good news has been the announcement by the International Trachoma Initiative that three more countries (Ghana, Mexico and Saudi Arabia) have now met the criteria for elimination of trachoma as a public health problem. It is unusual to see a low-, a medium- and a high-income country mentioned together for the same achievement! Tropical diseases can indeed afflict both rich and poor but it those who live in poverty who are the most vulnerable.

Many of the countries where dengue fever is a problem are emerging economies in Latin America and Southeast Asia. The economic impact of the disease is therefore considerable. Probably the most comprehensive study to date seeking to quantify this impact has just been published. Infectious diseases that affect poor people are by and large neglected, but with increasing wealth in dengue-afflicted nations, perhaps the economic imperative will lead to an expansion of efforts to develop a vaccine and a treatment for this increasingly common disease.

The diagnosis of the infectious diseases of poverty is itself a neglected issue. When advances are made in the treatment of a disease, rapid and reliable diagnosis becomes even more important, as was discussed in the case of malaria in a recent BMJ article.

Two initiatives to address the neglect of diagnosis have made an appearance in TropIKA.net during the last few days. The African Network for Drugs and Diagnostics Innovation (ANDi) has announced that it will present its strategy and business plan in October, and the TropIKA.net blog links to an interview with Joseph Ndung’u of the Foundation for Innovative New Diagnostics (FIND) about the search for a new diagnostic test for trypanosomiasis (sleeping sickness).

- For more on new developments in diagnosis, see also a recent article in TDR News.

Paul Chinnock
Editor-in-Chief, TropIKA.net