The atlas  is important for several reasons. Mapping the burden of disease is a critical first step to control and elimination. Without knowing how many are affected, and where the disease hotspots are located, health experts trying to tackle these diseases are largely aiming in the dark.

For many years, this is what researchers fighting neglected diseases have had to do. National reporting on the burden of diseases such as African sleeping sickness or lymphatic filiariasis has been patchy at best, largely because of weak surveillance systems or problems with diagnosis. While there have been large-scale mapping efforts for schistosomiasis and onchocerciasis, the information they contain is now fairly outdated.

The atlas will exploit new methods of data-capture, in which data is sent as soon as it has been collected to a central database via laptops or other mobile technologies. GIS (geographical information systems) frameworks allow this disease data to be meshed with environmental data on climate variability and weather patterns, which are key in the transmission of infectious neglected diseases.

The ease with which data can now be captured and organised on a macro level has been at the heart of other mapping efforts such as new global maps for malaria (see Q&A with Simon Hay on mapping malaria, http://www.tropika.net/svc/specials/mim2009/profiles/Q_A_Hay). These maps have offered malaria researchers an opportunity to better target their efforts.

The world is finally seeing substantial political will to fight neglected diseases. The Obama administration, for example, is expected to release US$100 million a year to fight these diseases under its new Global Health Initiative. The atlas for helminth infection is a start - neglected disease researchers must now pool their efforts to create more atlases of neglected diseases.

The Colombian Institute of Tropical Medicine “Antonio Roldan Betancourt” ICMT-CES is a center of excellence in research, nonprofit, described by COLCIENCIAS full exaltation granted by that organization: Group A1 “Institution of Excellence in research.”

It was founded in 1989 as a Joint Participation Corporation for purposes of public and social interest. Currently the Institute has an operating headquarters in the CES University facilities in the town of Sabaneta and another office located in Apartado - Antioquia.

The ICMT is managed by the University of Medellín CES, an institution renowned for the quality of its academic programs and unconditional support to the development of research and science, as well as the provision of services, consulting and advisory services in the Colombian health sector and Latin America.

ICMT-CES Mission Working continuously for the development of science, through research and academic training of health professionals, with the aim to contribute actively in improving the health of the citizens.

Our Institute has international recognition, thanks to the work associated with other research institutions and the many publications of scientific contribution.

ICMT-CES focuses its research activities in all areas of Tropical Medicine, based on epidemiology and immunology of infectious diseases, supported by the most advanced techniques of molecular biology for diagnosis. They stand out for their development research in progress: leishmaniasis, Chagas disease, intestinal parasites, salmonellosis, leprosy, tuberculosis, malaria, cysticercosis, dengue, leptospirosis, diagnostic methods, medical entomology and brucellosis.

Writing in PLoS Neglected Tropical Diseases, Peter Hotez, President of the Sabin Vaccine Institute and Distinguished Research Professor of The George Washington University Medical Center, and Bernard Pecoul, Executive Director of Drugs for Neglected Diseases initiative (DNDi), outline in eight points why the global community should increase financial support for NTD control and elimination efforts and research and development.

The manifesto states that:

·      All NTDs are “tool ready” with cost-efficient and effective interventions that could be implemented now, even if for some diseases such tools are far from being perfect or complete.

·      At the same time that NTDs are tool ready they are also tool deficient, signifying that the tools are incomplete, or inadequate, to sustain elimination efforts.

·      NTDs have received little attention from the international community during the past ten years despite their large disease burden.

·      Increasing evidence indicates an association between NTD prevalence and conflict and violation of human rights.

·      NTDs can be particularly destabilizing and disrupt agricultural productivity and food security. Many poor societies with high NTD burdens have been recently engaged in a civil or international conflict or are currently at war.

·      Sustained involvement by the WHO and other international health agencies is crucial for current and future NTD control and elimination efforts.

·      Nothing is more important to the success of global NTD control than the involvement of communities themselves and disease-endemic countries’ health ministries.

·      Achievement of Millennium Development Goal 8 (”develop a global partnership for development”) will rest with stakeholders — health ministries, affected communities, public–private partnerships, large and small non-governmental organizations, etc. — establishing a well-functioning international strategy for NTD control.

While acknowledging that policymakers are “slowly beginning to appreciate the importance of NTDs” — evidenced by the creation of a new department of Neglected Tropical Diseases at the World Health Organization; TDR’s 10-year strategic plan; and the identification, by NIH’s Francis Collins, of neglected diseases as a research priority, among other developments — Hotez and Pecoul argue that the challenge of NTDs calls for a manifesto — “a public declaration of motives by a government or by a person or group regarded as having some public importance.”

Moreover, they add, by doing more to tackle NTDs, the global health community can make progress toward Millennium Development Goals.

“[NTD control] activities have facilitated the delivery of additional interventions such as insecticide-treated bed nets, antimalarial drugs, micronutrients, and childhood immunizations,” they write.

The authors urge scientists working on NTDs to increase collaboration and identify funding opportunities and cost-efficient interventions.

“By highlighting important challenges in the fight against NTDs, this ‘manifesto’ calls on the global community for urgent, renewed, and innovative efforts.”

Reference
1. Spiegel JM, Dharamsi S, Wasan KM, Yassi A, Singer B, et al. (2010) Which New Approaches to Tackling Neglected Tropical Diseases Show Promise? PLoS Med 7(5): e1000255. Available from: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000255

Perhaps the world’s most vocal advocate for the control of neglected diseases, Hotez is constantly coming up with creative arguments to engage and connect with a US audience far removed from the diseases in question. Writing in Scientific American last December, for example, he appealed to Americans’ consumption savvy by making the case for a global economic incentive for defeating NTDs and by marketing an investment in their control as a public health “best buy”.

“Now Hotez is trying a different tack to make Americans care. Writing in the Times (”Parasites in Paradise”), he points out that, in fact, Americans are not as far removed from neglected diseases of poverty as many of them might have thought. Leptospirosis lurks in their own big cities, and close to three million African-Americans suffer from toxocariasis, a parasitic worm infection transmitted by dogs. And then there’s the Caribbean, where a host of other parasites all but unknown in “paradise” - Chagas’ disease, schistosomiasis, and hookworm to name just a few - have thrived ever since the slave trade.

And here, Hotez introduces yet another angle, this one sure to resonate with American readers on both sides of the political aisle: disease as vestige of slavery and racism. Indeed, if there’s one thing with the potential to raise awareness through the roof - even for something as obscure and forgettable as “trichomoniasis” - it’s the notion that racism is in some way responsible.

Hotez says most of the neglected diseases in the Caribbean could be controlled or eliminated for an estimated $20 million a year, “a total that is roughly equivalent to one dollar for every tourist who visits there ever year”. He adds that the Sabin Vaccine Institute, in collaboration with the World Health Organization and the Interamerican Development Bank, is working to find that funding.

[Prof Hotez was also the subject of a recent TropIKA.net Profile article.]

The second edition of Sources and prices of selected medicines for children lists sources and prices for 75% of the 612 formulations needed for the 240 medicines in the Essential Medicines List for Children.

WHO and UNICEF note that more than half of the nine million preventable deaths in children annually are caused by diseases which could be treated with safe essential child-specific medicines: acute respiratory infections - pneumonia (17%), diarrhoeal diseases (17%), neonatal severe infections (9%), malaria (7%), and HIV/AIDS (2%).
The number of sources for the paediatric treatment of diarrhoea and HIV/AIDS is, however, limited and there is a serious challenge to obtain child-specific medicines to treat tropical infections endemic in Africa and Asia. There are few manufacturers who produce child-specific medicines to treat infections such as filariasis, schistosomiasis and soil-transmitted helminthiases.

A commentator on the website Essentialdrugs.org notes that, “UNICEF and WHO could not find a manufacturer for 144 of the 612 needed formulations. Is it lack of commercial markets? Or is it that there is not yet enough demand? Here is a good opportunity for the pharmaceutical industry to show some corporate social responsibility!”

PLoS NTDs has interviewed Dr Kabatereine in his office at the Vector Control Division (VCD) of Uganda’s Ministry of Health in Kampala, where he spoke to the journal about his career - including his work on schistosomiasis and soil-transmitted helminthiases - and his enthusiasm for the integrated approach to NTD control.

The first of four papers reviews elimination and control programmes. Subsequent papers will describe the integration, mapping, and financing of international control initiatives. The series is introduced by a commentary article from David Molyneux of the Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, who is well known as an active campaigner for action against NTDs to be stepped up. A podcast and a profile of Professor Molyneux also form part of the series.

The Lancet is not an open-access journal. However, as with many of its articles on global health topics, the series may be viewed freely online. (Registration is required.)

The interview with Dr Biritwum is available on GhanaWeb.

Established in 2002, the Human Hookworm Vaccine Initiative (HHVI) is an international product development partnership based at the Sabin Vaccine Institute. The Institute’s website includes a section devoted to HHVI, which provides comprehensive information on the initiative. The initiative is also described in an article published last month Case Studies for Global Health. (Thirty-one other case studies are also featured in this publication, all of them related to diseases that have a disproportionate impact on developing countries.)