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

The report comes from the Pacific nation of Vanuatu, where the disease had been thought to have been eradicated. Tests by researchers have, however, indicated that it is once again present, though perhaps in a milder form than previously. The authors of the study suggest that use of oral azithromycin to treat cases would be appropriate, as such treatment could easily be incorporated into primary health care activities.

Reference
1. Fegan D, Glennon MJ, Thami Y, Pakoa G (2010). Resurgence of yaws in Tanna, Vanuatu: time for a new approach? Trop Doct; 40(2):68-69.

The interview with Dr Biritwum is available on GhanaWeb.

Médecins Sans Frontières (MSF), which is working in the conflict zone, says a quarter of women undergoing antenatal and post-natal care have tested positive for treponematosis. This group of infections includes both syphilis and other non-sexually transmitted diseases such as yaws. Provincial health officer Elizabeth Samama said the women could have yaws as it is known to exist in the area. Given that yaws most commonly infects children, it does seem likely that most of these women are infected with syphilis. Nevertheless, MSF has stressed the importance of further testing.

Yaws can progress to cause major damage to bone and cartilage and is known to be re-emerging in poor, rural and marginalised populations in Africa, Asia and South America.

It is therefore encouraging to note that UNICEF, in its media releases for this year’s Day of the African Child is featuring a ten-year-old Congolese boy who is receiving yaws treatment.

It is not clear whether UNICEF has any plan to attempt to restart yaws eradication efforts but anything which highlights the disease is a step in the right direction.

A recent review article on yaws has been highlighted on TropIKA.net.

Ghana is known to be one of the countries where yaws eradication efforts have failed; 26,000 cases were reported there nationally in 2005. Based on the experience of West Akim, it is possible that the figure may have increased. An article featured on TropIKA.net last year pointed out that no global estimate of yaws prevalence is available. The author of this article argued that, while it seems to be increasing, the disease would be one of the easiest to eradicate worldwide.