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FamiliesUSA The Neglected Tropical Diseases

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1 FamiliesUSA The Neglected Tropical Diseases
Peter Hotez MD PhD FAAP The George Washington University Sabin Vaccine Institute

2 The Millennium Development Goals (MDGs)
The 2000 Millennium Declaration The Millennium Development Goals (MDGs) 1.      Eradicate extreme poverty and hunger. 2.      Achieve universal primary education. 3.      Promote gender equality and empower women. 4.      Reduce child mortality. 5.      Improve maternal health. 6.      Combat HIV/AIDS, malaria and other diseases. 7.      Ensure environmental sustainability. 8.      Develop a global partnership for development.

3 The Neglected Tropical Diseases “Ancient Afflictions of Stigma and Poverty” Core Group of 13
Protozoan Infections African Trypanosomiasis Chagas Disease Leishmaniasis Bacterial Infections Buruli Ulcer Leprosy Trachoma Helminth Infections Ascariasis Hookworm Infection Trichuriasis Schistosomiasis Lymphatic Filariasis Onchocerciasis Dracunculiasis

4 The Most Common Infections of Poor People
Disease Number of Cases Population at-risk Ascariasis 807 million 4.2 billion Trichuriasis 604 million 3.2 billion Hookworm 576 million Schistosomiasis 200 million 0.6 billion Lymphatic Filariasis 120 million 1.0 billion Trachoma 84 million 0.5 billion Onchocerciasis 18-37 million 0.1 billion Leishmaniasis 12 million 0.4 billion Chagas Disease 8-9 million 0.025 billion Leprosy 0.4 million ND Trypanosomiasis 0.3 million Dracunculiasis 0.01 million

5 Neglected Tropical Diseases COMMON FEATURES
The Most Prevalent Infections of Poor People Up to half of the 2.7 billion people who live on less than $2 per day Rural areas (slums and poor urban areas) of low-income countries Non-Emerging Ancient Conditions Indigenous Populations Chronic Conditions Disabling Conditions Growth Delays Blindness Disfigurement Stigma Poverty Promoting Conditions Child development and education Pregnancy outcome Productive capacity

6 Leishmaniasis Onchocerciasis Buruli Ulcer

7 “It’s quite a problem for me when I have to stand at work for long periods.”

8 “I am a fisherman. I can’t work continuously
“I am a fisherman. I can’t work continuously. I am ill every other week with renewed pain.”

9 “My parents brought me two suitors but neither decided to marry me.”

10 Lymphatic Filariasis in Sri Lanka

11 Ranking of Communicable Diseases By DALYs
Disease Condition Disease Burden HIV-AIDS million Neglected Tropical Diseases 56.6 million Malaria million Tuberculosis million Hotez PJ, Molyneux DH, Fenwick A, Ottesen E, Ehrlich Sachs S, Sachs JD PLoS Medicine 2006; 3: e102

12 Version 2.0: Integrating Neglected Tropical Disease Control

13 Low Cost of Interventions
$0.03 to $0.50 for each individual disease intervention… <$0.50 for packaged intervention – delivery costs for donated drugs

14 Global Network for Neglected Tropical Diseases
Schistosomiasis Control Initiative International Trachoma Initiative Helen Keller International Liverpool School - GAELF Human Hookworm Vaccine Initiative Earth Institute at Columbia Univ. Task Force for Child Survival Mectizan Donation Program Albendazole Donation Program Mebendazole Donation Program

15 New NTD Control Projects
The Global Network for Neglected Tropical Disease Control 8 / 56 Countries Geneva Global Burundi Rwanda Exxon Mobil Equatorial Guinea USAID Burkina Faso Ghana Mali Niger Uganda

16 The Buzz on NTDs “Comprehensive, Africa-wide control of malaria and NTDs together would probably cost no more than $3 billion a year, or just two days of Pentagon spending. If each of the billion people in the rich world devoted the equivalent of one $3 coffee a year to the cause, several million children every year would be spared of death and debility, and world would be spared the grave risks when disease and despair run unchecked. A new Global Network for Neglected Tropical Disease Control is helping make this opportunity a reality.” - Jeffrey Sachs, Director of the Earth Institute, Scientific American January 2007 “The world is now paying attention to these [neglected] diseases and making progress in unprecedented ways, with ambitious goals, excellent interventions, and growing evidence of multiple benefits for health. The attention to long-neglected diseases is a positive sign that health is a responsibility shared by the international community.” Dr. Margaret Chan, Director-General of the World Health Organization “It quickly became clear that this story is not just about the staggering numbers of the world’s citizens overwhelmed by HIV, AIDS, TB, and malaria. And it’s not just the story about one billion people who are afflicted with disabling, oftentimes stigmatizing, neglected tropical diseases, such as human hookworm infection and elephantiasis… it’s all about the faces of dying children and sick mothers who haunt those who have seen them...What struck me, and what I think struck us all…that these challenges are all interconnected.” - Clinton Global Initiative, Closing Remarks

Hookworm Re-Infection HHVI Human Hookworm Vaccine Initiative Product Development Partnership Sabin Vaccine Institute George Washington University FIOCRUZ Instituto Butantan London School Hyg. Trop. Med. Queensland Inst. Med. Res Low efficacy of Mebendazole Re-infection within 4-12 mos Diminishing efficacy

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