FN’s sundhedsorganisation rapporterer om store fremskidt i kampen mod oversete tropesygdomme

Hedebølge i Californien. Verdens klimakrise har enorme sundhedsmæssige konsekvenser. Alligevel samtænkes Danmarks globale klima- og sundhedsindsats i alt for ringe grad, mener tre  debattører.


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Laurits Holdt

De oversete tropesygdomme

Below is a short description of the neglected tropical diseases:

Dengue: mosquito-borne viral disease causing flu-like illness. Occasionally develops into a lethal complication called severe dengue.

Rabies: viral disease transmitted to humans through the bites of infected dogs. Invariably fatal once symptoms develop.

Trachoma: infection transmitted through direct contact with eye or nasal discharge. Causes irreversible corneal opacities and blindness.

Buruli ulcer: debilitating skin infection causing severe destruction of the skin, bone and soft tissue.

Yaws: chronic bacterial infection affecting mainly the skin and bone.

Leprosy: caused by infection mainly of the skin, peripheral nerves, mucosa of the upper respiratory tract and eyes.

Chagas disease: infection transmitted through contact with vector insects, ingestion of contaminated food, infected blood transfusion, congenital transmission, organ transplantation or laboratory accidents.

Human African trypanosomiasis (sleeping sickness): parasitic infection spread by bites of tsetse flies. Almost 100% fatal without prompt diagnosis and treatment.

Leishmaniases: transmitted through the bites of infected female sandflies. In its most severe (visceral) form, it attacks the internal organs. The most prevalent (cutaneous) form causes face ulcers, disfiguring scars and disability.

Taeniasis and neurocysticercosis: infection by adult tapeworms in human intestines; cysticercosis occurs when humans ingest tapeworm eggs that develop as larvae in tissues.

Dracunculiasis (guinea-worm disease): nematode infection transmitted by drinking-water contaminated with parasite-infected water fleas.

Echinococcosis: infection caused by larval stages of tapeworms forming pathogenic cysts. Transmitted to humans through ingestion of eggs, shed in faeces of dogs and wild animals.

Foodborne trematodiases: infection acquired by consuming fish, vegetables and crustaceans contaminated with larval parasites.

Lymphatic filariasis: Infection transmitted by mosquitoes causing abnormal enlargement of limbs and genitals from adult worms inhabiting and reproducing in the lymphatic system.

Mycetoma: debilitating, disabling bacterial/fungal skin infection thought to be caused by the inoculation of fungi or bacteria into the subcutaneous tissue.

Onchocerciasis (river blindness): parasitic eye and skin disease, transmitted by the bite of infected blackflies. Causes severe itching and eye lesions, leading to visual impairment and permanent blindness.

Schistosomiasis: larval worm infection. Transmission occurs when larval forms released by freshwater snails penetrate human skin during contact with infested water.

Soil-transmitted helminthiases: group of intestinal helminth infections transmitted through soil contaminated by human faeces.

Kilde: WHO

GENEVA, 19 APRIL, 2017 (WHO): WHO reports remarkable achievements in tackling neglected tropical diseases (NTDs) since 2007. An estimated 1 billion people received treatment in 2015 alone.

“WHO has observed record-breaking progress towards bringing ancient scourges like sleeping sickness and elephantiasis to their knees,” said WHO Director-General, Dr Margaret Chan. “Over the past 10 years, millions of people have been rescued from disability and poverty, thanks to one of the most effective global partnerships in modern public health”.

The WHO report, Integrating neglected tropical diseases in global health and development, demonstrates how strong political support, generous donations of medicines, and improvements in living conditions have led to sustained expansion of disease control programmes in countries where these diseases are most prevalent.

Since 2007, when a group of global partners met to agree to tackle NTDs together, a variety of local and international partners have worked alongside ministries of health in endemic countries to deliver quality-assured medicines, and provide people with care and long-term management.

In 2012, partners endorsed a WHO NTD roadmap, committing additional support and resources to eliminating 10 of the most common NTDs.

Key achievements include:

  • 1 billion people treated for at least one neglected tropical disease in 2015 alone.
  • 556 million people received preventive treatment for lymphatic filariasis (elephantiasis).
  • More than 114 million people received treatment for onchocerciasis (river blindness: 62% of those requiring it.
  • Only 25 human cases of Guinea-worm disease were reported in 2016, putting eradication within reach.
  • Cases of human African trypanosomiasis (sleeping sickness) have been reduced from 37 000 new cases in 1999 to well under 3000 cases in 2015.
  • Trachoma – the world’s leading infectious cause of blindness – has been eliminated as a public health problem in Mexico, Morocco, and Oman. More than 185 000 trachoma patients had surgery for trichiasis worldwide and more than 56 million people received antibiotics in 2015 alone.
  • Visceral leishmaniasis: in 2015 the target for elimination was achieved in 82% of sub-districts in India, 97% of sub-districts in Bangladesh, and in 100% of districts in Nepal.
  • Only 12 reported human deaths were attributable to rabies in the WHO Region of the Americas in 2015, bringing the region close to its target of eliminating rabies in humans by 2015.

However, the report highlights the need to further scale up action in other areas.

“Further gains in the fight against neglected tropical diseases will depend on wider progress towards the Sustainable Development Goals,” said Dr Dirk Engels, Director of the Department of Control of Neglected Tropical Diseases. Meeting global targets for water and sanitation will be key. WHO estimates that 2.4 billion people still lack basic sanitation facilities such as toilets and latrines, while more than 660 million continue to drink water from “unimproved” sources, such as surface water.

Meanwhile, global concern about the recent outbreaks of Zika virus disease, and its associated complications, has re-energized efforts to improve vector control. In May this year, the World Health Assembly will review proposals for a new Global vector control response. There are also brighter prospects to prioritize cross-sectoral collaboration to promote veterinary public health.

Global Partners’ Meeting

Integrating neglected tropical diseases in global health and development is being released at the Global Partners’ Meeting on Neglected Tropical Diseases (NTDs) in Geneva, on 19 April 2017.

The Meeting will celebrate efforts to “Collaborate. Accelerate. Eliminate”, and will be attended by health ministers, industry representatives, partners and a host of well-known personalities, including philanthropists, donors and stakeholders.

Besides celebrating 10 years of multi-stakeholder collaboration, the event will also mark the 5th anniversary of the WHO NTD Roadmap which established targets and milestones for the global control, elimination, and eradication of many of these diseases as well as that of the London Declaration.

London declaration on neglected tropical diseases

Rammer på landet, i slummen og i konfliktzoner

Neglected tropical diseases blind, maim, disfigure and debilitate hundreds of millions of people in urban slums and in the poorest parts of the world.

Once widely prevalent, these diseases are now restricted to tropical and sub-tropical regions with unsafe water, inadequate hygiene and sanitation, and poor housing conditions. Poor people living in remote, rural areas, urban slums, or conflict zones are most at risk.

More than 70% of countries and territories that report the presence of NTDs are low or lower-middle income economies.