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      The cross-cutting contribution of the end of neglected tropical diseases to the sustainable development goals

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          Abstract

          The Sustainable Development Goals (SDGs) call for an integrated response, the kind that has defined Neglected Tropical Diseases (NTDs) efforts in the past decade.

          NTD interventions have the greatest relevance for SDG3, the health goal, where the focus on equity, and its commitment to reaching people in need of health services, wherever they may live and whatever their circumstances, is fundamentally aligned with the target of Universal Health Coverage. NTD interventions, however, also affect and are affected by many of the other development areas covered under the 2030 Agenda. Strategies such as mass drug administration or the programmatic integration of NTD and WASH activities (SDG6) are driven by effective global partnerships (SDG17). Intervention against the NTDs can also have an impact on poverty (SDG1) and hunger (SDG2), can improve education (SDG4), work and economic growth (SDG8), thereby reducing inequalities (SDG10). The community-led distribution of donated medicines to more than 1 billion people reinforces women’s empowerment (SDG5), logistics infrastructure (SDG9) and non-discrimination against disability (SDG16). Interventions to curb mosquito-borne NTDs contribute to the goals of urban sustainability (SDG11) and resilience to climate change (SDG13), while the safe use of insecticides supports the goal of sustainable ecosystems (SDG15). Although indirectly, interventions to control water- and animal-related NTDs can facilitate the goals of small-scale fishing (SDG14) and sustainable hydroelectricity and biofuels (SDG7).

          NTDs proliferate in less developed areas in countries across the income spectrum, areas where large numbers of people have little or no access to adequate health care, clean water, sanitation, housing, education, transport and information. This scoping review assesses how in this context, ending the epidemic of the NTDs can impact and improve our prospects of attaining the SDGs.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s40249-017-0288-0) contains supplementary material, which is available to authorized users.

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          Schistosomiasis and water resources development: systematic review, meta-analysis, and estimates of people at risk.

          Peter Steinmann, Jennifer Keiser, Robert Bos … (2006)
          An estimated 779 million people are at risk of schistosomiasis, of whom 106 million (13.6%) live in irrigation schemes or in close proximity to large dam reservoirs. We identified 58 studies that examined the relation between water resources development projects and schistosomiasis, primarily in African settings. We present a systematic literature review and meta-analysis with the following objectives: (1) to update at-risk populations of schistosomiasis and number of people infected in endemic countries, and (2) to quantify the risk of water resources development and management on schistosomiasis. Using 35 datasets from 24 African studies, our meta-analysis showed pooled random risk ratios of 2.4 and 2.6 for urinary and intestinal schistosomiasis, respectively, among people living adjacent to dam reservoirs. The risk ratio estimate for studies evaluating the effect of irrigation on urinary schistosomiasis was in the range 0.02-7.3 (summary estimate 1.1) and that on intestinal schistosomiasis in the range 0.49-23.0 (summary estimate 4.7). Geographic stratification showed important spatial differences, idiosyncratic to the type of water resources development. We conclude that the development and management of water resources is an important risk factor for schistosomiasis, and hence strategies to mitigate negative effects should become integral parts in the planning, implementation, and operation of future water projects.
          Article 0 comments Cited 756 times – based on 0 reviews     Review now
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            Estimating the Global Burden of Endemic Canine Rabies

            Katie Hampson, Laurent Coudeville, Tiziana Lembo … (2015)
            Background Rabies is a notoriously underreported and neglected disease of low-income countries. This study aims to estimate the public health and economic burden of rabies circulating in domestic dog populations, globally and on a country-by-country basis, allowing an objective assessment of how much this preventable disease costs endemic countries. Methodology/Principal Findings We established relationships between rabies mortality and rabies prevention and control measures, which we incorporated into a model framework. We used data derived from extensive literature searches and questionnaires on disease incidence, control interventions and preventative measures within this framework to estimate the disease burden. The burden of rabies impacts on public health sector budgets, local communities and livestock economies, with the highest risk of rabies in the poorest regions of the world. This study estimates that globally canine rabies causes approximately 59,000 (95% Confidence Intervals: 25-159,000) human deaths, over 3.7 million (95% CIs: 1.6-10.4 million) disability-adjusted life years (DALYs) and 8.6 billion USD (95% CIs: 2.9-21.5 billion) economic losses annually. The largest component of the economic burden is due to premature death (55%), followed by direct costs of post-exposure prophylaxis (PEP, 20%) and lost income whilst seeking PEP (15.5%), with only limited costs to the veterinary sector due to dog vaccination (1.5%), and additional costs to communities from livestock losses (6%). Conclusions/Significance This study demonstrates that investment in dog vaccination, the single most effective way of reducing the disease burden, has been inadequate and that the availability and affordability of PEP needs improving. Collaborative investments by medical and veterinary sectors could dramatically reduce the current large, and unnecessary, burden of rabies on affected communities. Improved surveillance is needed to reduce uncertainty in burden estimates and to monitor the impacts of control efforts.
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              Household catastrophic health expenditure: a multicountry analysis.

              Christopher Murray, Lewis Evans, J Klavus … (2003)
              Health policy makers have long been concerned with protecting people from the possibility that ill health will lead to catastrophic financial payments and subsequent impoverishment. Yet catastrophic expenditure is not rare. We investigated the extent of catastrophic health expenditure as a first step to developing appropriate policy responses. We used a cross-country analysis design. Data from household surveys in 59 countries were used to explore, by regression analysis, variables associated with catastrophic health expenditure. We defined expenditure as being catastrophic if a household's financial contributions to the health system exceed 40% of income remaining after subsistence needs have been met. The proportion of households facing catastrophic payments from out-of-pocket health expenses varied widely between countries. Catastrophic spending rates were highest in some countries in transition, and in certain Latin American countries. Three key preconditions for catastrophic payments were identified: the availability of health services requiring payment, low capacity to pay, and the lack of prepayment or health insurance. People, particularly in poor households, can be protected from catastrophic health expenditures by reducing a health system's reliance on out-of-pocket payments and providing more financial risk protection. Increase in the availability of health services is critical to improving health in poor countries, but this approach could raise the proportion of households facing catastrophic expenditure; risk protection policies would be especially important in this situation.
              Article 0 comments Cited 305 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Mathieu Bangert:
                ORCID: http://orcid.org/0000-0003-1320-8145
                bangertm@who.int
                David H. Molyneux: david.molyneux@lstmed.ac.uk
                Steve W. Lindsay: s.w.lindsay@durham.ac.uk
                Christopher Fitzpatrick: fitzpatrickc@who.int
                Dirk Engels: engelsd@who.int
                Journal
                Journal ID (nlm-ta): Infect Dis Poverty
                Journal ID (iso-abbrev): Infect Dis Poverty
                Title: Infectious Diseases of Poverty
                Publisher: BioMed Central (London )
                ISSN (Electronic): 2049-9957
                Publication date (Electronic): 4 April 2017
                Publication date PMC-release: 4 April 2017
                Publication date Collection: 2017
                Volume: 6
                Electronic Location Identifier: 73
                Affiliations
                [1 ]ISNI 0000000121633745, GRID grid.3575.4, Department of Control of Neglected Tropical Diseases, , World Health Organization, ; 20 Avenue Appia, 1211 Geneva, Switzerland
                [2 ]ISNI 0000 0004 1936 9764, GRID grid.48004.38, Department of Parasitology, , Liverpool School of Tropical Medicine, ; Liverpool, UK
                [3 ]ISNI 0000 0000 8700 0572, GRID grid.8250.f, Department of Biosciences, , Durham University, ; Durham, UK
                Author information
                http://orcid.org/0000-0003-1320-8145
                Article
                Publisher ID: 288
                DOI: 10.1186/s40249-017-0288-0
                PMC ID: 5379574
                PubMed ID: 28372566
                SO-VID: 567db3ea-b671-4a19-9fc8-67eba1b7059d
                Copyright © © World Health Organization. 2017
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution IGO License (< http://creativecommons.org/licenses/by/3.0/igo/legalcode>), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. In any reproduction of this article there should not be any suggestion that WHO or this article endorse any specific organization or products. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.

                History
                Date received : 26 December 2016
                Date accepted : 16 March 2017
                Categories
                Subject: Scoping Review
                Custom metadata
                issue-copyright-statement © The Author(s) 2017

                Keywords: neglected tropical diseases,sustainable development goals
                Data availability:
                Keywords: neglected tropical diseases, sustainable development goals

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