By: Alanna Shaikh
At first glance, the new focus on cardiovascular and non-communicable diseases looks like trouble for the funding for things like neglected tropical diseases. They’re very different ailments, and they affect different populations. In a world of limited funding for global health, no matter how often we advocate to increase the whole pool, in reality funding for one disease almost always comes at the expense of another. Plus, the two acronyms are really similar and someone might get confused.[i]
Luckily, that conflict is mostly superficial. NCDs and NTDs have much more in common than their initials.
1) They occur in the same countries. That’s part of our weird new globalized world. You can’t divide types of sickness into rich versus poor any more. To some degree you can look at urban versus rural, but even that division isn’t especially hard and fast. The NTD Belt of Central Africa also faces rising rates of diabetes and cardiovascular problems. So the same doctors, clinics, and health care systems are addressing both sets of problems.
2) Both categories of disease tend to take a stealth approach to destroying health. Diabetes, cancer, and high blood pressure all have long symptomless incubation periods before they start to do visible damage. So do guinea worm, leprosy, and many helminthes. Both kinds of illness, therefore, rely on mass screenings to detect disease, and need to look at large populations when considering diagnosis and treatment. The treatment approach often requires long-term treatment regimes even in the absence of life-affecting symptoms, and requires a powerful commitment from the patient to staying on their treatment.
3) Finally, NTDs and NCDs both include a large proportion of diseases with environmental causes. In the case of NTDs, that means helminthes transmitted by soil or water. In the case of NCDs, it includes air pollution, poor access to opportunities for exercise, or a city dominated by fast food outlets with few opportunities to get healthy food. In both cases, the solution lies in individual behavior change and environmental amelioration. To prevent NTDs, people need to wear shoes, treat their drinking water so it’s safe, and refrain from swimming or wading in infected water sources or clean drinking water sources (to prevent contamination) – among other things. To prevent NCDs, people need to make different food choices, avoid smoking and tobacco products, refrain from drinking alcohol, and engage in physical activity. Both groups of diseases also require control over the environment – eliminating mosquito habitats and treating water sources, for example, or reducing air pollution and regulating urban environments.
Obviously, the other thing that NCDs and NTDs have in common is that they are both terms for a wide range of diseases with different causes, effects, and mortality rates. Any generalization of the kind I just did is bound to have exceptions. But I think I’ve made a decent case for the surprising commonalities between non-communicable diseases and Neglected Tropical Diseases. Those commonalities also mean that there is a single approach that will help to fight both kinds of disease.
Stay tuned for my next post to find out what that is…
[i] You think I’m kidding. I wish. These are totally the kinds of mistakes that get made.
Alanna Shaikh is an expert in health consulting, writing about global health for UN Dispatch and about international relief and development at Blood & Milk. She also serves as a frequently contributing blogger to ‘End the Neglect.’ The views and opinions expressed by guest bloggers are not necessarily the views and opinions of the Global Network. All opinions expressed here are Alanna’s own and not those of any employer or the US government.