The Neglected NTDs

By: Alanna Shaikh

The public discourse around the neglected tropical diseases focuses almost entirely on the developing world. We talk about the NTD belt in Africa, helminthes in Asia, Chagas in Latin America. We hardly ever, though, think about at the NTDs in the wealthy world. What do they look like, then, in the places we don’t expect them? According to Peter Hotez and Meredith Gurwith, not great. In a July 2011 article published in the Public Library of Science, they look at Europe’s NTD burden, and the results are frustrating but illuminating.

It’s an interesting view on our new world of wealth distribution. We’re moving away from rich and poor countries. What we have, instead, are rich and poor communities. And the poor communities of Europe, just like the poor communities of Africa – or the United States – are afflicted with neglected tropical diseases. They are truly diseases of poverty and not geography. More than 20 percent of the population of Europe – 165 million people lives below poverty thresholds, and that’s where you find the NTDs.

Eastern Europe and Turkey bear the biggest helminth burden, high enough to cause concerns about cognitive development among children. This stems from several causes. They’re the poorest countries in Europe, and they’ve faced the most hardship. The Balkans lost ground on health care during the extensive regional conflict, and the former Soviet bloc countries suffered as they tried to develop health structures without the leadership and financial support of Moscow.

However, it’s not just Europe’s poorest countries that face NTDs. It’s also poor people in the wealthy countries. Thirteen percent of schoolchildren in Italy have been found to have chikungunya in 2007, following the arrival of a single infected traveler from India. Roma children throughout Europe have very low vaccination rates and in addition, “High exposure to intestinal parasites, bacteria, and viruses are of particular concern, and a high prevalence of giardiasis, shigellosis and salmonellosis, and hepatitis A, respectively, have been reported, as well as selected respiratory and ectoparasitic infestations, especially pediculosis” (Hotez & Gurwith, 2011).

The lessons we take from this are the same lessons we take from almost all NTD case studies. You can control – and eliminate – most NTDs with good public health efforts and sufficient funding. You need a solid health system to really make that happen. Poverty is bad for health, and poor health breeds poverty. Globalization has made sure that we all share all our infectious diseases with each other and borders are meaningless in that context.

And finally, most importantly we can’t afford to ignore the poor. Because social justice is a moral imperative, and because sooner or later their suffering becomes our own.

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.

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