By Ambassador Donald J. Planty
Latin America and the Caribbean (LAC) have made impressive economic, political and social strides since the “Lost Decade” of the 1980s. Economies are more developed and diversified, education and health are improving, democratic systems are more prevalent and more people are moving into the middle class. Despite this economic and political progress, the region still faces enormous challenges. Too many people are poor, income distribution is skewed and governments do not invest enough in education and health. Without providing for more educated and healthier populations, countries are automatically putting the brakes on creating more equitable societies in the future.
This is particularly the case in health and manifests itself in the devastating consequences of neglected tropical diseases (NTDs) that are felt every day in the lives of more than 200 million people in LAC.
What Are NTDs and Why Are They Important?
NTDs are a group of parasitic and bacterial diseases that afflict 1.4 billion people around the world, the majority of whom live on less than US $1.25 per day. NTDs are considered diseases of “neglected people” because they primarily affect the most marginalized communities, who often live in remote areas and have little voice in national affairs. Control and elimination of these diseases are critical to a society’s well being.
NTDs disproportionately burden women and children and can cause blindness, disfigurement, disability, severe malnutrition and anemia. If left untreated, NTDs can impair physical and cognitive development and can lead to adverse pregnancy outcomes such as low birth weight. These diseases also take a toll on mental health and diminish human and social capital since people suffering from NTDs are often stigmatized and isolated.
NTDs are an obstacle to economic development, resulting in billions of dollars in lost wages and decreased economic productivity. When parents or other family members are infected with or disabled by NTDs, children often have to take on chores, work outside the home and other responsibilities that keep them from going to school.
The burden of NTDs on social, economic, and human development in LAC is largely hidden from political leaders and policymakers.
What about Resources?
The good news is that controlling and eliminating NTDs in Latin America and the Caribbean is achievable. Cost effective, proven interventions are available. The Inter-American Development Bank and the Global Network for Neglected Tropical Diseasesto launch a major effort to fight NTDs in LAC.
For as little as 50 cents per person per year, we can prevent and treat the most common intestinal parasites in Central America. The majority of the necessary treatments for NTDs are either donated or available at an extremely low-cost, making the prevention, treatment and elimination of NTDs a ‘best buy’ in global health. Furthermore, by coupling deworming with access to clean water, proper sanitation and hygiene education currently ongoing in many countries, intestinal worm infections can be drastically reduced.
The Central America region is currently on track to controlling and eliminating neglected infectious diseases 2015; however, additional resources—both technical and financial—are necessary to scale up deworming to meet coverage levels recommended by the World Health Organization. A commitment of US$5 million over 5 years would ensure an integrated, comprehensive approach to soil transmitted helminthes (STH) control in Central America.
Building on the region’s strong history of implementing successful programs to defeat polio, measles and rubella, Central American countries are now well poised to address the treatment gap for children affected by intestinal parasites. Together, with heightened political will and deepened commitment by key partners and people affected, we can truly end the neglect of these diseases.
Donors from around the world have also increased their commitments in response to the renewed efforts of endemic countries. The largest partnership to date, the London Declaration on NTDs, was announced in January 2012, by pharmaceutical companies, bilateral aid agencies, and other public and private sector partners. These partners pledged to work together to control or eliminate 10 NTDs by 2020 by increasing drug donations, research and development, and bilateral support for NTD programs around the world. With the new and existing pledges totalled, companies committed an average of 1.4 billion treatments each year to those in need, but unfortunately, few South American countries have applied to request support.
Needed: Political Action
Because these diseases are not immediately life threatening and are largely diseases of poverty, NTDs do not attract the attention of political leaders. As a result, few countries have national plans to attack NTDs. The issue, then, is twofold: how to garner the attention of political leaders and how to find and allocate resources to alleviate the situation.
In order to control and eliminate NTDs in LAC by 2015, countries must recommit themselves to launching effective national programs. This recommitment must include 1) preparing and enacting national plans for the elimination of NTDs, 2) defining the distribution networks to be used for delivering medications and 3) monitoring and evaluating the effectiveness of the treatments.
LAC countries should also include the issue of NTDs on the agendas of the various regional summits that take place periodically in the region. Given the prevalence of NTDs in Central America, the issue should become a prominent agenda item for upcoming meetings of the Central American Presidents in the SICA (Central American Regional Integration System) process. Similarly, NTDs should make the agenda of the UNASUR Presidents, the Ibero-American Summit and other high-level regional meetings.
The final step is for Presidents, Prime Ministers and Ministers of Health to avail themselves of the moral and material resources available to support the planning and implementation of national action plans. Unlike so many other issues facing political leaders today, this is one problem that can be resolved. What national leader would not like to report to the people that, under his or her administration, millions of children will grow up to lead healthy lives and have the chance to become able and productive citizens.