Upholding Germany’s Historic Commitment to Poverty-Related and Neglected Diseases

by Peter J. Hotez and Neeraj Mistry

The German Bundestag has an opportunity to make unprecedented commitments toward the treatment and prevention of the world’s most common poverty-related diseases — a group of debilitating infections known as the neglected tropical diseases (NTDs). They include ancient scourges linked to poverty such as elephantiasis, river blindness, blinding trachoma, schistosomiasis, roundworm, whipworm and hookworm. Today, these NTDs are among the most common afflictions of the poor, and almost every person living in abject poverty suffers from at least one NTD. New research has shown that these NTDs, because of their long-standing effects on the mental and physical health of children and adults but especially girls and women, now rank among the most important reasons why people cannot escape poverty in the “global south,” including Africa and the Middle East, Asia and Latin America.

A man receives medications to prevent neglected tropical diseases

Prince Marah takes ivermectin and albendazole at Levuma community health center in Levuma, Sierra Leone.

For more than 150 years, German science has provided leadership in tropical medicine that makes it possible today to discuss the eventual global elimination of the NTDs. Theodor Bilharz discovered the cause of schistosomiasis (also known as bilharziasis) while working in Egypt in the 1850s; Otto Henry Wucherer conducted studies in Brazil in the 1860s that helped discover Wuchereria bancrofti, which causes 90 percent or more of elephantiasis cases; and Arthur Looss at the turn of the 20th century co-discovered the cause of hookworm, also in Egypt.

Then, in 2005, the Deutsche Gesellschaft für Technische Zusammenarbeit (GTZ) and the World Health Organization organized a landmark conference in Berlin to integrate the control and elimination of the most common NTDs by combining mass treatments for these diseases in a simple “rapid impact package” of medicines. Today those low-cost (less than one Euro per person annually) packages have reached at least 450 million people. As a result, we are now seeing major reductions in the global prevalence of elephantiasis, river blindness and blinding trachoma. Thus, a decade following that historic Berlin meeting, we have the opportunity to eliminate at least these three NTDs.

The Berlin conference also promoted the importance of research and development so that today new interventions are underway including a human hookworm vaccine now in clinical trials in Gabon through a European HOOKVAC Consortium that includes both the Sabin Vaccine Institute’s product development partnership and the Institut für Tropenmedizin, Universitätsklinikum Tübingen. In the 19th century, both Bilharz and Wucherer trained in Tübingen.

The German Bundestag now has a significant opportunity to build on these successes. New legislation to support non-profit product development partnerships to produce new drugs, diagnostics, and vaccines could create a new generation of ground breaking technologies for the world’s poverty related diseases. In parallel, Germany can join the governments of the United States and United Kingdom in supporting the delivery of low-cost rapid impact packages, now recognized as one of the most cost effective global health interventions known.

Earlier this year, Chancellor Angela Merkel also delivered a historic address to the World Health Assembly about the important role the Group of 7 (G7) nations could have in eliminating NTDs. Her call to the G7 to take on NTDs can now be backed with time-sensitive action. The German Bundestag should reassert its historic commitment to these diseases, in the research and development space and for mass treatment. In so doing, Germany can lead efforts to finish the job it began more than a century ago.

Peter Hotez, M.D., Ph.D., is president of the Sabin Vaccine Institute (Sabin), Texas Children’s Hospital Endowed Chair for Tropical Pediatrics and dean of the National School of Tropical Medicine at Baylor College of Medicine. He also serves as U.S. Science Envoy for the White House and State Department.

Neeraj Mistry, M.D., M.P.H., is managing director of the Global Network for Neglected Tropical Diseases, an initiative of Sabin.

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