By: Vino Sundaram, MPH Candidate, Case Western Reserve University

India and Southeast Asia is of great interest to me due to my Indian decent.  My trips to India have shown me first hand how NTD’s have severely impacted rural, impoverished areas of India…it’s truly a heartbreaking sight.  As a public health student, I have a strong interest in socioeconomics and health outcomes on a global level.  Anyone who studies this field knows that it has been long established that poor socioeconomic status leads to increased rates of several diseases, with NTD’s among that list.  However, recently I came across a published article discussing the increasing burden of NTD’s in South Asia and India despite an a 7% economic growth in 2010.  As you can imagine, my eyebrows went “huh?”

The article went into great detail about the increasing number of cases in this region and an analysis of each individual disease.  South Asian countries make up one-fourth of all soil-transmitted helminth infections (the largest number being in India), at least one-third of global rabies deaths, and at least half of the global cases of lymphatic filariasis, visceral leishmaniasis, and leprosy.  Soil-transmitted helminth diseases have a large impact on children who are school-age with schoolteachers being the most responsible for administering meds to the affected children.  Often, children with this disease are unable to attend school or be productive workers for their families. (Note: In impoverished areas of India, the children often are pulled from school so that they can work to bring in income for a struggling family.  In turn, diseases that impact children and teenagers have a huge impact on the socioeconomic status of a household.)  Lymphatic filariasis has a large impact on worker productivity…India loses $1 billion dollars a year due to lymphatic filariasis.  Visceral leishmaniasis (VL) has had a similar effect on the region.  Because of the high price of treatments, families are forced to spend most of their income on treatments.  Therefore, there is a propagation of poverty that takes place due to this illness.  Also, similarly to lymphatic filariasis, it affects children and worker productivity.

It appears that the authors of the article suggest that there needs to be better management of NTD programs, specifically in this region of the world.  I definitely agree.  It is important to have management that involves people that are from the community being affected.  South Asia and India are regions that have gotten a great deal of attention from outside sources for their severe disease prevalence and incidence.  However, unfortunately, that same attention is not received from sources within the region.  In my opinion, this is a big part of the problem.  Governments, organizations, and medical facilities need to understand and realize how critical these diseases are.  This is not to downplay what has already been done, because there has been a lot of improvement.   Great efforts have been made to decrease incidence of these cases with a good amount of success. However much more work needs to be done.  Funding is critical; however, management and sustainability of programs is just as important.  It is also important to have the people of the community involved with their own preventative measures.  From a policy standpoint, the governments in these regions need to recognize the severity of their NTD problems.  If there is not involvement and support from the government, then economic improvements will not trickle down to health outcomes.  The non-profit organizations involved in NTD prevention need to be running at optimal efficiency so that funding and cases of disease are handled properly.  South Asia and India are facing a major disconnect between economic growth and conquering of NTD’s.  It will take more involvement from the government and from the people themselves in order to eventually eradicate these diseases.

As an Indian, I know that the region has so much potential to contribute great things to the world.  However, if the region itself does not help its own people to fight illness, then they will never help India and neighboring countries fulfill that potential.