Neglected diseases no longer neglected?

When was the last time you heard about someone getting hookworm? Or leprosy? You might have thought these diseases were relegated to the history books. But they are still affecting people today – they’re hidden in the poorest parts of the world. And according to the World Health Organization (WHO), 1 billion people, or 2/3 of people who live on under $2 a day, suffer from these forgotten and neglected diseases.

Neglected Tropical Diseases (yes, these diseases are technically called “neglected”), which include hookworm, leprosy, and also lesser known diseases like river blindness and Chagas disease, are finally getting some attention. The WHO released its first-ever report on neglected tropical diseases late last week, shining a spotlight on problems that have long lingered in the darkness of poverty.

A few months ago, I spoke with Dr. Peter Hotez, president of the Sabin Vaccine Institute and co-founder of the Global Network for Neglected Tropical Diseases. We talked about how these diseases – despite the label of “tropical” – also exist in the United States, in poor areas like post-Katrina New Orleans, along the border of Mexico, and Appalachia. Regardless of where they’re found and how they are caused, Dr. Hotez said that there’s one overwhelming determinant to getting a neglected disease: Poverty.

“So there’s something about poverty that is making people susceptible to these infections,” Hotez told me. “It’s not clear to me that there’s one particular factor – poor housing, poor sanitation, lack of access to clean water, poor nutrition. More likely it’s some combination of these factors.”

Children can pick up disease-causing worms by playing around where stray dogs have left feces behind. Parasitic infections are often spread by insects infesting homes. Other diseases can come from bad meat. And the diseases frequently go undiagnosed, because the symptoms can be so similar to other diseases, Hotez said. A parasitic infection can appear to be asthma at first look, and many doctors aren’t trained to look for neglected diseases.

But one of the most interesting – and tragic – things about these diseases is that they  anchor people in poverty. They can cause developmental delays in children, have negative impacts on pregnancies, and leave people unable to work. “These infections not only occur in the setting of poverty, but they are actually causing poverty,” Dr. Hotez said.  “They’re basically preventing the poor people from achieving full potential, because of the impact on child development, pregnancy outcome, and worker productivity.” The WHO report mentions that the diseases are one of the factors preventing entire countries from reaching the Millennium Development Goals.

When we talked, Dr. Hotez told me that it was a struggle to get funding to develop life-saving vaccines. But with the WHO report, and the power yielded by that organization, things are looking up. WHO says that controlling the 17 diseases they identify is “feasible” and they’ve launched a campaign to achieve that goal. Several large pharmaceutical companies have made  pledges of drugs and support to help eliminate these diseases.

For Dr. Hotez, it’s likely that the attention hasn’t come a moment too soon. He told me, “Very sadly, these problems have been ignored because they occur because people have no voice. We need to now give them a voice.”