Neglected Tropical Diseases and its Impact on Indigenous People

The World Health Organization (WHO) recognizes 20 “neglected tropical diseases” (NTDs)[1]. These diseases share key common features, including disproportionately affecting poor communities and individuals with little social or political capital.

While all 20 NTDs are preventable—and to varying degrees, treatable—they nonetheless affect over one billion people worldwide living in 149 countries and territories [2]. At least 100 countries are endemic for two or more diseases, and 30 countries are endemic for six or more [1]. NTDs also predominately affect those who are most disadvantaged—individuals living in low-income countries are most burdened with NTDs, and within those countries, the burden of NTDs is higher among poorer households. The people in these communities often live in inadequate housing, lack access to clean water and sanitation, and have little protection from insects and other disease vectors [1].

NTDs are both a cause and a consequence of poverty, causing physical and intellectual impairments, preventing children from attending school, and reducing economic productivity [3]. They can also be severely stigmatizing: for example, lymphatic filariasis causes swelling (lymphedema) in 40 million people and, as with the deformations resulting from Buruli ulcer and yaws, can be socially exclusionary, often affecting individuals’ ability to work, to marry, and to care for and live with their families [4]. Fear of the disfiguring effects of leprosy and a centuries-long ignorance of the disease have resulted in individuals being shunned or exiled by their communities [5]. 

Recognition of the underinvestment in the response to NTDs, relative to their significant health, economic, and social impacts, has led to increased global attention and commitment to their control and elimination. In May 2013, the World Health Assembly adopted a resolution calling on WHO member states to intensify efforts to address NTDs, with the goal of reaching previously established targets for the elimination or eradication of 11 NTDs. The resolution also called for the integration of NTD efforts into primary health services and universal access to preventive chemotherapy and treatment. NTDs were subsequently included in Sustainable Development Goal (SDG) 3, adopted in September 2015, which calls for an end to the “epidemics of AIDS, tuberculosis, malaria and NTDs” by 2030 [6]

Public health practitioners working for NTD control and elimination can benefit from understanding how to integrate human rights principles into their programs and how engagement with human rights mechanisms, such as special rapporteurs and expert committees related to international human rights treaties, can complement the medical and clinical aspects of their interventions [ibid.]. 

References:

1.Working to Overcome the Global Impact of Neglected Tropical Diseases. (2024). Google Books. //books.google.co.in/books?hl=en&lr=&id=Sh6x7aybTk8C&oi=fnd&pg=PP2&ots=xsl0iAcOHx&sig=BIgWLp4tDckv8J137UMUkhveyGs&redir_esc=y#v=onepage&q&f=false

2. Neglected tropical diseases.  //www.cdc.gov/globalhealth/ntd.  US Centers for Disease Control and Prevention. 

3. Hotez P.J., Fenwick A., Savioli L.. Molyneux D. H.. “Rescuing the bottom billion through control of neglected tropical diseases,” Lancet. 373(9674):1570–1575. and. pp. [PubMed] [Google Scholar]

4. Stienstra See Y., van der Graaf W. T. A., Asamoa K.. van der Werf T. S.. “Beliefs and attitudes towards Buruli ulcer in Ghana,” American. Journal of Tropical Medicine and Hygiene. 2007;85(6):421–500. and. 67/2 (2002), pp. 207–213; A. Rinaldi, “Yaws: A second (and maybe last?) chance for eradication,” PLoS Neglected Tropical Diseases 2/8 (2002), p. e275; S. Wynd, W. D. Melrose, D. N. Durrheim, et al., “Understanding the community impact of lymphatic filariasis: A review of the sociocultural literature,” Bulletin of the World Health Organization. pp. [PubMed] [Google Scholar]

5. Human Rights Council, Progress report on the implementation of the principles and guidelines for the elimination of discrimination against persons affected by leprosy and their family members, UN Doc. 2016. A/HRC/AC/17/CRP.1.

6. Sun, N., & Amon, J. J. (2018). Addressing Inequity: Neglected Tropical Diseases and Human Rights. Health and Human Rights, 20(1), 11–25. //www.ncbi.nlm.nih.gov/pmc/articles/PMC6039727/#r9

ibid.

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Neglected Tropical Diseases are prevalent among the people living in extreme poverty in sub-Saharan Africa, Asia, Latin America, and the Caribbean. However, Among the impoverished population known as the bottom billion, neglected tropical diseases (NTDs) lead to enduring infections that can last for years or even decades. These diseases give rise to chronic disabilities, negatively impacting child growth, intellectual and cognitive development, pregnancy outcomes, and overall worker productivity. Consequently, the adverse effects extend beyond health, affecting childhood education and economic productivity, thereby perpetuating poverty within the bottom billion. Additionally, many NTDs induce blindness and disfigurement, causing profound psychological distress and social stigma. Despite the significant morbidity, economic setbacks, and social consequences, NTDs generally result in high-morbidity but low mortality conditions, highlighting the enduring and debilitating nature of these diseases.

The World Health Organization (2010) identifies conditions as neglected tropical diseases (NTDs) based on several observations:

• NTDs serve as indicators of poverty and disadvantage to the Indigenous population
• They impact the Indigenous population with limited visibility and political representation;
• They typically have localized prevalence;
• They contribute to stigma and discrimination, particularly affecting girls and women, with significant implications for morbidity and mortality;
• They receive comparatively little attention in research efforts; and
• They are susceptible to control, prevention, and potentially elimination through effective and feasible interventions.

Reference:

Hotez, P. J. (2021). Forgotten people, forgotten diseases: the neglected tropical diseases and their impact on global health and development. John Wiley & Sons.

Neglected tropical diseases (NTDs) includes parasitic, fungal bacterial, and non-communicable diseases largely prevalent across the globe (1). NTDs are known as neglected as these diseases are majorly absent or neglected. They are majorly seen in global south in poor and under-developed countries in regions where quality of water, poor health access and sanitation issues are not paid attention (2)

The number of NTDs cases has enlarged from 1990 to 2019 indicating it is still a public health problem (3). Dengue for instance has been reported which can cause effects on individuals and a country’s economy (4). Developing countries like India also suffer from various NTDs (2). It is noteworthy that these diseases cause significant consequences on health and socio-economic indicators (5) and hence needs to be addressed. A lot many strategies have been include to reduce the risk and emergence of NTDs. One approach is one health approach which aids in monitoring of disease. (6,7)

However, Literature indicates, NTDs are still not a priority, and there are not enough prevention and treatment options resulting in increased burden on public health worldwide. Recent research indicates interventions including rehabilitation, reducing stigma and enhancing mental well-being is necessary as the communities require support and quality healthcare to achieve health for all (8).  It also has been noted that several publications are happening related to NTDs in US and UK, however there is a gap in developing countries like Brazil and India indicating a need to solve the community problems and offer solutions (2) in order to reduce the impact of indigenous people.

1. Wang W, Li J and Habib MR (2023) Editorial:Innovative tools to support the elimination of neglected tropical diseases (NTDs). Microbiol. 14:1208113. doi: 10.3389/fmicb.2023.1208113
2. Swapan Kumar Patra, Akash Adhikary. (2023). India’s Contribution in Neglected tropical diseases: A Scientometrics Study. Qeios. doi:10.32388/WRJP0G.
3. Lin, Y., Fang, K., Zheng, Y., Wang, H. L., and Wu, J. (2022). Global burden and trends of neglected tropical diseases from 1990 to 2019. J. Travel Med. 29, taac031. doi: 10.1093/jtm/taac031
4. The Global Health Observatory. Reported number of people requiring interventions against NTDs. World Heal. Organ. 2021. // www. who. int/ data/ gho/ data/ indic ators/ indic ator-​detai ls/ GHO/ repor ted-​numberof-​people-​requiring-​inter venti ons-​again st-​ntds. Accessed 1 Mar 2021.
5. Bai J, Li W, Huang YM, Guo Y. Bibliometric study of research and development for neglected diseases in the BRICS. Infectious Diseases of Poverty. 2016 Dec;5(1):1-0.
6. Pike J, Bogich T, Elwood S, Finnoff DC, Daszak P. Economic optimization of a global strategy to address the pandemic threat. Proc Natl Acad Sci USA. 2014;111:18519–23.
7. Berthe FCJ, Bouley T, Karesh WB, Le Gall FG, Machalaba CC, Plante CA, et al. One Health—Operational framework for strengthening human, animal and environmental public health systems at their interface. Washington, D.C.; 2018.
8. Rie R Yotsu, L Claire Fuller, Michele E Murdoch, Chandrakant Revankar, Yves Thierry Barogui, Venkata Ranganandha Rao Pemmaraju, Jose-Antonio Ruiz-Postigo, Daniel Argaw Dagne, Kingsley Asiedu, Roderick J Hay, World Health Organization strategic framework for integrated control and management of skin-related neglected tropical diseases: what does this mean for dermatologists?, British Journal of Dermatology, Volume 188, Issue 2, February 2023, Pages 157–159,  //doi.org/10.1093/bjd/ljac031

Neglected Tropical Diseases (NTDs) are a group of diseases that are prevalent in tropical areas, where they thrive among people living in impoverished communities. They are caused by a variety of pathogens including viruses, bacteria, parasites, fungi and toxins, and are responsible for devastating health, social and economic consequences.  Indigenous people (An estimated 370 million people are today classified as belonging to Indigenous or Aboriginal groups) are disproportionately affected by NTDs due to their limited access to healthcare, poor sanitataion, and lack of education (1).

Infectious illnesses disproportionately impact Aboriginal people, including skin infections (e.g., impetigo and tungiasis), eye infections (e.g., trachoma), and ear infections (e.g., acute and chronic otitis), dental caries, respiratory and urinary tract infections, and diarrheal diseases.

The impact of NTDs on indigenous people is multifaceted. It affects their physical and mental health, social and economic well-being, and cultural identity. NTDs can cause disfigurement, disability, and death, leading to a loss of productivity and income. They can also lead to social stigma and discrimination, which can further marginalize indigenous people (2).

To manage NTDs, it is essential to address the root causes of poverty, inequality, and lack of access to healthcare and education. This requires a comprehensive approach that involve governments, non governmental organizations, and communities working together to improve the health and well-being of indigenous people. NTDs have a significant impact on indigenous people, and addressing this issue requires a concerted effort from all stakeholders. By working together, we can ensure that indigenous people have access to the healthcare, education, and resources they need to lead healthy and fufilling lives (2).

References

1. Hotez, P. J. (2014). Aboriginal Populations and Their Neglected Tropical Diseases. PLOS Neglected Tropical Diseases, 8(1), e2286–e2286. //doi.org/10.1371/journal.pntd.0002286

2. World. (2021, July 27). Neglected tropical diseases -- GLOBAL. Who.int; World Health Organization: WHO. //www.who.int/health-topics/neglected-tropical-diseases#tab=tab_2

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