Neglected Diseases or Neglected People?
Neglected tropical diseases (NTDs) are a diverse group of communicable diseases endemic to tropical and subtropical regions, primarily affecting subsistence communities with limited access to healthcare, hence the term 'neglected'.
The WHO has identified 17 diseases, many of which also form a sub-category of Skin_NTDs, and these include lymphatic filariasis (LF), Buruli ulcer, Cutaneous leishmaniasis, Leprosy (Hansen's disease), Scabies, and Yaws (bacterial ulcerations).
Many NTDs are vector-borne and have animal reservoirs with complex life cycles. These factors layered onto a background of poverty and inadequate housing, and in the absence of locally available specialty health services, make public-health control in NTDs extremely challenging.
The Global Impact of Neglected Populations
The WHO defines Neglected Tropical Diseases as
"A diverse group of communicable diseases associated with devastating health, social and economic consequences."
More than 1 billion people are in need of immediate interventions, while 1.6 billion are at risk.
Despite their significant health burden, NTDs have historically received limited attention from global health initiatives compared to other diseases such as malaria, tuberculosis, and HIV/AIDS.
However, addressing NTDs is critical to achieving the United Nations Sustainable Development Goal (SDG) 3, which aims to ensure healthy lives and promote well-being for all.
LKN Foundation efforts fit within Target 3.3, combating communicable diseases. In particular we work toward achieving Indicator 3.3.5: the number of individuals needing interventions for neglected tropical diseases.
Our work also contributes toward Target 3.8: Achieve universal health coverage, specifically Indicator 3.8.1: Coverage of essential health services.
NTDs impose a considerable socioeconomic burden, perpetuating cycles of poverty and inequality. They often lead to chronic disability, stigma, and reduced productivity, affecting individuals' quality of life and broader community development. Among the NTDs, lymphatic filariasis (LF) and podoconiosis are prominent causes of lymphoedema, leading to significant morbidity and disability.
Lymphatic Filariasis and Podoconiosis: A Statistical Perspective
Lymphatic filariasis, is a parasitic infection caused by filarial worms transmitted through mosquito bites. Many people will be infected without significant symptoms, but 25 million men are suffering from hydrocele, and 15 million people have filariasis-related lymphoedema, causing significant physical, social, and psychological challenges.
Podoconiosis, is a non-infectious form of lymphoedema caused by prolonged exposure to irritant soils, and mainly affects barefoot farmers in volcanic highland areas of Ethiopia, Cameroon, Uganda, and Rwanda. An estimated 5 million individuals live with the devasting consequences of untreated podoconiosis and both forms of lymphoedema disproportionately impact marginalised communities, compounding the challenges faced by those already living in poverty.
WHO’s Morbidity Management and Disability Prevention (MMDP) Pillar
The WHO’s Global Program to Eliminate Lymphatic Filariasis (GPELF) aims to interrupt disease transmission through Mass drug Administration (MDA), and manage morbidity among those already affected. The Morbidity Management and Disability Prevention (MMDP) pillar is a cornerstone of the program, addressing the long-term care needs of individuals with existing disease, lymphoedema and hydrocele.
Whereas hydrocele can be cured with surgery, lymphoedema management is life, requiring ongoing health services and community support. Since lymphoedema management is essentially the same regardless of cause, the WHO recommend that both L:F and podoconiosis affected communities be included in the LF-MMDP program in co-endemic regions.
Key Components of the MMDP Strategy:
1. Lymphedema Management: Providing education on hygiene practices, early detection of acute attacks, and self-care to prevent disease progression.
2. Integrated Service Delivery: Strengthening health systems to deliver sustainable care and reduce stigma associated with disfigurement and disability.
3. Community Engagement Involving affected individuals and their communities in awareness-raising and advocacy efforts.
Progress and Challenges
Significant strides have been made under the GPELF initiative. Since its launch in 2000, the number of people at risk has declined by 74%.
Effort is now need to scale up morbidity management services to match the strides taken in MDA delivery. Particularly in delivering timely lymphoedema self-care education to affected families to intervene early and prevent significant disability.
Many challenges remain. Endemic countries often face resource constraints, conflict or famine. Meanwhile the stigma and lack of awareness continue to hinder care-seeking behaviour among affected populations. Strengthening partnerships, mobilising resources, and integrating MMDP services into primary healthcare systems are essential to overcoming these barriers.
LKN Foundation are doing their part to address this complex global health issue.
We provide quality, evidenced-based information on lymphoedema-care into the hands of the people who need it.
World NTD Day
January 30 is the 6th anniversary of the 2012 London Declaration on NTDs, which unified partners around the globe to push for greater investment and action to end Neglected Tropical Diseases.
You can join LKN in pushing back against the stigma, disability and neglect of lymphoedema. We have programs in Ethiopia and Bangladesh where a few Australian dollars can make a huge difference to a family struggling to even buy and extra bar of soap to keep their lymphoedema clean.
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