Transcript Presentation by Mr. Denis Daumerie, World Health Organization, Neglected Tropical Diseases Department

Neglected Tropical Diseases
Hidden and silent : Key problems
 Complacency, lack of information and commitment
 The poor, with little political voice, suffer most
 Not perceived as a threat to western society
 Incapacitating more than killing
 Low profile in public health priorities
 Negative image, complicated names and complex
strategies
1|
Global distribution: the burden
divides the
world in two
.
Approximately 1 billion people are affected by more than one of NTDs
2|
Large scale interventions
Lymphatic filariasis
Leprosy
Onchocerciasis
Schistosomiasis
Helminthiasis
Trachoma
Yaws
Case management and
development of new tools
Human African trypanosomiasis
Chagas diseases
Buruli ulcer
Leishmaniasis
3|
Rapid Impact Interventions
Improving access
Focused interventions
Improving innovation
The importance of the Right to health
for the control of NTDs
 Advocacy: Participation of Paul Hunt in two international meetings on NTDs, and several
meetings in WHO. Goodwill Ambassador Mr Sasakawa
 Help scientific community to focus thinking on strategies adapted to the local reality: Berlin
and Bangalore
 Assessment at country level...Mission report in Uganda
 Specific recommendations to Governments, private sector, NGOs and international
community
 If integrated into policies, programmes and projects, the right to health helps to ensure that
they are evidence-based, robust, sustainable, equitable and meaningful to those living in
poverty.
 Key role of the civil society, NGOs and people affected by NTDs
4|
The case of Leprosy
Leprosy is considered shameful and people hid their symptoms for fear
of ostracism despite free and effective multidrug treatment.
5|
Leprosy situation in 2008
 Between 1985 and 2008, more than 15 million cases
have been cured with MDT. The number of persons
registered for treatment fell from 5.4 million in 1985 to
250 000 in 2008.
 Global case detection continues to fall every year
 Only 3 countries remain with prevalence rates above 1
per 10,000 population (1985: 122 countries): Brazil,
Nepal and Timor Leste)
6|
Registered prevalence by WHO Region
in 2007 and 2008, and % change*
Region
Prevalence at
beginning of 2007
Prevalence at
beginning of 2008
% change from
2007 to 2008
Africa
29 548
30 055
+1.71%
Americas
64 715
49 388
-23.68%
3 986
4 240
+6.37%
South East Asia
116 663
120 967
+3.69%
Western Pacific
9 805
8 152
-16.86%
224 717
212 802
-5.30%
East Mediterranean
World
* Patients registered for treatment, excluding Europe
7|
New case detection by WHO Region
in 2006 and 2007, and % change*
Region
Cases detected
during 2006
Cases detected
during 2007
% change from
2006 to 2007
Africa
34 480
31 037
- 9.99%
Americas
47 612
41 978
- 11.83%
3 261
4 091
+ 25.45%
South East Asia
174 118
171 552
- 1.47%
Western Pacific
6 190
5 867
- 4.20%
265 661
254 525
- 4.19%
East Mediterranean
World
* excluding Europe
8|
Milestones in MDT treatment
 Multidrug therapy (MDT) recommended as a standard
treatment for leprosy by WHO in 1982, contains
rifampicin, clofazimine and dapsone
 1986: only 5% of registered patients on MDT
 1991: World Health Assembly resolution to eliminate
leprosy as a public health problem
 1995: WHO started global supply of high quality MDT
free of cost
 1998 onwards : 100% of registered cases on MDT
9|
MDT changes the face of leprosy
 Highly effective - cures patients in 6 – 12 months
 Single MDT dose renders patient non-infectious
 Best way to prevent disabilities through early cure
 Treatment is safe with few side effects
 No drug resistance following MDT has yet been reported
 The numbers of relapses after treatment remains very low, at
less than one case per 1,000 patients per year.
10 |
But still a long way to go
 Stigma and discrimination are still present in developed and
developing countries
 An estimated one million persons live with severe disabilities
and are highly vulnerable
 Despite the medical progress and information, a significant
number of countries have regulations aiming at isolating,
limiting access to work, public transport, international travel,
divorce
11 |
Key features of a right to health approach to
neglected diseases
 Community participation
 Fighting stigma and discrimination
 Research and development
 An integrated health system that is responsive to local priorities
 Monitoring and accountability: monitor and hold to account
national and international actors in the public and private sectors.
The guiding question should be: have all duty-bearers done all they
reasonably can to promote and protect the right to health of those
suffering from, or vulnerable to, neglected diseases?
12 |