Winning the War Against Ancient Diseases

CNN/ Newswire | 4/19/2017, 8:17 a.m.
The World Health Organization is on track to meet its goals to control, eliminate or eradicate sleeping sickness, Chagas and ...
Elephantiasis of leg due to filariasis.

African trypanosomiasis or sleeping sickness, is a possibly fatal parasitic infection spread by tsetse flies. Chagas disease, which can progress from no symptoms to heart inflammation, is an infection transmitted by contaminated food, insects and a variety of other routes. Visceral leishmaniases attacks the internal organs, while cutaneous leishmaniases causes face ulcers, disfiguring scars and disability. Both these forms of leishmaniases are transmitted by female sandflies.

The aim of medical interventions, then, is to help people early "because sometimes when you're too late, you cannot change much anymore," said Engels.

"There's also a group of diseases that you can actually treat preventatively," said Engels, such as worm diseases. "The principle here is with a few worms you can live happily, it's only when you have too many that you start to get problems and you actually develop a disease," he explained.

"So for diseases like elephantiasis, Guinea worm disease, schistosomiasis, the intestinal worms and trachoma, you can regularly treat people with safe, single dose drugs and then they never actually build up a worm load that could cause them problems," said Engels.

Schistosomiasis is a larval worm infection transmitted by contact with infested water. Trachoma is a blinding infection spread by contact with discharge from the nose or eye.

Trachoma is the world's leading infectious cause of blindness and has been eliminated as a public health problem in Oman, Morocco and Mexico over the past 10 years, according to the new WHO report. At the same time, more than 185,000 trachoma patients have benefited from surgery.

Using medical interventions, then, "you can either treat whole communities, or you can treat specific groups like school-aged children through the schooling system, but if you keep on treating them, they never develop the symptoms anymore," said Engels.

"What has contributed enormously to that progress was the help we have received from the private sector," said Engels, noting that pharmaceutical companies donated medicines to the cause.

In addition to medical interventions, the WHO also recommends three "supportive interventions," said Engels: vector (carrier of disease) control, veterinary public health, and provision of water and sanitation.

All three are "fundamentally preventive" and "deal with the root causes of the neglected tropical diseases," said Engels. Not only do the poor lack appropriate housing in many cases, they often live in close proximity to their livestock and animals, they live in circumstances where mosquitoes, parasites and other disease-causing agents thrive, and they lack access to water and sanitation. A preventative intervention, then, might be improving a community's water system or building better houses.

"Here we're counting a lot on the new development framework," said Engels. The World Bank has developed a framework for infrastructure and social development. As Engels sees it, the neglected tropical diseases can be used "as a proxy for poverty," so if investments go "as a matter of priority to the poorest areas, then we can envisage that these diseases will be eliminated, or near eliminated, by 2030."

Engels' claims are not just wishful thinking, they are supported by hard numbers. In the Region of the Americas, for instance, only 12 reported deaths were attributable to rabies in 2015. Meanwhile, the WHO recorded well under 3,000 cases of sleeping sickness in 2015 -- a considerable decline from 37,000 new cases reported in 1999.