Chapter 12 : Repairing the World

Abstract:

The neglected tropical diseases (NTDs) are the most common infections of the world’s poorest people, in whom they cause chronic disability and disfigurement on a massive and, at times, almost unimaginable scale. Through their poverty-promoting impact on child development, pregnancy outcome, and worker productivity, the NTDs represent a major reason why poor people cannot lift themselves out of poverty and why the low-income countries where they live cannot economically advance. Therefore, a global assault on the NTDs through both widespread deployment of rapid-impact packages and the simultaneous development and implementation of new control tools could one day become a highly productive application of medical science and public health for repairing the world. The basis by which conflict has promoted the reemergence of human African trypanosomiasis (HAT) and other vector-borne NTDs has been reviewed, and at least four key determinants have been identified. They include (i) economic and global effects, such as abandonment or appropriation of land, collapse of local economies, and the purging of educated and business elite, all of which lead to an interruption of public health services; (ii) a decline in specific health services, especially collapse in vector control programs; (iii) forced migration and internal displacement of populations, with resulting decreased access to health facilities, as well as land abandonment, regrowth of vegetation, and increased vector habitat; and (iv) regional insecurity and restricted access for external humanitarian support. A new government-academic-industrial enterprise devoted to NTDs offers an unprecedented new opportunity for reducing global poverty and repairing the world.