Preventive chemotherapy as a strategy for elimination of neglected tropical parasitic diseases: endgame challenges.

Abstract

Global efforts to address neglected tropical diseases (NTDs) were stimulated in January 2012 by the London declaration at which 22 partners, including the Bill & Melinda Gates Foundation, World Bank, World Health Organization (WHO) and major pharmaceutical companies committed to sustaining and expanding NTD programmes to eliminate or eradicate 11 NTDs by 2020 to achieve the goals outlined in the recently published WHO road map. Here, we present the current context of preventive chemotherapy for some NTDs, and discuss the problems faced by programmes as they consider the 'endgame', such as difficulties of access to populations in post-conflict settings, limited human and financial resources, and the need to expand access to clean water and improved sanitation for schistosomiasis and soil-transmitted helminthiasis. In the case of onchocerciasis and lymphatic filariasis, ivermectin treatment carries a significant risk owing to serious adverse effects in some patients co-infected with the tropical eye worm Loa loa filariasis. We discuss the challenges of managing complex partnerships, and maintain advocacy messages for the continued support for elimination of these preventable diseases.

• Authors: Moses J Bockarie, Louise A Kelly-Hope, Maria Rebollo, David H Molyneux
• Journal: Philosophical transactions of the Royal Society of London. Series B, Biological sciences (Philos Trans R Soc Lond B Biol Sci) Vol. 368 Issue 1623 Pg. 20120144 (Aug 05 2013) ISSN: 1471-2970 [Electronic] England
• PMID: 23798692 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Disease Eradication (methods)
• Drug Therapy (economics, methods)
• Humans
• International Cooperation
• Neglected Diseases (epidemiology, prevention & control)
• Parasitic Diseases (epidemiology, prevention & control)
• Public Health (methods, trends)
• Tropical Medicine (methods, trends)