Management of neglected tropical diseases now and in the future

Jyotirmoy Pal, MD, is a professor of medicine at R.G. Kar Medical College, Kolkata, India, and editor in chief of the South Asian edition of the McMaster Textbook of Internal Medicine.

What are the most important advances in the diagnosis, treatment, and prevention of tropical diseases in the past years? Can we expect any breakthrough in the treatment of neglected tropical diseases?

Neglected [diseases]… There is one segment where the World Health Organization (WHO) already coined the term “neglected tropical diseases.” Even in the tropical countries, few of the diseases get immense importance, but [a] few of the diseases do not get much importance, such as helminthiases or, for instance, kala-azar. Theseis diseases are basically considered diseases of the poor people. In tropical countries, we can divide the population into two 2 categories. As in most of the countries there’s massive economic growth—one segment is becoming richer and richer, while another segment remains poor—so some of the diseases are more prevalent in the poorer section because of the lack of education, lack of hygiene, poor health, infrastructures, governments giving less care to this zone. These are the diseases—dracunculiasis, then the worm infections, kala-azar—that are considered neglected tropical diseases.

So, these diseases... If you consider the economic burden, there is a huge economic burden of the neglected tropical diseases. That is why the WHO has warned all the tropical countries to give due importance to the neglected tropical diseases.

There is one more point I can mention, regarding research in the drugs. From the viewpoint of pharmaceutical companies, who basically invest in research of the new drugs, they do list ??no investments in the neglected tropical disease sector because profitability is very low. So, all the government agencies, nongovernment agencies (NGOs), nonprofit organizations, should put stress on these neglected tropical diseases, on disease diagnosis, on disease management, on drug discovery, and on vaccination, if at all applicable.