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Wednesday, 12 December 2012

Neglected Tropical Diseases: What Next?

Neglected Tropical Diseases and the Post-2015 Global Development Agenda

Part Two: What Next?

By E. Michelle Taylor and James Smith

Given the recent meeting of the high-level panel in London and high profile debate around both the success of the Millennium Development Goals (MDG) and what might supersede them, it is significant to reflect that the strides made in Neglected Tropical Disease (NTD) control in the first decade of 21st century were made despite the diseases’ effective omission from the MDGs. Does this mean that getting onto the post-2015 agenda is immaterial to the NTDs?

It is possible that Global Health post-2015 might be driven by new sets of partnerships and actors. For instance, it is instructive to look at exactly who has endorsed the London Declaration on NTDs. The bulk of signatories are pharmaceutical companies, DNDi has signed, as has the Bill and Melinda Gates Foundation. The only traditional donors to sign so far are USAID, DFID and the World Bank.

Regardless of the eventual configuration of the post-MDG world there will remain a powerful impetus to support the NTDs. The NTDs are now framed as a human rights issue; the drugs are being made available for free and therefore why would mass drug administration for NTDs amenable to such an approach not be undertaken?9  Eliminating these NTDs have been described as ‘low-hanging fruit’. This perspective may pose risks unless fully rooted in health systems strengthening. They may entrench a vertical and medicalised approach to the NTDs.

Furthermore, they risk bypassing, or neglecting, the other NTDs – those that are not easily managed or eliminated through mass drug administration. It is not clear whether there is yet enough debate, data or analytical tools to think through how to support the mix of vertical and horizontal approaches necessary to solidly root the low hanging fruit.

We are entering a period of increasingly complexity regarding Global Health. New partnerships are emerging, new actors – significantly the pharmaceutical sector and philanthropic organisations – are becoming more influential, and new alliances are emerging. We need to move beyond the disease binary generated by MDG 6 towards more horizontal approaches if we are to embed the gains made by NTD programmes to date.

Read Part 1: Jostling For Position

References

1 Shiffman J. Has donor prioritization of HIV/AIDS displaced aid for other health issues? Health policy and planning. 2008; 23(2): 95-100. 

2 Allen T, Parker M. The "other diseases" of the Millennium Development Goals: rhetoric and reality of free drug distribution to cure the poor's parasites. Third world quarterly. 2011; 32(1): 91-117.

3 Liese BH, Schubert L. Official development assistance for health–how neglected are neglected tropical diseases? An analysis of health financing. International Health. 2009; 1(2): 141-7.

4 World Health Organisation. The global burden of disease 2004 update. Geneva: World Health Organisation; 2004.

5 Adams J, Gurney KA, Pendlebury D. Thomson Reuters global research report: neglected tropical diseases. Leeds: Evidence Thomson Reuters; 2012.


6 London declaration on neglected tropical diseases. 2012. http://unitingtocombatntds.org/downloads/press/ntd_event_london_declaration_on_ntds.pdf [Accessed 20th November 2012].

7 World Health Organisation. Accelerating work to overcome the global impact of neglected tropical diseases: a roadmap for implementation. Geneva: World Health Organisation; 2012.

8 Buse K, Walt G. Global public-private partnerships: Part I--A new development in health? Bull World Health Organ. 2000; 78(4): 549-61.

9 Molyneux DH, Malecela MN. Neglected tropical diseases and the millennium development goals: why the "other diseases" matter: reality versus rhetoric. Parasites & vectors. 2011; 4: 234.

10 Chan M. Address to the Sixty-fifth World Health Assembly 21st May 2012. Geneva, Switzerland; 2012. 

11 Molyneux DH. The 'Neglected Tropical Diseases': now a brand identity; responsibilities, context and promise. Parasites & vectors. 2012; 5: 23.

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