Strategic and technical meeting on intensified control of neglected tropical diseases : a renewed effort to combat entrenched communicable diseases of the poor : report of an international workshop, Berlin, 18-20 April 2005

Overview

Infectious and parasitic diseases – most of which are preventable and/or treatable – remain the primary cause of death worldwide. International attention is currently focused on HIV/AIDS, malaria and tuberculosis, as well as on global health security. However, many other chronically endemic tropical diseases, which have a significant negative impact on the lives of poor populations, are still much neglected in the global public health agenda.

In 2003, WHO and Deutsche Gesellschaft für Technische Zusammenarbeit (GTZ) convened meeting in Berlin on the intensified control of neglected tropical diseases, which was an important milestone in defining a collective response against these diseases. It moved many forgotten diseases out of the shadows and on to the public health agenda. It made a strong case to tackle these diseases from various perspectives - economic, public goods and human rights. Tropical diseases are an important health problem for affected communities and health services.

This first meeting also provided the conceptual framework to move away from a purely disease-centred approach to one that is more sensitive to the health needs of communities. It essentially shifted the focus to neglected communities and to an integrated approach. Given the close links between these diseases and poverty, tackling them together could provide some of the “quick wins” for the achievement of many of the Millennium Development Goals. This opportunity was met with interest and readiness to act on the part of funding agencies.

This proactive approach to tackling neglected diseases would reach all at risk as a population-based intervention, and would attack transmission with a real promise of reducing the burden to locally manageable levels. Moreover, it is compatible with the human rights agenda as it is non-discriminatory and ethical. It is also a pro-poor strategy as it enhances human capital by protecting millions of people from debilitating diseases, with considerable collateral benefits on education and productivity.

Berlin II takes the vision a significant step forward to translate the paradigm shift from a disease oriented approach to an integrated one. Amid debates around the streamlining and coordination of activities, the involvement of other sectors in the provision of services, risks, caution, open issues, a bold new approach emerged. It established the framework for a menu that can be adapted to local needs and offered to policy-makers, health services and funding agencies. This integrated, yet flexible, approach can be implemented at a fraction of the cost for many other public health interventions. In addition to the direct health benefits, it provides a host of collateral benefits.

The shift from compartmentalized thinking to viewing the linkages across individual programmes, although intuitive, will be challenging in view of the plethora of partnerships and agencies involved. This process will require a radical change in thinking and moving out of individual areas of expertise towards collaboration with a range of institutions across disease areas on practical issues of implementation.

It is crucial that we now move towards translating the vision into reality and realize the tremendous impact of tackling tropical diseases on ill-health, disability and poverty.