What is the issue?
- South Asian region has recorded a notable progress in eliminating and containing various diseases.
- However, the status of neglected tropical diseases (NTDs) in the South Asian region calls for a last-mile push.
What are the health achievements in South Asia?
- Maternal and neonatal tetanus has been eliminated.
- HIV, TB and malaria epidemics have been halted and reversed after decades of struggle.
- These will hopefully be ended altogether in the coming years.
- Regional - India is now yaws-free.
- Maldives, Sri Lanka and Thailand have eliminated lymphatic filariasis as a public health problem.
- Nepal is in the process of validating the elimination of trachoma as a public health problem.
- Nepal also maintained the elimination target for kala-azar for more than 3 consecutive years.
- By the end of 2017, 100% of sub-districts in Bangladesh and 90% of blocks in India had done the same.
- As a whole, the region remains responsible for the world’s largest preventive chemotherapy campaign.
What are the shortfalls?
- NTDs include diseases like leprosy, trachoma, lymphatic filariasis and kala-azar.
- As the name suggests, NTDs take their most severe toll on the poor and marginalised communities.
- The political influence of these sections is limited and their health needs are often overlooked.
- Evidently, South Asian region has eliminated leprosy as a public health problem.
- But the disease continues to circulate among vulnerable communities.
- They accounts for more than 60% of leprosy-caused grade two disabilities worldwide.
- Similarly, several member countries have eliminated lymphatic filariasis.
- However, its burden continues to haunt communities in remote and hard-to-reach areas elsewhere.
- Region-wide, 53% of all people require mass drug administration to stay free of this disfiguring disease.
What is the way forward?
- No member country of the South Asian region can be complacent as one of the 20 NTDs is endemic to each of them.
- Stable domestic funding for national programmes is central to taking forward the progress achieved so far.
- Member countries must ensure programming is both dynamic and flexible i.e. pursuing large-scale campaigns as well as working creatively across sectors.
- Going for mass drug administration where appropriate and strengthening NTD-related services at the primary level are essential.
- Simultaneously, specific efforts such as roping in agro-engineers in the battle against schistosomiasis can be taken up.
- Similarly, vector control must be actively pursued and harnessed by programmes at the local level.
- These can have immediate and substantial impact on disease transmission in NTD-affected areas.
- Importantly, member countries should take full advantage of innovations in research and technology.
- The effective use of rapid diagnostics can facilitate swift and accurate diagnosis of a range of NTDs.
- IT infrastructure should be integrated with existing surveillance systems to allow programme managers to gather, analyse and act on real-time data.
- Ensuring all communities have access to health services and the benefits they provide is essential to make them free of NTDs.
Source: Business Line
Quick Fact
Preventive Chemotherapy Campaign
- This is a public health strategy recommended by WHO against a set of Neglected Tropical Diseases.
- Preventive Chemotherapy consists of the regular, large-scale administration of drugs, either alone or in combination.
- It is administered to entire population groups, with the aim of reducing transmission and associated morbidity.
Lymphatic filariasis
- Lymphatic filariasis is commonly known as elephantiasis.
- It is caused by infection with parasites classified as nematodes (roundworms), which are transmitted to humans through mosquitoes.
- Mosquitoes are infected with microfilariae by ingesting blood when biting an infected host.
- Infection is usually acquired in childhood causing hidden damage to the lymphatic system.
- Its visible manifestations may occur later in life, causing temporary or permanent disability.
Schistosomiasis
- Schistosomiasis is an acute and chronic disease caused by parasitic worms.
- People are infected during routine agricultural, domestic, occupational, and recreational activities, which expose them to infested water.
- Water contamination due to excreta containing parasite eggs, which hatch in water, is also a mode of transmission.
Trachoma
- Trachoma is a disease of the eye caused by infection with the bacterium Chlamydia trachomatis.
- It causes blindness or visual impairment. It is the cause for about 1.4% of all blindness worldwide.
- Blindness from trachoma is irreversible.
- Environmental risk factors influencing the transmission of the disease include:
- poor hygiene
- crowded households
- water shortage
- inadequate latrines and sanitation facilities
Kala-azar
- Visceral leishmaniasis (VL), also known as kala-azar, is caused by the protozoan Leishmania parasites.
- It is transmitted to humans through infected sandflies.
- The parasite migrates to the internal organs such as the liver, spleen, and bone marrow; if left untreated, it may result in death.
- It is characterized by irregular bouts of fever, weight loss, enlargement of the spleen and liver, and anaemia.
- It is endemic to the Indian subcontinent in 119 districts in four countries (Bangladesh, Bhutan, India and Nepal).