neglected diseases


Another neglected disease: Cancer in the Developing World | 


Breast cancer rates worldwide, 1980-2010

Freelance (and former NPR) health journalist Joanne Silberner of Seattle is doing a series of reports on cancer in the developing world for a number of news organizations with funding from the Pulitzer Center for Crisis Reporting.

The gist of it is that cancer in poor countries is often a neglected disease. As Silberner says in announcing her reporting tour starting in Uganda, moving on to India and Haiti:

Worldwide, more people die from cancer than from HIV/AIDS, tuberculosis and malaria – combined. Yet until recently, cancer was almost ignored by the global health groups, charitable organizations and governments working to improve conditions in developing countries.

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How Jimmy Carter became a serpent slayer and global health pioneer | 

Tom Paulson

President Jimmy Carter speaks at World Affairs Council 60th Anniversary event

Former President Jimmy Carter is in Seattle, having spoken last night at the World Affairs Council’s 60th anniversary celebration and speaking today at the Bill & Melinda Gates Foundation about Guinea worm.

Mike Urban,

A Nigerian woman with Guinea Worm

Guinea worm is a human parasite that eats its way through the human body and emerges a year later, incapacitating people with the pain of completing its life cycle. It’s horrible.

I’ve seen people with Guinea worm in Africa. Over the years, I’ve also seen what Jimmy Carter and his team at the Carter Center have done to come close now to completely ridding the world of this horrific disease.

It’s a great story, and perhaps of much broader significance to global health than many might realize.

Earlier this week, the Gates Foundation, major pharmaceutical companies and others announced a major $$785 million push against “neglected tropical diseases.” This was celebrated by Bill Gates, World Health Organization chief Margaret Chan and others as a critical turning point in global health. The Carter Center got some of the loot, $40 million of it, to finish off Guinea worm.

But in one sense, this push against neglected diseases got a good first shove nearly 30 years ago by Jimmy Carter. One look at the Carter Center’s website shows they got to this point, of recognizing the need to fight neglected diseases, decades ago.

Diseases like river blindness, Guinea worm, parasitic (lymphatic) elephantiasis and schistosomiasis have been in Carter’s cross hairs since the mid-1980s. Continue reading

PATH acquires drug company to speed fight on neglected diseases | 

Seattle-based PATH announced today that it is acquiring the non-profit drug company OneWorld Health.

OneWorld Health, which will continue to operate from its headquarters in San Francisco, was created in 2000 as the first non-profit pharmaceutical company and has been focused from the beginning on creating drugs and vaccines for use in poor countries.

“I don’t think we could have considered trying to partner with a for-profit drug company,” said Hugh Chang, head of special projects at PATH who will act as interim chief of drug development for the PATH-OneWorld Health merger. “That would have been a misalignment in terms of our missions.”

PATH, launched in the late 1970s in Seattle initially focused on women’s health issues, has grown into one of the largest players in the global health arena — due largely to its key role administering and carrying out many well-funded projects sponsored by the Bill & Melinda Gates Foundation.

Known for its talent at bringing together public and private partners in innovative ways to solve health problems in poor countries, this is the first time PATH will have a direct role in developing drugs.

In the past, PATH has had to spend a lot of time and effort working to convince drug makers to join in the fight against neglected diseases. Now it is a drug maker. Continue reading

NPR: Using lay therapists to deal with mental illness in India | 

Flickr, by Dierk Schaefer

Neon Brain

In the global health arena, mental health care is typically considered — or not considered at all, more accurately — as infeasible for poor communities compared to the more pressing disease burdens of physical illness like AIDS, tuberculosis, malaria, pneumonia, malnutrition and the like.

But as I’ve written here before, the burden of mental illness in the developing world is massive and many experts are exploring innovative ways to bring mental health care to poor communities.

For example, NPR’s Joanne Silberner reports on the use of lay people doing mental health therapy in India. Silberner’s report is based on a new study in the Lancet that found people suffering from anxiety or depression can be assisted by therapists with minimal training. Says Silberner:

In India, there is only one psychiatrist for every 400,000 people, according to the Indian government. The Lancet study involved about 2,600 people in the state of Goa with common mental illnesses such as anxiety or depression. About half were assigned case managers who had taken a two-month training course in mental health counseling.

For another example, take a look at my post “The most neglected disease in global health” about a pair of local experts training locals to treat PTSD in Iraq, Congo and Cambodia for another example.

Foot note 2: Neglected “shoe” disease gets recognition by WHO | 

Flickr, poppalina

One neglected disease is a little bit less neglected today. The World Health Organization has decided to recognize that lack of shoes causes disease.

A month ago, I wrote about Dr. Gail Davey’s campaign to gain wider recognition of a little known foot disease called podonociosis that afflicts the poorest of the poor simply because they lack shoes.

Davey, who first encountered “podo” working in Ethiopia, says this disorder appears to afflict millions of people living in remote and very poor villages, causing massive disability and disfigurement that is often misdiagnosed as as a parasitic disease elephantiasis.

“This is a disease that is directly caused by extreme poverty, by people too poor to buy shoes,” Davey says.

How can we hope to help the poor by solving much more complex problems, she says, if there appears so little interest in just getting shoes to people to prevent this disease?

Gail Davey

Foot with podoconiosis

I had also noted in my previous post that the World Health Organizations neglected to mention this highly neglected disease in its new Neglected Tropical Disease report.

The problem, Davey says, had been sort of a Catch-22:

“Many people thought this must either be a trivial disease or very rare, or they would have heard of it,” she says.

In reality, lack of recognition is caused by the fact that this disease hits the very poorest of the poor who still remain out of sight and reach of most anti-poverty, global health and development projects.

WHO has decided now to include “podo” on its list of neglected tropical disease, Davey told me today, which she hopes will both raise awareness of this affliction and support efforts to prevent it by making sure nobody is permanently disabled simply because they can’t afford shoes.

Foot note: Millions suffer simply for lack of shoes | 

Flickr, poppalina

Millions of bare feet prove we still aren’t reaching the very poorest of the poor.

The international community is doing a lot to help the world’s poor — spending billions of dollars (not enough, but still billions) to combat AIDS, TB and malaria, doing research, figuring out clever new uses of cell phones to help subsistence farmers increase productivity and getting microfinance loans to poor women.

And yet, millions of people worldwide suffer disfigurement and disability simply for a lack of shoes?

Gail Davey

Foot with podoconiosis

The disease I’m talking about is called podoconiosis and, chances are, you haven’t heard of it. It is a much lesser-known cause of elephantiasis (see right, a condition also caused by mosquito-borne parasitic worms) that one researcher believes may nevertheless afflict more than 4 million people worldwide. Continue reading

What is a Neglected Disease? | 

One of the funny, maddening things about global health is all the terminology people use that seems to lack precise definition. Global health itself is fairly imprecise and debatable, as it turns out.

Flickr, by David M*


I wrote yesterday about the “most neglected disease” in global health — mental illness. Those who work at bringing mental health therapies to poor countries contend, with good evidence, that mental illness is a huge contributor to disability.

But even the powerful and well-funded cancer research industry claims it is neglected, at least when it comes to global health. Others are pushing to get more chronic diseases, like diabetes or heart disease, on the agenda.

So what makes a disease neglected?

Wikipedia contends they are tropical diseases that afflict poor countries.

An organization devoted to this issue, the Global Network of Neglected Tropical Diseases, similarly identifies 13 parasitic and bacterial diseases that disproportionately afflict people in poor communities.

Which diseases do you think are neglected?

The Most Neglected Disease in Global Health | 

Flickr, by Dierk Schaefer

Neon Brain

Is it Kala-azar black fever? Elephantiasis? African sleeping sickness? Guinea worm?

How about mental illness?

“Mental health is the Rodney Dangerfield of international health,” says Paul Bolton, an expert in evaluating treatments at Johns Hopkins University, paraphrasing the comedian’s signature line: “It gets no respect.”

But it should, Bolton says, if our goal is to improve lives rather than simply cure or prevent disease.

Hundreds of millions of people in the developing world suffer from emotional, neurological or behavioral disorders, according to the World Health Organization.

Okay, but we also have loads of people in poor countries dying from AIDS, malaria and TB — to name just a few — and you want to talk about depression? Continue reading