In January, U.S. Rep. Chris Smith, R-N.J., introduced a bill to the House Committee on Energy and Commerce meant to facilitate research on neglected tropical diseases through domestic and international efforts.
The End Neglected Tropical Diseases Act, bill H.R. 826, also aims to provide single-dose, annual deworming medications for susceptible populations in developing countries.
“[This bill] deals with a group of 17 parasitic, bacterial and viral diseases which blind, disable, disfigure and sometimes kill victims from among the more than 1 billion of the world’s poorest people,” Smith said while presenting the bill to the House of Foreign Affairs Committee in 2017.
According to the World Health Organization (WHO), there are 20 neglected tropical diseases (NTDs). Typically associated with poverty and found in developing countries, these infectious diseases are grouped because of their chronic, disfiguring, and stigmatizing commonalities.
Approximately 2 billion people around the world are at risk of contracting an NTD. In fact, afflicting over 1.4 billion people currently, deaths from these diseases surpass deaths from malaria and tuberculosis.
An estimated 534,000 people die from NTDs each year and 57 million become disabled after contracting one.
In 2014, an outbreak of the Ebola Virus Diseases caused a pandemic that infected more than 20,000 people and caused more than 8,000 deaths. Ebola is not currently listed as an NTD by WHO but it shares the same characteristics as other NTDs as it was concentrated in impoverished populations in the developing world. When it was spread to the United States and other developed countries, it was contained and controlled by developed health systems.
NTDs in the U.S. and other developed countries still require attention. In the U.S., NTDs disproportionately affect impoverished people, especially minorities. Almost 3 million African-Americans suffer from toxocariasis. Of the 300,000 people who experience another parasitic disease, known as Chagas, most are Hispanic.
“These diseases trap the most marginalized communities in a cycle of poverty. [This bill] will support the control and elimination of NTDs in the U.S. and abroad,” Smith said in 2017.
Since people afflicted by NTDs have high medical costs from hospital stays and ongoing treatment, the economic burdens of NTD can severely impact a community – contributing to lack of productivity and heightened healthcare costs. At a personal level, NTD sufferers experience fatigue, which may make it difficult for them to hold a job, get an education and contribute to their communities.
In addition to these disadvantages, Smith also spoke to the effect of NTDs on pregnancy.
“[NTDs] also cause excessive bleeding by mothers during birth and result in low birth weight babies.”
In STH diseases, health problems are caused by nutrition in childhood. STH infection may lead to anemia, malabsorption of nutrients, diarrhea and nausea. When these issues present themselves during developmental stages in childhood, mental and physical damage occurs.
To avoid these damages, the bill proposes a simple and cost-effective solution to STH and schistosomiasis infections: a single-dose deworming pill that can be safely administered once or twice annually to those at risk. Pharmaceutical companies have committed to donate the drugs needed to treat at-risk children. Regular administration of the pills would reduce overall disease morbidity.
Roughly 80 percent of infections are caused by soil-transmitted helminths (STH), a group of three parasitic worms that infect more than one billion people worldwide, and schistosomiasis. Of those billion people, 600 million are school-aged children of whom 300 million dies. The other aforementioned helminth infection, Schistosomiasis, touches nearly 200 million people in developing countries. Some estimates indicate that the actual number of people affected by schistosomiasis is double or triple that number, according to the bill.
“The most common NTDs can be controlled and eliminated with the application of low-cost donated medicines. However, there is still much work to be done to prepare for currently unknown diseases that may appear on the international scene and to reach the WHO’s control and elimination goals by 2020,” Smith said. To achieve these goals, heightened support is needed now from both new and long-standing partners.”
For diseases that don’t yet have treatment, the bill suggests research and development. Smith proposes developing control strategies that identify at-risk populations and ensure treatment frequency and availability. In addition, the bill seeks to improve access to clean water, sanitation and hygiene in order to reduce disease.