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Several countries made progress in disease elimination this year


A global effort to stamp out certain undertreated diseases is making progress. As NPR's Nurith Aizenman reports, countries are making strides in combating what global health officials call neglected tropical diseases.

NURITH AIZENMAN, BYLINE: Dr. Albis Gabrielli is a top official in the World Health Organization's program for these diseases. And he stresses that the fact that for decades they'd been neglected doesn't mean they're obscure.

ALBIS GABRIELLI: We calculate that approximately 1 billion people are affected, so a significant proportion of the global population.

AIZENMAN: The trouble is the people who contract these diseases have historically been among the world's lowest-income citizens, living in some of the world's lowest-resourced nations.

GABRIELLI: People with no voice, living in poverty in remote rural areas, and therefore the diseases are not, let's say, prioritized.

AIZENMAN: By governments, by donors and by private pharmaceutical companies who don't stand to make as much of a profit addressing them. But in the early 2000s, the WHO and other global health partners came up with a plan to change that dynamic. They created an official list of 20 neglected tropical diseases to target with international research and cooperation. This year, the effort hit a major milestone. Iraq became the 50th nation in the world to eliminate the threat from at least one of the diseases on the list by stamping out a bacterial infection called trachoma. And it came just after two other nations, Benin and Mali, also stopped trachoma spread. Dr. Gabrielli says that's a major achievement.

GABRIELLI: It's one of the leading causes of preventable blindness in many parts of the world.

AIZENMAN: The disease can be transmitted when flies land on an infected person's eyes and nose, coming into contact with contaminated discharge, then spreading it on. So Dr. Gabrielli says a key strategy was to administer antibiotics en masse to practically everyone in areas where trachoma was endemic.

GABRIELLI: If you treat thousands of people at the same time, you decrease transmission rate in the environment in the area where these people live.

AIZENMAN: Another huge victory? Bangladesh became the first country to end the threat from not one, but two neglected tropical diseases in the same year, including a deadly illness that no other afflicted country has managed to beat. It's called visceral leishmaniasis, caused by a parasite that's spread through the bite of the sandfly.

Dr. Dinesh Mondal is a Bangladeshi research scientist. He recalls the scenes in the mid-2000s, when he first started working with the government to combat this disease.

DINESH MONDAL: I have seen hospitals full of patients. If you see, you know how patients are suffering. It was miserable.

AIZENMAN: The parasite attacks a person's liver, their spleen, causing their abdomens to swell.

MONDAL: Really very shocking pictures.

AIZENMAN: And the only treatment...

MONDAL: Which was a very painful injection.

AIZENMAN: ...That had to be administered 30 times. But as a result of the new focus on visceral leishmaniasis, scientists realized something - a one-shot treatment with an antifungal drug originally developed by a U.S. pharmaceutical company for cancer and HIV patients might also be worth trying against visceral leishmaniasis. Mondal, who's with the research institute ICDDR,B, assisted with testing it on a man in his 30s whose doctors had practically left him for dead.

MONDAL: It was amazing. Within three days, he was feeling so good.

AIZENMAN: WHO officials then helped negotiate a deal to drastically reduce the price of the drug in low-income countries. For all the progress, this year, the WHO added a new entry to the neglected tropical disease list, a gangrenous illness called Noma that mostly afflicts malnourished young children. Meanwhile, Mondal is concerned that Bangladesh's success with visceral leishmaniasis has led to a drop in international funding to ensure the disease doesn't return. He says there's still a lot to do.

Nurith Aizenman, NPR News. Transcript provided by NPR, Copyright NPR.

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