Funding in Africa is concentrating too heavily on the big three

[Guest guest]

Funding in Africa is concentrating too heavily on the " big three "

Klaus Morales

Certain tropical diseases are being unjustly ignored in Africa because

funding is so heavily concentrated on the " big three "

diseases—HIV/AIDS, tuberculosis, and malaria—says a new study by

Molyneux and colleagues (PLoS Medicine, doi:

10.1371/journal.pmed.0020336).

The neglected tropical diseases, including schistosomiasis,

onchocerciasis, trachoma, lymphatic filariasis, and the

soil-transmitted helminth infections, are responsible for as many as

500 000 deaths a year. But the international health community gives

priority to the big three.

" Instead of 95% of funding being addressed to the big three, give them

90% and we will be able to do a lot of cost effective treatment with

the extra 5%. We don't need research; we just need funds to sustain

the implementation of control programmes, and we urge policy makers

and donors to rethink policies, and address the neglected diseases, "

said Alan Fenwick, professor of tropical parasitology at Imperial

College, London and one of the co-authors of the paper.

These diseases can be effectively treated with a minimum budget,

estimated at $0.40 (£0.23; {euro}0.33) a year. The proposed rapid

impact package includes four drugs—praziquantel, albendazole,

ivermectin, and azithromycin—with the three last being donated by

multinational pharmaceutical companies, the paper says.

" Compared to a minimum of $200 per person per year to treat HIV/AIDS,

$200 to treat a single episode of tuberculosis and $7-10 to treat a

single episode of malaria, the cost of the package would be

negligible. It is equivalent to the costs of 12 condoms for HIV

prevention and a quarter of the price of an antimalarial bednet, " the

paper says.

Professor Molyneux, director of the Lymphatic Filariasis Support

Centre at the Liverpool School of Tropical Medicine, added, " For the

big three, transmission would still continue at the present rate. For

example, treating three million people until the end of this year as

stated in the `3 by 5' target for HIV would still leave 90% of HIV

infected individuals untreated and actively transmitting. "

There are currently six public-private partnerships working in Africa

linked to specific neglected tropical diseases, each reaching a large

number of people. " Our plan is to bring all of them together to

complete the job we have started, and reach half a billion people

annually for five years. In doing so, we would take morbidity due to

these diseases out of the burden of disease equation for Africa.

" If donors would just get the funding more evenly balanced, we can put

forward this emergency treatment package through these integrated

programmes, " said Professor Molyneux.

Implementing these goals, however, might be not as simple as it

sounds. " The final costs of an integrated package may need to include

the costs of drug use monitoring and of developing new tools for

neglected disease control. Additional costs must therefore be

considered in order to promote ongoing research and development for

new neglected diseases control tools, " the article says.

http://bmj.bmjjournals.com/cgi/content/full/331/7521/866-a