Incorpora(ng a Rapid Impact Package for Neglected Tropical Diseases with Programs for HIV/AIDS, Tuberculosis, and Malari

Transcription

1 Incorpora(ng a Rapid Impact Package for Neglected Tropical Diseases with Programs for HIV/AIDS, Tuberculosis, and Malari Dr. Hotez et al. Jiyoon K March 1st, 20 HESO44

2 Dr. Peter Hotez!

3 Current programs to fight "the big three" 1. UNAIDS received ~$120mil in Roll back Malaria downturn in 2004 (1), increas funding in 2008 (2) 3. Stop TB currently suffering $30.8 billion in funding gap (4) 4. Global fund to fight AIDS, TB, Malaria $19.3bil 2008 (5) 5. TIME's 2005 Global Health Summit mostly talked about AIDS and Malaria (3)

4 NTD Neglected Tropical Diseases "Disease of the poor endemic, localized poor living condi(ons ascariasis, hookworm infec(on, trichuriasis, lympha(c filariasi onchocerciasis, dracunculiasis, schistosomiasis, Chagas disease, human African trypanosomiasis, leishmaniasis, Buruli ulcer, leprosy, trachoma, dengue fever, treponematoses, leptospirosis, strongyloidiasis, foodborne trematodiases, neurocys(cercosis, and scabies (7)

5 Warning: graphic images!

6 Why "neglected"? Why treat them? Millennium Development Goals "other diseases"? (7) 1 billion people "low priority no "poli(cal voice must compete with more visible diseases that cause much higher mortality and akract much more aken(on, na(onally and interna(onally." (6 Compete?

7 Table 2 NTD is "4th" in DALY rankin

8 How to control NTD's Geographical overlap "Rapid Impact Package

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10 4 pills a year keeps 7 doctors away? (7)

11 Pros and Cons of RIP Pros Inexpensive ($0.50 per dose) Implemented easily Decreases medicine delivery costs (10) Cons Complica(ons? Resistance? Compliance?

12 Next steps

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14 Comorbid condi(on: anemia HIV, TB, Malaria, and many NTD s cause anemia (low red blood cells) Severe anemia/combina(on of polyparasi(sm and malaria puts pregnant women, children, and people with HIV at high risk

15 There is a link!...sort of. The yays Increased risk of malaria from STH infec(on 1.8x increased risk of malaria for those with hookworm infec(on Increased risk of child born with HIV if mother has HIV+helminth coinfect Helminth infec(on increase risk of HIV infec(on And more The nays Uganda study fail to associate helminths and AIDS

16 4 is the new 3? Comorbidity Coinfec(on RIP may reduce anemia and boost immune system But Zimbabwe vs. Uganda discrepancy the data is s(ll far from conclusive

17 Efforts to control NTD February 20 th, 2008 (Bush) $350mil over 5 years Is now the NTD ini(a(ve in US (11) 2010 (Obama) Global Health Ini(a(ve $63 billion over 6 years 70% of it will go to AIDS relief, likle men(on of NTD Global Network, DNDi

18 More reasons to care about NTD s Curing NTD for the bokom billion may be of tremendous help in foreign policy (12)

19 Our take on this paper Jiyoon: compelling, but s(ll a hopeful argument Your thoughts, arguments, opinions?

20 The end!

21 Sources (1)hkp:// (2)hkp:// (3)hkp:// (4)hkp:// (5)hkp:// (6)hkp:// (7)hkp://content.nejm.org/cgi/reprint/357/10/1018.pdf (8)hkp://www3.interscience.wiley.com/cgibin/fulltext/ /PDFSTART (9) hkp:// (10) hkp:// we do/benefits of control (11) hkp:// (12)hkp://

22 Picture sources (by slide number) 2. Dr. Hotez: hkp://media3.washingtonpost.com/wp dyn/content/photo/2008/06/27/ph jpg 2. Global Network for NTD: hkp:// logo small.gif 2. Geoff Costeloe: hkp:// content/uploads/2009/07/cgiu.jpg 5. Leishmaniasis: hkp:// 5. Hookworm: hkp://scienceblogs.com/zooillogix/hookworm.jpg 5. African sleeping sickness parasite: hkp:// 5. Schistomaniasis: hkp://asb.wchsgis.net/huge/cano_carlos/schistosomiasis_itch.jpg 5. Chagas disease: hkp://wiki.knoesis.org/images/thumb/a/a4/phil_2617_lores.jpg/300px PHIL_2617_lores.jp 7. DALY ranking table: hkp:// 8. Two birds with one stone picture: hkp://farm4.sta(c.flickr.com/3009/ _aa7f jpg 9. World map of NTD overlap: hkp:// pills for 7 diseases: hkp://content.nejm.org/cgi/reprint/357/10/1018.pdf 12. Water sanita(on: hkp://kar14.files.wordpress.com/2008/12/africa jpg 12. Educa(on: hkp://bankstreetcollege.files.wordpress.com/2009/02/nsp.jpg 13: xkcd research terms : hkp:// 18: Medical diplomacy: hkp://blog.usni.org/wp content/uploads/2009/05/dsc jpg