World Health Organization and Partners Unveil New Coordinated Approach to Treat Millions Suffering from Neglected Tropical Diseases

World Health Organization and Partners Unveil New Coordinated Approach to Treat Millions Suffering from Neglected Tropical Diseases

October 27, 2006

    WASHINGTON and GENEVA, Oct. 27 /Xinhua-PRNewswire/ --
Today, the World Health Organization (WHO) and a group of
more than 25 partner organizations unveiled a new strategy
to fight some of the most neglected tropical diseases that
destroy the lives and health of poor people.  

    (Logo: 
http://www.newscom.com/cgi-bin/prnh/20040610/CNTH001LOGO )

    The approach contained in a newly published manual,
Preventive Chemotherapy in Human Helminthiasis, focuses on
how and when a set of low-cost or free drugs should be used
in developing countries to control a set of diseases caused
by worm infections. Preventive chemotherapy in this context
means using drugs that are effective against a broad range
of worm infections to simultaneously treat the four most
common diseases caused by worms: river blindness
(onchocerciasis), elephantiasis (lymphatic filariasis),
schistosomiasis, and soil-transmitted helminthiasis. 
Significant opportunities also exist to integrate these
efforts with the prevention and control of diseases such as
trachoma.  

    "Preventive chemotherapy does not necessarily stop
infection taking place but it can help to reduce
transmission.  The benefit of preventive chemotherapy is
that it immediately improves health and prevents
irreversible disease in adults," says Dr Lorenzo
Savioli, Director of the WHO Department for the Control of
Neglected Tropical Diseases in Geneva.  "In the same
way as we protect people against a number of
vaccine-preventable diseases throughout their lives, the
regular and coordinated use of a few drugs can protect
people against worm-induced disease, improving children's
performance at school and the economic productivity of
adults."

    The new approach provides a critical first step in
combining treatment regimens for diseases which, although
different in themselves, require common resources and
delivery strategies for control or elimination.  

    The second key component of the strategy brings
together for the first time dozens of agencies, NGOs,
pharmaceutical companies and others into a coordinated
assault on neglected diseases.  These organizations are
integrating their expertise and resources to deliver the
manual's protocols for wide-scale drug use. A wealth of
experience and success already exists in the public health
community in dealing with these diseases. 

    More than one billion people are afflicted by these
diseases.  Their impact can be measured in the impaired
growth and development of children, complications during
pregnancies, underweight babies, significant and sometimes
disabling disfigurements, blindness, social stigma, and
reduced economic productivity and household incomes.  These
effects can now be dramatically reduced by scaling up
interventions using highly effective drugs of proven
quality and excellent safety record -- the majority donated
free by companies or costing less than US$ 0.40 per person
per year, including the cost of the drugs and their
delivery.

    "We need to urgently work together to improve
access to rapid-impact interventions and quality
care," says Dr David Heymann, WHO Acting Assistant
Director-General for Communicable Diseases.  "The need
to do so is incontestable from all perspectives: moral,
human rights, economic and global public good. The task is
feasible and must be done."

    Work must now begin in earnest to implement the
practical guidelines in the manual and sustain the progress
that preventive chemotherapy offers.  The governments of the
Member States of the United Nations have committed
themselves to attaining the Millennium Development Goals. 
The application of preventive treatment for worm infections
will make a significant contribution to overcoming the
challenges set out for us in the Millennium Development
Goals. 
 
    Note to Editors

    Neglected tropical diseases include:

    -- Lymphatic filariasis: It is estimated that 1.2
billion people in 83 
       countries live in areas endemic for lymphatic
filariasis and about 120 
       million people are affected by the disease. Filarial
infection may be 
       clinically asymptomatic; the disease may also
present as one or more 
       acute manifestations (fever, local swelling,
tropical pulmonary 
       eosinophilia syndrome, lymphangitis). Chronic
complications include
       lymphoedema or elephantiasis of the limbs, damage to
the genital      
       organs(including hydrocele in men), and damage to
the kidney 
        (including chyluria) and lymphatic system. The
causal agents of 
       lymphatic filariasis are the filariae Wuchereria
bancrofti, Brugia 
       malayi and Brugia timori. 

    -- Schistosomiasis: It affects about 200 million people
worldwide, and 
       more than 650 million people live in endemic areas.
Urinary 
       schistosomiasis is caused by Schistosoma haematobium
and intestinal   
       schistosomiasis by any of the organisms S.
intercalatum, S. mansoni, S. 
       japonicum, and S. mekongi. Disease is caused
primarily by schistosome 
       eggs, which are deposited by adult worms in the
blood vessels 
       surrounding the bladder or intestines. The classical
sign of urinary 
       schistosomiasis is haematuria (blood in urine).
Bladder and ureteral 
       fibrosis and hydronephrosis are common findings in
advanced cases, and 
       bladder cancer is a possible late-stage
complication. Intestinal 
       schistosomiasis has a nonspecific clinical picture
of abdominal pain, 
       diarrhoea, and blood in the stool. Liver enlargement
is common in 
       advanced cases and frequently associated with
ascites and other signs 
       of increased portal pressure. In such cases there
may also be 
       splenomegaly. 

    -- Onchocerciasis: Onchocerciasis is endemic in 30
countries in Africa, 6 
       countries in the Americas, and in Yemen in the
Arabian peninsula. It is 
       estimated that 100 million are at risk of infection
while 37 million 
       are estimated to be infected. The causal agent of
onchocerciasis is 
       Onchocerca volvulus, a nematode filaria. Symptoms
begin 1 3 years 
       after infection, usually at the time when adult
females begin to 
       produce microfilariae. These include: rashes,
papular skin lesions, 
       subcutaneous nodules, intense itching and
depigmentation of the skin, 
       lymphadenitis, which results in `hanging groin"
and elephantiasis of 
       the genitalia, and general debilitation. Eye lesions
lead to serious 
       visual impairment including blindness. 

    -- Soil-transmitted helminthiasis (ascariasis,
trichuriasis, hookworm 
       infections): Soil-transmitted helminthiasis affects
more than 2 billion 
       people worldwide. Recent estimates suggest that
Ascaris lumbricoides 
       infects 1.221 billion people, Trichuris trichiura
795 million, and 
       hookworms (Ancylostoma duodenale and Necator
americanus) 740 million. 
       The causal agent of soil-transmitted helminthiasis
is any of the 
       following worms: Ascaris lumbricoides, Trichuris
trichiura and the 
       hookworms. Infection is caused by ingestion of eggs
in contaminated 
       soil or food (Ascaris lumbricoides and Trichuris
trichiura) or by 
       active penetration of the skin by larvae in the soil
(hookworms). Soil-
       transmitted helminths produce a wide range of
symptoms that include 
       intestinal manifestations (diarrhoea, abdominal
pain), general malaise 
       and weakness that may affect working and learning
capacities, and 
       impaired physical growth. Hookworms cause chronic
intestinal blood loss 
       that results in anaemia. 

    -- Trachoma: Trachoma affects about 84 million people
of whom about 8 
       million are visually impaired. It is caused by
Chlamydia trachomatis   
       a microorganism which spreads through contact with
eye discharge from 
       the infected person (on towels, handkerchiefs,
fingers, etc.) and 
       through transmission by eye-seeking flies. After
years of repeated 
       infection, the inside of the eyelid may be scarred
so severely that the 
       eyelid turns inward and the lashes rub on the
eyeball, scarring the 
       cornea (the front of the eye). If untreated, this
condition leads to 
       the formation of irreversible corneal opacities and
blindness. 

    Additional Quotes from Partners:

    Dr James Mwanzia, Director, Division of Communicable
Disease Prevention and Control, WHO African Regional
Office, Harare, Zimbabwe

    "The next step will be to adapt the manual to the
specific needs of countries. This will enable them to
implement the integrated WHO strategy using the strengths
of their public health systems to the benefit of those
communities affected by neglected tropical diseases."


    Dr Regina Rabinovich, Director of Infectious Diseases,
Bill & Melinda Gates Foundation, Seattle, USA 

    "We applaud WHO's leadership in the fight against
neglected tropical diseases.  We look forward to working
with WHO and other partners to demonstrate the important
role that preventive chemotherapy can play in bringing
these terrible diseases under control."

    Dr Uche Amazigo, Director, African Programme for
Onchocerciasis Control (APOC), Burkina Faso

    "We need a concerted, coordinated action and in
partnership to help the poorest populations overcome the
burden of the neglected diseases. The continuous existence
of the NTDs, for which control strategies, tools and drugs
for large-scale use exist, is evidence of the failure of
public health to break the barriers. Empowering
communities, building strong partnerships and strengthening
the health systems for integrated disease control to meet
the Millennium Development Goals, are necessary elements
for our joint efforts to succeed."

    Dr J.-P. Garnier, Chief Executive Officer,
GlaxoSmithKline, London, United Kingdom 

    "GlaxoSmithKline is proud to play our part in
tackling neglected tropical diseases, particularly through
our donation of albendazole for the elimination of
lymphatic filariasis. We welcome the WHO guidelines which
will help countries combine different disease interventions
using several medicines to make a greater impact on the
health of poor people in the developing world." 

    Dr Jacob Kumaresan, President, International Trachoma
Initiative, New York, USA

    "Unfortunately, these neglected tropical diseases
affect the poorest populations in the world, causing
unnecessary suffering and reducing productivity and
development. By working together to ensure there is synergy
in our interventions, we can achieve greater coverage more
rapidly, thereby improving their health and helping to
alleviate poverty."

    Professor David Molyneux, Director, Lymphatic
Filariasis Support Centre, Liverpool, United Kingdom

    "WHO is to be congratulated on producing such a
relevant, timely, well presented and globally-relevant
document.  Addressing the practical issues of helminth
chemotherapy, this most comprehensive text provides those
responsible in endemic countries with the vital information
required to plan their programmes. WHO and its collaborators
have elegantly translated theory into practice thereby
enabling countries to implement programmes which directly
address the Millennium Development Goals in a cost
effective way." 
 
    Dr Mark L. Eberhard, Director, Division of Parasitic
Diseases , Centers for Disease Control, Atlanta, GA, USA

    "A critical first step in controlling infectious
diseases is the development of a cohesive and comprehensive
set of guidelines - turning ideas into reality in a
practical way.  WHO has once again masterfully crafted such
a document that will serve as the framework and strategy
around which the global community can focus efforts on the
control of neglected tropical diseases, some of the most
common and debilitating, yet controllable, conditions
afflicting major populations of the world."

    Professor Alan Fenwick, Director, USAID NTD Project,
Washington, D.C., USA

    "These guidelines are exactly what is needed to
assist the control of neglected tropical diseases. As both
the Bill & Melinda Gates Foundation and the USAID have
recently increased their support for control and other
donors are coming on board, it is essential that strategies
for control are based on sound evidence-based knowledge, and
these guidelines provide a strong foundation for developing
appropriate strategies."

    Professor Peter Hotez, Professor and Chairman, Dept. of
Microbiology and Tropical Medicine, The George Washington
University,  Washington, D.C., USA

    "The new WHO guidelines represent an important
step in the integration of neglected tropical disease
control worldwide.  This new document provides an urgently
needed blueprint for moving forward on a global effort to
address the Millennium Development Goals."

    Dr Ralph H. Henderson, Decatur, GA, USA (formerly
Assistant Director-General, Communicable Diseases, World
Health Organization, Geneva, Switzerland)

    "This Manual is a breakthrough in the coordination
of mass treatment programmes against helminths.  It provides
a critical first step in combining treatment regimens for
diseases which, although different in themselves, require
common resources and delivery strategies for control or
elimination.  It now needs to be translated into full-scale
national programmes which can reap the full benefits of the
savings which coordination can bring."

    Dr B. Thylefors, Director, Mectizan  Donation Program,
Decatur, GA, USA

    "This WHO manual will be an important tool for
expanding appropriate combinations of anthelminthic
chemotherapy through community-directed treatment, as is
already being successfully implemented for onchocerciasis
and LF in African countries. The manual will also stimulate
the gaining of all needed operational experience to deliver
such new combinations of mass chemotherapy through safe and
effective interventions in different settings."

    Dr Ousmane Bangoura, Coordinator, Onchocerciasis (River
blindness) Coordination Unit, World Bank Africa Region,
Washington, D.C., USA

    "Neglected tropical diseases are global public
goods. The intensification of their control is consistent
with the Millennium Development Goals adopted by the
international community to alleviate poverty and reduce
human suffering. The costs entailed are expected to be
limited because of large scale drug donations and
cost-effective implementation measures.  The development
impact will be important through improved quality of life
and increased worker productivity and contribute to
economic growth. The new manual on preventive chemotherapy
in human helminthiasis is timely. It will help greatly
health professionals, programme managers, donors and
governments of endemic countries in their approach of the
diseases targeted and integration."

    Dr Eric A. Ottesen, Director, Lymphatic Filariasis
Support Center, The Task Force for Child Survival and
Development, Decatur, GA, USA

    "What a timely document!  Helminth infections,
pervasive and debilitating in their own right, exacerbate
co-endemic killer diseases and perpetuate cycles of poverty
throughout the developing world.  Yet today, the
availability of effective drugs at zero or low cost --
through extraordinary private-sector generosity -- makes
these diseases largely, or even completely, preventable. 
To take advantage of this unique opportunity; however, a
practical, how-to blueprint was needed to guide in-country
deployment of a new health strategy based on multi-disease
preventive chemotherapy.  This WHO manual not only provides
such practical guidelines, but also explains the rationale
and evidence-base underlying the new strategy with a
clarity guaranteed to achieve broad consensus and
commitment among both the public health community and the
public itself."

    Dr Nana A. Y. Twum-Danso, Acting Director, Mebendazole
Donation Initiative, Task Force for Child Survival and
Development, Decatur, GA, USA

    "This WHO manual will surely lead the way in
improving the efficiency and effectiveness of mass drug
administration programmes for these important but often
neglected diseases. However, the challenge for us all will
be in ensuring that the non-drug components of the
programmes, such as improvements in sanitation for the
control of soil-transmitted helminth infections, are not
neglected. 

    List of partners with contact names, telephone numbers
and email addresses

    -- African Programme for Onchocerciasis Control (APOC)
- Dr Uche Amazigo, 
       Director, African Programme for Onchocerciasis
Control (APOC), 
       Ouagadougou, Burkina Faso. Tel. [phone];
e-mail: 
       [e-mail] or [e-mail] ;
website: 
       http://www.apoc.bf /

    -- Bill & Melinda Gates Foundation - Dr David
Brandling-Bennett, Senior 
       Program Officer, Infectious Diseases Global Health
Program, Bill &  
       Melinda Gates Foundation, PO Box 23350, Seattle, WA 
98102, USA.  Tel. 
       [phone]; Fax. [phone]; e-mail:
david.brandling-
       [e-mail]; website:
http://www.gatesfoundation.org/

    -- Centers for Disease Control and Prevention (CDC) -
Dr Mark L. Eberhard, 
       Director, Division of Parasitic Diseases F22,
National Center for 
       Zoonotic, Vectorborne, and Enteric Diseases, 4770
Buford Highway, NE, 
       Atlanta, GA 30341-3724, USA. Tel. [phone];
Fax. [phone] 
       7794; e-mail: [e-mail]; website:
http://www.cdc.gov/

    -- GlaxoSmithKline (GSK) - Mr Andy L. D. Wright,
Director Lymphatic 
       Filariasis Programme, Global Community Partnerships,
GlaxoSmithKline, 
       Building C, 12th Floor, 980 Great West Road,
Brentford, Middlesex TW8 
       9GS, United Kingdom. Tel. [phone]; Fax.
[phone]; 
       e-mail: [e-mail]; website:
http://www.gsk.com

    -- Global Alliance to Eliminate Lymphatic Filariasis
(GAELF) - 
       Secretariat, Liverpool School of Tropical Medicine,
Pembroke Place, 
       Liverpool L3 5QA, United Kingdom. Tel. [phone]
3145; Fax. +44 
        [phone]; e-mail: [e-mail]; website: 
       http://www.filariasis.org.uk/

    -- Global Health Council - Dr Nicole Bates, Director,
Government Relatio
       ns; e-mail: [e-mail]; website: 
       http://www.globalhealth.org/ ; 

    -- Human Hookworm Vaccine Initiative (HHVI) - Professor
P.J.    
       Hotez,Professor and Chairman, Dept. of Microbiology
and Tropical 
       Medicine, The George Washington University, Ross
Hall, Room 736, 2300 
       Eye St. NW, Washington, D.C. 20037, USA. Tel. +1
[phone]; e-
       mail: [e-mail] ; website:
http://www.sabin.org/hookworm/

    -- International Trachoma Initiative (ITI) - Dr Jacob
Kumaresan, 
       International Trachoma Initiative, 441 Lexington
Avenue, 11th Floor, 
       Suite 1101, New York, N.Y.10017, USA. Tel.+1 (212)
490 6460; Fax. +1 
       (212) 90 6461; e-mail: [e-mail];
website: 
       http://www.trachoma.org

    -- Johnson & Johnson - Dr William Lin, One Johnson
& Johnson Plaza, New 
       Brunswick, NJ 08933, USA. Tel. [phone]; Fax.
+ 1 732 524 3300; 
       e-mail: [e-mail]

    -- Mebendazole Donation Initiative - Dr Nana A. Y.
Twum-Danso, Acting 
       Director, Mebendazole Donation Initiative, Task
Force for Child 
       Survival and Development, Decatur, Georgia, USA.
Tel. [phone] 
       5623, Fax. [phone], e-mail:
[e-mail]; 
       website: http://www.taskforce.org/

    -- Mectizan(R) Donation Program (MDP) - Dr Bjorn
Thylefors, Director, 
       Mectizan(R) Donation Program, 750 Commerce Drive,
Decatur, GA 30030,    
       USA. Tel. [phone]; Fax. [phone];
e-mail: 
       [e-mail]; website:
http://www.taskforce.org/
 
    -- Merck & Co., Inc. - Mr Ken Gustavsen, Manager,
Global Product 
       Donations, Merck Mectizan  Donation Program, Merck
& Co., Inc., One 
       Merck Drive, Whitehouse Station, NJ 08889-0100, USA.
Tel. [phone] 
       3088; Fax. [phone]; e-mail:
[e-mail]; website:   
       http://www.merck.com/

    -- Novartis - Dr Heiner Grueninger, Head Project
Management and 
       Operations, Tropical Medicines Initiatives,
WSJ-103.2.25, Pharma 
       Development, Novartis Pharma AG, CH-4002 Basel,
Switzerland. Tel. +41 
       61 324 1491; Cell. [phone]; e-mail: 
       [e-mail]; website:
http://novartis.com/

    -- NTD Project (RTI/United States Agency for
International Development) 
       (USAID) - Professor Alan Fenwick, Director,
Neglected Tropical Diseases 
       Control Project, RTI International, 701 13th St.,
NW, Washington, D.C. 
       20005, USA. Tel. [phone]; e-mail:
[e-mail]; website: 
       www.rti.org/idg

    -- Partners for Parasite Control (PPC) - Dr Dirk
Engels, Coordinator, 
       Preventive Chemotherapy & Transmission Control,
Dept. of Control of 
       Neglected Tropical Diseases, World Health
Organization, Geneva, 
       Switzerland. Tel. [phone]; Fax. +41 (22)
791 4777; e-mail:
       [e-mail]; website:
http://www.who.int/neglected_diseases/

    -- Pfizer Inc. - Ms Paula Luff, Senior Director,
International 
       Philanthropy, The Pfizer Foundation, 235 East 42
Street, 12th Floor, 
       New York, N.Y. 10017, USA. Tel. [phone];
Fax. [phone] 
       2883; e-mail: [e-mail];  website:
http://www.pfizer.com/ 

    -- Schistosomiasis Control Initiative (SCI) - Professor
Joanne Webster, 
       SCI, Imperial College, Department of Infectious
Disease Epidemiology, 
       St. Mary's Campus, Norfolk Place, London W2 1PG,
United Kingdom. Tel. 
       [phone]; Fax. [phone]; e-mail: 
       [e-mail]; website:
http://www.schisto.org

    -- The Carter Center - Dr D. Hopkins, Carter Center,
Global 2000, One 
       Copenhill, 30307 - Atlanta, GA, USA. Tel. +1 (312)
266 2420; Fax. +1 
       [phone]; e-mail: [e-mail]; website:

       http://www.cartercenter.org/

    -- The Global Network For Neglected Tropical Diseases
Control (GNNTDC) -  
       Senior Program Officer, Albert B. Sabin Vaccine
Institute, 1889 F   
       Street, N.W., Suite 200S, Washington, D.C. 20006,
USA. Tel. +1 (202) 
       842 5025; e-mail: [e-mail]; website:
http://www.gnntdc.org/

    -- The Liverpool School of Tropical Medicine, Pembroke
Place, Liverpool,L3 
       5QA, United Kingdom. Tel. [phone]; Fax. +44
151 705 3370; 
       website: http://www.liv.ac.uk/lstm/

    -- The Millennium Village(TM) Project - Dr Sonia
Ehrlich Sachs, Millennium 
       Village Project, Earth Institute at Columbia
University, New York, 
       N.Y., USA. e-mail: [e-mail]; website:

       http://www.earth.columbia.edu/

    -- The WHO Alliance for the Global Elimination of
Trachoma by 2020 
       (GET2020) - Dr Silvio P. Mariotti, Prevention of
Blindness and   
       Deafness, Dept. of Chronic Diseases and Health
Promotion, World Health   
       Organization, Geneva, Switzerland. Tel. [phone]
34 91; Fax. +41 
       (22) 791 47 72; e-mail: [e-mail]; website:

       http://www.who.int/blindness/

    -- United Nations Children's Fund (UNICEF) - Dr Kopano
Mukelabai, Senior 
       Health Advisor, Health Section, Programme Division,
Three United 
       Nations Plaza, New York, N.Y. 10017, USA. Tel. +1
212 326 7130; Fax. +1   
       212 824 6464/60; e-mail: [e-mail]; 
website: 
       http://www.unicef.org/

    -- World Bank - Dr. Ousmane Bangoura, Onchocerciasis
(River blindness) 
       Coordination Unit, Africa Region, Room J9-093, World
Bank, Washington, 
       D.C., USA. Tel. [phone]; Fax. [phone]
3157; e-mail:    
       [e-mail]

    -- World Food Programme (WFP) - Dr Francisco Espejo,
Chief, School Feeding 
       Service, Via Cesare Giulio Viola, 68/70, 00148,
Rome, Italy. e-mail: 
       [e-mail]; website:
http://www.wfp.org/

    NB: The Global Alliance to Eliminate Lymphatic
Filariasis (GAELF) and the Partners for Parasite Control
(PPC) are "umbrella" organizations which include
organizations/institutions from various sectors, including
the public and private sector, academia, international
agencies, government bodies and nongovernmental development
organizations.

    For more information, please contact:

     Mr Dick Thompson
     Communication Officer
     World Health Organization
     Tel:    [phone]
     Mobile: [phone]
     Email:  [e-mail]

SOURCE  World Health Organization