Vanderbilt Political Review Fall 2013 | Page 9

FALL 2013 INTERNATIONAL Neglected Tropical Diseases A lmost all of the most impoverished billion human beings suffer from at least one infectious disease. A cluster of thirty diseases – collectively known as neglected tropical diseases – afflicts 1.4 billion people, more than one-sixth of the global population. According to USAID, neglected tropical diseases tend to be concentrated in “the world’s most vulnerable populations, almost exclusively poor and powerless people living in rural areas and urban slums of low-income countries,” though there is increasing documentation of their prevalence among marginalized populations in the developed world, such as urban African-Americans in the southern United States. These diseases cripple, disfigure, and scar their victims, often leaving them subject to lifelong stigmatization or severely impairing their cognitive and economic potential. The result is a poverty trap: due to deficient sanitation, little access to health care, and proximity to conflict, the world’s “bottom billion” are particularly vulnerable to neglected tropical diseases; these diseases, in turn, deprive USAID How disease makes poverty permanent by MICHAEL ZOOROB ‘16 their victims of the ability to improve their position. As victims of these diseases tend to be poor, uneducated, and politically disenfranchised, neglected tropical diseases have garnered relatively little attention from medical authorities in the developed world. Unlike malaria or HIV/AIDS, the names of these diseases may be unfamiliar but their prevalence and destruction are staggering. According to the Population Research Bureau, “roundworm (ascariasis) affects 807 million people worldwide; whipworm (trichuriasis) affects 604 million; and hookworm affects 576 million. The four other most common NTDs include schistosomiasis (snail fever), affecting about 200 million people; lymphatic filariasis (elephantiasis), which affects 120 million people; blinding trachoma, affecting more than 80 million people; and onchocerciasis (river blindness), which affects almost 40 million people.” Combined, due to their chronic nature and the enormous disability they create, neglected tropical diseases may shave off as many disability-adjusted life years (a standard mea- surement of the cost of illness) as malaria. These neglected tropical diseases share several characteristics in transmission, age, and, of course, neglect. Several are caused by helminths—worms or flukes—and others by protozoa, bacteria, fungi, or viruses. A few can pass directly from person to person; others are transmitted by the bites of insects or through contaminated soil or water. Another shared characteristic of these diseases is the role of conflict as a catalyst for their transmission. Many hotbeds of neglected tropical diseases, such as the Congo, are also rife with military conflict, which tends to degrade sanitation, health care, and housing conditions, as well as lead to mass-migrations which spread diseases. The recent conflict in Syria has promulgated the outbreak of the neglected tropical disease gastroenteritis, a flesh-eating bacteria sometimes known as the Aleppo Evil. Although sometimes deadly in their own right, neglected tropical diseases mostly cause chronic disability, including blindness. Several disfigure and stigmatize sufferers. Trachoma, for example, causes swelling of the eye, corneal scarring, and eventually, permanent blindness. Schistosomiasis leads ?????????????????????????)??????????????????????????????????)???????????????????????????1???????)???????????????????????????????)??????????????????????????????????)=?????????????????????????????????)?????????????????????????Q????????????)??????????????????????????????????)??????????????????????????????????????????????????????Q????????????????)?????????????????????????????????)???????????????????????????????????)?????????????????????????????????((?((0