Department of Communicable Diseases, World Health Organization Regional Office for South-East Asia, IP Estate, Mahatama Gandhi Road, New Delhi 110002, India.
Bull World Health Organ. 2010 Mar;88(3):206-10. doi: 10.2471/BLT.09.072322.
The neglected tropical diseases (NTDs), which affect the very poor, pose a major public health problem in the South-East Asia Region of the World Health Organization (WHO). Although more than a dozen NTDs affect the region, over the past five years four of them in particular - leprosy, lymphatic filariasis, visceral leishmaniasis (kala-azar) and yaws - have been targeted for elimination. These four were selected for a number of reasons. First, they affect the WHO South-East Asia Region disproportionately. For example, every year around 67% of all new leprosy cases and 60% of all new cases of visceral leishmaniasis worldwide occur in countries of the region, where as many as 850 million inhabitants are at risk of contracting lymphatic filariasis. In addition, several epidemiological, technological and historical factors that are unique to the region make each of these four diseases amenable to elimination. Safe and effective tools and interventions to achieve these targets are available and concerted efforts to scale them up, singly or in an integrated manner, are likely to lead to success. The World Health Assembly and the WHO Regional Committee, through a series of resolutions, have already expressed regional and global commitments for the elimination of these diseases as public health problems. Such action is expected to have a quick and dramatic impact on poverty reduction and to contribute to the achievement of the Millennium Development Goals. This paper reviews the policy rationale for disease control in the WHO South-East Asia Region, the progress made so far, the lessons learnt along the way, and the remaining challenges and opportunities.
被忽视的热带病(NTDs)影响着非常贫困的人群,对世界卫生组织(WHO)东南亚区域构成了重大公共卫生问题。尽管有十几种 NTDs 影响该区域,但在过去五年中,特别针对其中四种疾病 - 麻风病、淋巴丝虫病、内脏利什曼病(黑热病)和雅司病 - 进行了消除工作。选择这四种疾病有几个原因。首先,它们对 WHO 东南亚区域的影响不成比例。例如,全世界每年约有 67%的新麻风病病例和 60%的内脏利什曼病新病例发生在该区域的国家,多达 8.5 亿居民面临感染淋巴丝虫病的风险。此外,该区域特有的几种流行病学、技术和历史因素使得这四种疾病都适合消除。为实现这些目标,已经有安全有效的工具和干预措施,并且单独或综合地加大力度推广这些措施,很可能会取得成功。世界卫生大会和世卫组织区域委员会已经通过一系列决议,表达了在该区域消除这些疾病作为公共卫生问题的承诺。这种行动预计将对减贫产生快速而显著的影响,并有助于实现千年发展目标。本文回顾了在 WHO 东南亚区域进行疾病控制的政策依据、迄今为止取得的进展、沿途的经验教训,以及仍然存在的挑战和机遇。