Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK.
Parasit Vectors. 2011 Dec 13;4:234. doi: 10.1186/1756-3305-4-234.
Since 2004 there has been an increased recognition of the importance of Neglected Tropical Diseases (NTDs) as impediments to development. These diseases are caused by a variety of infectious agents - viruses, bacteria and parasites - which cause a diversity of clinical conditions throughout the tropics. The World Health Organisation (WHO) has defined seventeen of these conditions as core NTDs. The objectives for the control, elimination or eradication of these conditions have been defined in World Health Assembly resolutions whilst the strategies for the control or elimination of individual diseases have been defined in various WHO documents. Since 2005 there has been a drive for the expanded control of these diseases through an integrated approach of mass drug administration referred to as Preventive Chemotherapy via community-based distribution systems and through schools. This has been made possible by donations from major pharmaceutical companies of quality and efficacious drugs which have a proven track record of safety. As a result of the increased commitment of endemic countries, bilateral donors and non-governmental development organisations, there has been a considerable expansion of mass drug administration. In particular, programmes targeting lymphatic filariasis, onchocerciasis, schistosomiasis, trachoma and soil transmitted helminth infections have expanded to treat 887. 8 million people in 2009. There has been significant progress towards guinea worm eradication, and the control of leprosy and human African trypanosomiasis. This paper responds to what the authors believe are inappropriate criticisms of these programmes and counters accusations of the motives of partners made in recently published papers. We provide a detailed response and update the information on the numbers of global treatments undertaken for NTDs and list the success stories to date.The paper acknowledges that in undertaking any health programme in environments such as post-conflict countries, there are always challenges. It is also recognised that NTD control must always be undertaken within the health system context. However, it is important to emphasise that the availability of donated drugs, the multiple impact of those drugs, the willingness of countries to undertake their distribution, thereby committing their own resources to the programmes, and the proven beneficial results outweigh the problems which are faced in environments where communities are often beyond the reach of health services. Given the availability of these interventions, their cost effectiveness and the broader development impact we believe it would be unethical not to continue programmes of such long term benefit to the "bottom billion".
自 2004 年以来，人们越来越认识到被忽视的热带病（NTDs）是发展的障碍。这些疾病是由各种传染病病原体引起的，在热带地区引起多种临床病症。世界卫生组织（WHO）已将其中的 17 种情况定义为核心 NTDs。世界卫生大会决议已确定了这些病症的控制、消除或根除目标，而各种 WHO 文件则确定了针对个别疾病的控制或消除战略。自 2005 年以来，通过社区为基础的分发系统和学校，开展了大规模药物治疗的综合方法，推动了这些疾病的广泛控制。这得益于主要制药公司捐赠的高质量和有效的药物，这些药物具有安全的良好记录。由于流行国家、双边捐助者和非政府发展组织的承诺增加，大规模药物治疗得到了极大的扩展。特别是，针对淋巴丝虫病、盘尾丝虫病、血吸虫病、沙眼和土壤传播性蠕虫感染的方案已经扩大，以在 2009 年治疗 88780 万人。在麦地那龙线虫病根除、麻风病和人体非洲锥虫病控制方面取得了重大进展。本文回应了作者认为对这些方案的不适当批评，并反驳了最近发表的论文中对合作伙伴动机的指责。我们提供了详细的回应，并更新了全球开展的 NTD 治疗次数的信息，并列出了迄今为止的成功案例。本文承认，在冲突后国家等环境中开展任何卫生方案都存在挑战。同时也认识到，必须在卫生系统背景下开展 NTD 控制。然而，必须强调的是，捐赠药物的供应、这些药物的多重影响、国家愿意开展其分发工作，从而将自己的资源投入到方案中，以及经过验证的有益成果，超过了在社区往往无法获得卫生服务的环境中面临的问题。考虑到这些干预措施的可用性、其成本效益以及更广泛的发展影响，我们认为，如果不继续开展对“最底层十亿人”有长期利益的方案，将是不道德的。
