Dunn Caitlin, Callahan Kelly, Katabarwa Moses, Richards Frank, Hopkins Donald, Withers P Craig, Buyon Lucas E, McFarland Deborah
Health Programs, The Carter Center, Atlanta, Georgia, United States of America; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America.
Health Programs, The Carter Center, Atlanta, Georgia, United States of America.
PLoS Negl Trop Dis. 2015 May 21;9(5):e0003703. doi: 10.1371/journal.pntd.0003703. eCollection 2015 May.
In 2000, 189 member states of the United Nations (UN) developed a plan for peace and development, which resulted in eight actionable goals known as the Millennium Development Goals (MDGs). Since their inception, the MDGs have been considered the international standard for measuring development progress and have provided a blueprint for global health policy and programming. However, emphasis upon the achievement of priority benchmarks around the "big three" diseases--namely HIV, tuberculosis (TB), and malaria--has influenced global health entities to disproportionately allocate resources. Meanwhile, several tropical diseases that almost exclusively impact the poorest of the poor continue to be neglected, despite the existence of cost-effective and feasible methods of control or elimination. One such Neglected Tropical Disease (NTD), onchocerciasis, more commonly known as river blindness, is a debilitating and stigmatizing disease primarily affecting individuals living in remote and impoverished areas. Onchocerciasis control is considered to be one of the most successful and cost-effective public health campaigns ever launched. In addition to improving the health and well-being of millions of individuals, these programs also lead to improvements in education, agricultural production, and economic development in affected communities. Perhaps most pertinent to the global health community, though, is the demonstrated effectiveness of facilitating community engagement by allowing communities considerable ownership with regard to drug delivery. This paper reviews the contributions that such concentrated efforts to control and eliminate onchocerciasis make to achieving select MDGs. The authors hope to draw the attention of public policymakers and global health funders to the importance of the struggle against onchocerciasis as a model for community-directed interventions to advance health and development, and to advocate for NTDs inclusion in the post 2015 agenda.
2000年,联合国189个成员国制定了一项和平与发展计划,由此产生了八个可付诸行动的目标,即千年发展目标(MDGs)。自千年发展目标确立以来,它们一直被视为衡量发展进展的国际标准,并为全球卫生政策和规划提供了蓝图。然而,对围绕“三大”疾病(即艾滋病毒、结核病和疟疾)实现优先基准的强调,影响了全球卫生实体不成比例地分配资源。与此同时,几种几乎只影响最贫困人口的热带疾病仍然被忽视,尽管存在具有成本效益且可行的控制或消除方法。盘尾丝虫病就是这样一种被忽视的热带病,更常见的名称是河盲症,是一种使人衰弱并带有污名的疾病,主要影响生活在偏远贫困地区的个人。盘尾丝虫病控制被认为是有史以来最成功、最具成本效益的公共卫生运动之一。这些项目除了改善数百万人的健康和福祉外,还促进了受影响社区的教育、农业生产和经济发展。不过,也许对全球卫生界最相关的是,通过让社区在药物分发方面拥有相当大的自主权来促进社区参与已被证明是有效的。本文回顾了为控制和消除盘尾丝虫病而做出的这些集中努力对实现选定千年发展目标的贡献。作者希望引起公共政策制定者和全球卫生资助者对防治盘尾丝虫病斗争的重视,将其作为促进健康和发展的社区主导干预模式,并倡导将被忽视的热带病纳入2015年后议程。