Posted on Jan 4, 2024
Some overlooked good news from 2023: Six countries knock out 'neglected' diseases
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https://www.npr.org/sections/goatsandsoda/2024/01/03/ [login to see] /some-overlooked-good-news-from-2023-six-countries-kayo-neglected-diseases
Xavier Vaheed-DNDi, James Gathany/CDC, AFP via Getty Images
The patient – a man in his mid-30s – was languishing in a hospital in Bangladesh, infected with a disease called visceral leishmaniasis. He was so close to death he wasn't even eligible for the inadequate treatment then available: Thirty painful injections with a drug that often didn't work.
The disease, which is caused by a parasite spread by the bite of sandlies, had swelled his organs, recalls Dr. Dinesh Mondal, of the Dhaka-based research institute icddr,b. "His spleen was so big. His liver was not functioning. He was just left to die."
So Mondal asked the man if he was willing to be the first Bangladeshi to try a new option – an antifungal drug that the U.S. pharmaceutical company Gilead Sciences had originally developed for patients battling cancer and AIDS.
Xavier Vaheed-DNDi, James Gathany/CDC, AFP via Getty Images
The patient – a man in his mid-30s – was languishing in a hospital in Bangladesh, infected with a disease called visceral leishmaniasis. He was so close to death he wasn't even eligible for the inadequate treatment then available: Thirty painful injections with a drug that often didn't work.
The disease, which is caused by a parasite spread by the bite of sandlies, had swelled his organs, recalls Dr. Dinesh Mondal, of the Dhaka-based research institute icddr,b. "His spleen was so big. His liver was not functioning. He was just left to die."
So Mondal asked the man if he was willing to be the first Bangladeshi to try a new option – an antifungal drug that the U.S. pharmaceutical company Gilead Sciences had originally developed for patients battling cancer and AIDS.
Some overlooked good news from 2023: Six countries knock out 'neglected' diseases
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PO1 William "Chip" Nagel
..."Other diseases on the ropes
Gabrielli, the WHO official, says it's also worth celebrating Bangladesh's other accomplishment in 2023: tackling lymphatic filariasis, better known as elephantiasis – which a second country, Laos, also eliminated in 2023.
"It's a disfiguring disease leading to swollen limbs and disfiguration of the human body," he notes. "So it's a disease that is associated with a lot of, not only physical suffering, but psychological suffering."
Lastly, adds Gabrielli, 2023 also saw Ghana triumph over gambiense human African trypanosomiasis.
"This is the 'sleeping sickness,' " says Gabrielli, "caused by a parasite transmitted by the tsetse fly." Essentially, the parasite kills an infected person by comprising their central nervous system. "So this is also a very severe disease."
For all the progress, in 2023 the WHO added a new entry to the neglected tropical disease list: A gangrenous illness called "Noma" that mostly afflicts malnourished young children.
Meanwhile, Mondal is concerned that Bangladesh's achievement against visceral leishmaniasis has already led to a drop in international funding to ensure the disease doesn't return.
"There's still a lot to do," he says.
For instance Mondal is currently researching an associated skin disorder that as many as 20% of recovered patients may go on to develop.
"These people are healthy clinically. But they harbor the parasite," he says. "So now the challenge is to search for them very actively and also bring them under treatment so that they cannot transmit the disease to others."
Mondal also worries that Bangladesh's government may find it harder to justify the expense of continuing one of the other strategies that proved successful against visceral leishmaniasis: frequent widespread fumigation of homes against sandflies.
So Mondal and collaborators are working on a potentially more cost-effective solution: a paint that contains insecticide that can be applied to walls. In trials he says, the impact was shown to last at least two years. And he hopes to develop it into a practical option for people to apply in their homes themselves.
It's too soon to relax the vigilance against this disease, he says. "We have to continue to prepare ourselves."
..."Other diseases on the ropes
Gabrielli, the WHO official, says it's also worth celebrating Bangladesh's other accomplishment in 2023: tackling lymphatic filariasis, better known as elephantiasis – which a second country, Laos, also eliminated in 2023.
"It's a disfiguring disease leading to swollen limbs and disfiguration of the human body," he notes. "So it's a disease that is associated with a lot of, not only physical suffering, but psychological suffering."
Lastly, adds Gabrielli, 2023 also saw Ghana triumph over gambiense human African trypanosomiasis.
"This is the 'sleeping sickness,' " says Gabrielli, "caused by a parasite transmitted by the tsetse fly." Essentially, the parasite kills an infected person by comprising their central nervous system. "So this is also a very severe disease."
For all the progress, in 2023 the WHO added a new entry to the neglected tropical disease list: A gangrenous illness called "Noma" that mostly afflicts malnourished young children.
Meanwhile, Mondal is concerned that Bangladesh's achievement against visceral leishmaniasis has already led to a drop in international funding to ensure the disease doesn't return.
"There's still a lot to do," he says.
For instance Mondal is currently researching an associated skin disorder that as many as 20% of recovered patients may go on to develop.
"These people are healthy clinically. But they harbor the parasite," he says. "So now the challenge is to search for them very actively and also bring them under treatment so that they cannot transmit the disease to others."
Mondal also worries that Bangladesh's government may find it harder to justify the expense of continuing one of the other strategies that proved successful against visceral leishmaniasis: frequent widespread fumigation of homes against sandflies.
So Mondal and collaborators are working on a potentially more cost-effective solution: a paint that contains insecticide that can be applied to walls. In trials he says, the impact was shown to last at least two years. And he hopes to develop it into a practical option for people to apply in their homes themselves.
It's too soon to relax the vigilance against this disease, he says. "We have to continue to prepare ourselves."
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