New Delhi: Neglected Tropical diseases (NTDs) are a group of multiple diseases/conditions prevalent in tropical areas. These can be found in several African, Asian, and Latin American countries, where people don’t have access to clean water, and sanitation, according to the World Health Organization (WHO). NTDs have affected over a billion people globally, and many of these diseases are prevalent in India as well. On January 30, the World Health Assembly (WHA) marks World Neglected Tropical Disease Day (NTDs), to create awareness about its devastating impact on people.
To highlight the importance of the day and the issues that need attention, the NDTV-Dettol Banega Swasth India team spoke to Dr. Neeraj Dhingra, Former Director of the National Vector Borne Disease Control Programme (NVBDCP) and Member, WHO Strategic and Technical Advisory Group on NTDs.
NDTV: What are Neglected Tropical Diseases and what do we mean by the description ‘neglected’ in NTDs?
Dr Neeraj Dhingra: The Neglected Tropical Diseases (NTDs) consist of 20 conditions that are listed by the World Health Organization (WHO). These diseases are mostly prevalent in tropical areas, where the climate remains warm and humid. NTDs mostly affect impoverished communities, especially women and children. Besides, they also cause a lot of morbidity, socio-economic consequences, and much more. The diseases sometimes happen to be complex because their transmission is linked to many environmental conditions. Many of these conditions are vector borne, have animal reservoirs, and have complex life cycles. So, all these factors make public health control a challenge for a country. When we say ‘neglected’, we mean that these conditions or diseases were not on the global health agenda, and the investment and funding for their treatment were minimal. Additionally, the social stigma associated with some of these diseases and the social exclusion have also contributed to the neglect of these diseases. So, for the population that is affected by NTDs, their educational outcomes and professional capacities are also affected.
NDTV: How many people globally are at the risk of contracting one or the other Neglected Tropical Diseases (NTDs)?
Dr Neeraj Dhingra: The World Health Organization (WHO) estimates that nearly 1.7 billion people globally need prevention and treatment for at least one of the NTDs. Besides, NTDs have so far caused 2 lakh deaths globally, and around 19 million disability-adjusted life years are lost every year to NTDs. These diseases are primarily found in underdeveloped and developing countries and lead to indirect health costs and loss of productivity in these nations.
NDTV: What are the top four-five Neglected Tropical Diseases that are prevalent in India?
Dr Neeraj Dhingra: In India, there are a number of NTDs, for example, Kala Azar (commonly known as “Black Fever” and scientifically as “Visceral Leishmaniasis”), Lymphatic Filariasis (commonly known as “Elephantiasis”), Dengue, Chikungunya, Scabies, snake bites, etc. But let me tell you, India has done very well in treating and eradicating some other NTDs, for example, the country successfully eliminated Guinea worm disease. We have also seen a drastic reduction in the number of Leprosy and Trachoma cases.
NDTV: About 670 million Indians are at risk of contracting Lymphatic Filariasis (LF), which bears 40 per cent of the global burden of the disease. What are our mitigation strategies?
Dr Neeraj Dhingra: Yes, we have the largest numbers. But it is to be noted that India is one of the few countries that has conducted mass drug administration for the prevention of Lymphatic Filariasis (LF). If you look at the prevention of LF, it is very simple, as we have drugs available for it. We started off with Diethylcarbamazine, followed by Albendazole, and now we are using a third drug called Ivermectin. A person has to take this drug once a year, continuously, for a few years, depending on the disease. These drugs kill the parasites and the helminths, and the transmission is further stopped. But the medicines would prove useful only if they were consumed by 65 per cent of the population, and that remains a challenge. Compliance does not reach a high level due to the misinformation and myths associated with some of these conditions and the drugs. It is to be noted that India has done quite well in administering the drugs. There were about 328 districts in which NTDs were endemic, but now around 131 districts are already out of danger. We are also one of the few countries to start administering the third drug for LF and we started with the pilot project in districts. The research was transformed into a programme within six months and was extended to 31 districts.
NDTV: What are the prominent programmes that exist to deal with Neglected Tropical Diseases?
Dr Neeraj Dhingra: There are various programmes in India catering to several NTDs, for example, we have the National Program to Eliminate Lymphatic Filariasis, which is managed by the National Vector Borne Disease Control Programme (NVBDCP). Besides, we have elimination programmes related to Kala Azar, deworming programmes for soil-transmitted helminths under the Health Ministry. Additionally, we have eradication programmes for Dengue and Chikungunya under the NVBDCP, National Leprosy Eradication Programme under the umbrella of the National Health Mission (NHM). India successfully eradicated polio and Guinea worm disease, so the lessons learned from that can be used for the elimination of other NTDs.
NDTV – Dettol have been working towards a clean and healthy India since 2014 via the Banega Swachh India initiative, which is helmed by Campaign Ambassador Amitabh Bachchan. The campaign aims to highlight the inter-dependency of humans and the environment, and of humans on one another with the focus on One Health, One Planet, One Future – Leaving No One Behind. It stresses on the need to take care of, and consider, everyone’s health in India – especially vulnerable communities – the LGBTQ population, indigenous people, India’s different tribes, ethnic and linguistic minorities, people with disabilities, migrants, geographically remote populations, gender and sexual minorities. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign will continue to raise awareness on the same along with focussing on the importance of nutrition and healthcare for women and children, fight malnutrition, mental wellbeing, self care, science and health, adolescent health & gender awareness. Along with the health of people, the campaign has realised the need to also take care of the health of the eco-system. Our environment is fragile due to human activity, which is not only over-exploiting available resources, but also generating immense pollution as a result of using and extracting those resources. The imbalance has also led to immense biodiversity loss that has caused one of the biggest threats to human survival – climate change. It has now been described as a “code red for humanity.” The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene. Banega Swasth India will also be taking forward the dream of Swasth Bharat, the campaign feels that only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and the country can become a Swasth or healthy India.