freeing the americas from nids: addressing the unfinished agenda
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Philadelphia, 6 December 2011
Mirta Roses, M.D., M.P.H.Mirta Roses, M.D., M.P.H.DirectorDirector
Pan American Health OrganizationPan American Health Organization
American Society for Tropical Medicine American Society for Tropical Medicine and Hygieneand Hygiene
Freeing the Americas from NIDs: Freeing the Americas from NIDs: Addressing the Unfinished AgendaAddressing the Unfinished Agenda
Neglected diseases, forgotten diseases.
Forgotten populations.
What are these diseases, and where are they?Who gets infected?
Do health workers really recognize the NIDs?...
A Case of Forgotten People, Forgotten Diseases
Key neglected infectious diseases in LAC
• 12 diseases are targeted under PAHO’s 2009 Resolution on NIDs:
– 10 targeted for elimination…– 2 targeted for reducing disease burden…
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Ten diseases targeted for elimination as a public health
problem
Lymphatic Filariasis Onchocerciasis Blinding Trachoma Chagas disease (domestic
vectors, blood transfusion) Human Rabies
transmitted by Dogs Plague Leprosy/Hansen’s disease Malaria (where possible) Neonatal Tetanus Congenital Syphilis
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Two diseases targeted to reduce the burden of disease, using available tools
• Schistosomiasis (S. mansoni)
• Soil-transmitted helminthiasis– Ascaris,
Trichuris, human hookworms
Persistence in areas or sites with a very high prevalence
Limited knowledge of the epidemiological situation
Many of these diseases are overlapping: affecting the same people within the same
geographical areas
6 NIDs mapped at the first administrative level:
•Schistosomiasis
•Lymphatic filariasis
•Onchocerciasis
•Trachoma
•Human Rabies transmitted by Dogs
•Soil-transmitted Helminthiasis
What is the Burden of Disease in Latin America and the Caribbean for NIDs?
Although disease burden in LAC is 8.8% of the global burden:•Soil-transmitted helminthiasis is widely disseminated: 43 million children at risk•Pockets of transmission of schistosomiasis in Brazil, Saint Lucia, Suriname and Venezuela•Lymphatic filariasis in Brazil, Guyana, Haiti and the Dominican Republic•Onchocerciasis in Brazil, Ecuador, Guatemala, Mexico, and Venezuela•Trachoma in Brazil, Colombia, Guatemala and Mexico
5 million DALYs , higher than the burden of HIV disease in the Region5 million DALYs , higher than the burden of HIV disease in the Region
Other challenge: Antimicrobial Resistance… NIDs NOT Exempt!
• Some examples– Leprosy– Leishmaniasis – Mycosis – Trachoma
• Special Risks of Resistance– Chronically
immunocompromised individuals
How do we reach Elimination?
Think of vulnerable peoples.Keep these diseases on the radar.
Diagnosis and treatment are necessary but not
enough.
We can eliminate NIDs in LAC working first within the health sector…by achieving universal coverage through
primary care
Inter-programmatic and inter-sectoral Integration: the approach needed
Protect the Medicines we have…
Prevention and Mitigation of Antimicrobial Resistance – via Rational Use of Medicines
Although still “neglected”, we have success stories to
share…
We need more stories, to reach millions more
Key actions, innovation, collaboration
Thank you
Together we can see the END of the NIDs! Together we can win the battle!
It’s an ethical and moral imperative!