An Integrated Approach to Neglected Skin Tropical Diseases Can Become a Game Changer in the Global Effort towards their Control

A panel of experts – two of them from ISGlobal- has published a paper in Plos Neglected Tropical Diseases that helps develop guidance in support of the new WHO strategic direction for the control of neglected tropical diseases with cutaneous manifestations (skin NTDs). The manuscript reinforces ISGlobal’s role in the definition and implementation of an innovative agenda for action in relation to these diseases. Building on the institution’s expertise in the field of yaws, where ISGlobal researcher Oriol Mitjà made a ground-breaking contribution that has paved the way for its eradication, ISGlobal now hosts a broader research line aimed at enhancing the control of skin NTDs.

Neglected tropical diseases (NTDs) are infectious diseases occurring almost exclusively among impoverished populations in developing tropical and subtropical countries. They affect more than 1000 million people and cost billions of dollars every year. Nine NTDs result in skin manifestations that can lead to long-term disfigurement, disability and stigma. Buruli Ulcer, cutaneous leishmaniasis and yaws are some examples of these so-called skin NTDs.

In May 2013, the World Health Assembly adopted a resolution to intensify and integrate control measures in order to optimize strategies and improve the health of NTD-affected populations. The Organization is thereby leading the deployment of a new strategic direction that will determine the approach of different stakeholders (governments of endemic countries, donors, philanthropic institutions, etc.) to policies and interventions targeting skin NTDs.

At its request, the panel of experts has designed an integrated approach involving three main activities: assessment of disease burdens to identify areas of geographic overlap, training of healthcare workers for the identification of multiple skin conditions, and establishment of clear pathways for the diagnosis and management of cases in the local community when possible.

By boosting cost-effectiveness, the new policy is likely to strengthen the health systems of the affected countries: people suffering from skin NTDs will enjoy better triage systems and, consequently, avoid the aggravation of the symptoms and their transformation into chronic, disabling conditions. The promotion of the integrated management of these and other diseases will be paramount in attaining Universal Health Coverage, and, consequently, to the successful implementation of the Sustainable Development Goals (SDGs).

The new policy will be discussed further in the upcoming WHO meeting on Buruli Ulcer, where ISGlobal’s skin NTDs research group will contribute with its expertise in the field of yaws elimination and its interaction with other NTDs in Papua New Guinea. Moreover, in 2017 ISGlobal and the WHO will co-host a training course aimed at enhancing the overall knowledge of skin NTDs and at disclosing the potential benefits of integrating their management.

The publication of the article comes at a timely manner, a couple of weeks before the celebration of the fifth anniversary of the London Declaration on Neglected Tropical Diseases, a coordinated effort endorsed by multiple actors to eliminate 10 neglected diseases (including some skin NTDs) by 2020. This declaration, which constitutes a major milestone in the agenda of control of NTDs, highlights the need for enhanced collaboration and coordination among programs and actors, in the pursuit of greater efficiency and effectiveness.

Reference:

Mitjà O, Marks M, Bertran L, et al. Integrated Control and Management of Neglected Tropical Skin Diseases. PLoS Negl Trop Dis. 2017 Jan 19;11(1):e0005136.