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!