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Monday, February 11, 2013

Progress in Combating Neglected Tropical Diseases (NTDs): U.S. and Global Efforts from FY2006 to FY2013

Tiaji Salaam-Blyther
Specialist in Global Health

The term “neglected tropical diseases” (NTDs) was coined by the World Health Organization (WHO) in 2003 to describe a set of diseases that are ancient, worsen poverty, and typically impair health and productivity while carrying low death rates. Some NTDs are easily treatable; others are not. While the use of the term “NTDs” has helped to raise awareness about these longstanding health challenges, its use risks simplifying a complicated health challenge. Health interventions to address the array of NTDs vary, but a common factor to an enduring solution to these illnesses is economic development. Industrialized countries, including the United States, have controlled these diseases in their territories by combining drug treatment with the construction and use of improved sanitation, modernization of agricultural practices, and utilization of improved water systems. Neglected tropical diseases are diseases that primarily plague the poorest people in developing countries. Changes in the environment and population flows, however, make industrialized countries, including the United States, increasingly vulnerable to some NTDs, particularly dengue haemorrhagic fever, for which there is no cure.

Congressional interest in NTDs has been growing. Appropriations for NTD programs have steadily increased from $15 million in FY2006 to $89 million in FY2012. The Administration requested $67 million to support NTD programs in FY2013. In addition to raising spending for NTDs, Congress has taken other actions to demonstrate support for tackling NTDs. In October 2009, for example, the House Malaria Caucus expanded its purview to include NTDs. The Senate Malaria Caucus did the same in September 2012.

The international community has made substantial progress in combating select NTDs, though some have been tackled more effectively than others. Guinea worm disease, for example, is on the cusp of eradication. More generally, expanding access to mass drug administration is contributing to decreases in prevalence of several NTDs, particularly across Latin America. Despite these advances, WHO cautions that these diseases cannot be banished without improving global access to clean water and sanitation, strengthening local health capacity (veterinary as well as human), and intensifying case detection and management. Making improvements in these areas will require long-term investments that are complex and may entail facing thorny issues such as addressing corruption, transferring ownership of health programs from donors to recipient countries, and evaluating the impact of political and economic policies on health programs (e.g., international lending requirements).

The United States has played an important role in combating NTDs, and President Barack Obama has prioritized tackling NTDs. Recommendations for congressional action may largely reflect broader arguments about congressional engagement in improving global health. Analysts who support congressional directives that set programmatic targets, outline the types of activities to be implemented in U.S. global health programs, and mandate reporting requirements would probably argue for the 113
th Congress to take similar steps. Observers who maintain that these steps make U.S. global health programs less effective by minimizing the capacity of implementing agencies to adapt global health programs to local conditions would likely argue for limiting congressional support for combating NTDs to appropriating sufficient resources. This report discusses the prevalence of NTDs, U.S. and global actions to address them, and options the 113th Congress might consider. For additional background on NTDs, including photographs and discussions about transmission of NTDs, descriptions of activities to combat NTDs by other agencies, and additional policy issues, see CRS Report R41607, Neglected Tropical Diseases: Background, Responses, and Issues for Congress, by Tiaji Salaam-Blyther.

Date of Report: January 22, 2013
Number of Pages: 23
Order Number: R42931
Price: $29.95

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