University of Khartoum

Neglected Tropical Diseases – a case for eradication and the related public health challenges

Neglected Tropical Diseases – a case for eradication and the related public health challenges

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Title: Neglected Tropical Diseases – a case for eradication and the related public health challenges
Author: Tanner, Marcel
Abstract: The global health community pays renewed attention to evaluating the feasibility of elimination and eradication of additional communicable diseases, particularly Neglected Tropical Diseases (NTDs) besides continuing to aim at reducing the burden of ill-health. While the health and economic benefits of disease elimination and subsequent eradication may be substantial, elimination initiatives represent resource-intensive efforts with associated opportunity costs. Thus, besides studying the biomedical approaches and the accompanying R&D agenda, any attempt of considering elimination and eradication efforts also entail engaging into developing the Eradication Investment Case (EIC). An EIC is an economic assessment addressing all three fundamental economics questions: 1) the “What question”, that compares remaining in control mode versus moving towards elimination and then eradication; 2) the “How question”, that assesses which intervention/s or strategy/ies should be adopted by which stakeholder, how much resources would be required and how they could be mobilized; and 3) the “For whom” question, that assesses who would benefit from control or elimination in terms of health and economic benefits, and the likely impact on equity and fairness. We will presents the rationale, the approaches to be pursued and the main methodological challenges of developing EICs for NTDs and will show that the EIC approach goes beyond traditional efficacy and efficiency measures to take into account multiple dimensions. An EICs will not only test the applicability and feasibility of elimination/eradication but will also serve to inform decisions of global and national policy makers. At the level of public health action, a key towards success is the development of surveillance and response approaches that are required to effectively achieve NTD elimination / eradication in a given endemic setting. Introducing surveillance-response approaches represents a paradigm shift from maintaining comprehensive monitoring and evaluation activities to focusing on the approaches that rapidly detect remaining / reemerging pockets or “hot spots” of transmission and allow swift public health action with well-tailored integrated response packages to interrupt transmission of NTDs. The main feature of the surveillance response systems / approaches is that they are based on the concept of collecting minimal essential data in space and time to identify pockets of transmission or reintroduction within the context of a given health and social system. EICs and the introduction of surveillance-response systems integrated into the respective national health system will form the crucial cornerstone for any effective and integrated use of old and new control/elimination tools/approaches and, thus, for any successful NTD elimination/eradication program.
URI: http://khartoumspace.uofk.edu/handle/123456789/19561
Date: 2015


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