Addressing the social determinants of neglected tropical diseases to achieve their control and elimination
Neglected populations living in poverty and in areas highly marginalized by the health sector throughout the world (e.g., slum and shanty-town dwellers, numerous indigenous groups and small ethnic groups as well as the rural-poor including migratory workers in agriculture, miners, and fishers) are often heavily burdened by somewhat neglected diseases. Fortunately, some drugs developed and donated by pharmaceutical companies are now available for effective control of morbidity as well as reduction in the transmission of many of these neglected diseases. This work brings to focus the determinants, which have been found to be particularly important for the perpetuation of Neglected Tropical Diseases (NTDs) in endemic communities: water and sanitation, housing and clustering, environment, migration, disasters and conflicts, socio-cultural factors and gender, and finally poverty. Notwithstanding the successes achieved by the international community in the use of drugs to control the neglected diseases, this paper is of the strong opinion that for sustainability of this programme, national and international communities should re-channel expenditures and activities also on preventive and promotive measures in addressing the issue of these determinants. These include (a) addressing safe and clean water supply, improved sanitation and household-related factors including personal hygiene (b) reducing environmental risk factors (c) improving the health of migrating populations (d) reducing inequity due to socio cultural factors and gender (e) reducing poverty in NTD-endemic populations. Addressing the social determinants related to NTDs is a direct way of gaining headway within public health and at the same time is a prerequisite for confronting inequities in NTD control.
Keywords: NTDs, poverty, housing and clusterig disasters and conflicts