'Kissing Bugs' That KILL

If you happen to be one of those who pay attention to world health news, then Chagas disease must have caught your attention. And if it hasn’t, then, well, here’s why you can’t let it go unnoticed. Chagas, one of the most deadly parasitic diseases in the world, affects around 14 million people worldwide and kills about 15,000 a year. It is transmitted to humans via the parasite Trypanosoma cruzi. One of the major health problems in South and Central America, it is spread by reduvid bugs, also known as “kissing bugs” because of their fondness for lips.

  Why should you care about Chagas?  
According to recent reports and warnings by scientists, Chagas disease could spread from its rural strongholds into urban areas, after a surprise outbreak in the Venezuelan capital was found to have local origins. Wondering why you should be worrying about a disease that has affected the far away, underdeveloped population of a Latin American country?

  Because 

• Chagas is a Neglected Tropical Disease, a symptom of poverty and disadvantage. According to the World Health Organization, those most affected by such diseases are the poorest populations often living in remote, rural areas, urban slums or in conflict zones. With little political voice, neglected tropical diseases have a low profile and status
  in public health priorities.
• India is not new to neglected tropical diseases. Hookworm infection and lymphatic filariasis, two dreaded tropical diseases affect over 100 million people in India. There is an urgent need for action on such diseases as they are underdiagnosed and under-researched.
• Speaking at the recently concluded seminar on “Control of the Neglected Tropical Diseases: Innovative Approaches and Role in U.S. Foreign Policy”, Peter Hotez, Distingui shed Research Professor and Chair of the Depart ment of Micro biology, Immuno - logy, and Tropical Medicine, George Washington Univer sity, said: “There were approximately 70 million cases of hookworm infection and 30 million cases of lymphatic filariasis, also known as elephantiasis, in India with the latter costing the country close to US $1 billion per year.” Hotex also mentioned Leish - maniasis, a disease with extremely high infection rates in Bihar.

  Diseases of the poor 

It is well understood that diseases such as Chagas, Elephantiasis, or the widespread Cholera and Malaria are the poor man’s diseases and therefore, not subject to much research. Diarrhoeal disease is one of the leading causes of illness and death in young children particularly in developing countries. Global death from diarrhoea in children below 5 years of age is estimated to be approximately 1.87 million, annually. India alone contributes about 20 percent of all global under-5 diarrhoeal deaths. Malaria is one of the major public health problems of the country. Around 1.5 million confirmed cases are reported annually by the National Vector Borne Disease Control Programme (NVBDCP). But how much attention is being paid to eradicate or reduce the cases of these fatal diseases?

  Millions for Viagra, Pennies for the Poor: Role played by pharmaceutical companies  

Reduction in the ‘innovation gap’ for neglected tropical diseases is the need of the hour and a meaningful impact needs to be brought about on neglected disease research. According to experts, total research funding for diabetes is more than 15 times greater than that for malaria, and more than 100 times that of other diseases such as schistosomiasis. Lifestyle drugs attract far more funding and research than the diseases of the poor and there is a proven reluctance of the pharmaceutical industry to invest in treatments of such diseases. The market for such drugs is worth billions of dollars a year and is growing rapidly. In a story titled ‘Millions for Viagra, Pennies for the Poor’, USbased writer Ken Silverstein, wrote, “Many people, most of them in tropical countries of the Third World, die of preventable, curable diseases.… Malaria, tuberculosis, acute lower-respiratory infections. People died because the drugs to treat those illnesses are nonexistent or are no longer effective. They died because it doesn’t pay to keep them alive.

  The future  

The solution to the problem, according to Hotez, and many other world scientists, lies in having simple, low-cost drug and vaccine treatments that governments need to promote. It is crucial that the world and its decision makers wake up and address critical issues such as availability of adequate funds for research and access to drugs for the diseases of the poor. Health care activists have long debated that drug patenting denies the poor access to essential medicines and discourages pharmaceutical firms from collaborating to develop new ones for neglected diseases. PM Dr Manmohan Singh’s Government has declared 2010-20 as the ‘Decade of Innovations’. It’s time the health care and pharma ceutical industries boost the research and development of drugs for the poor. It’s time for a change.