Health: Neglected Tropical Diseases

Lord Patel Excerpts

Thursday 6th February 2014 Grand Committee

[Lord Patel (CB)]

My Lords, I declare an interest as a chancellor of the University of Dundee, which has a drug development unit that focuses on finding treatments for five of the key neglected tropical diseases—human African trypanosomiasis, Chagas disease, visceral leishmaniasis, malaria and tuberculosis—and which has only recently announced a potential drug for the treatment of malaria.

However, today I wish to speak not about drug development at Dundee—fantastic though it is—but, in the few minutes that I have, about why a focus on neglected tropical diseases should be given priority in women’s health and gender equality in the millennium development goals post 2015, alongside HIV/AIDS, nutrition, access to contraception and poverty reduction.

I shall speak specifically about two helminth infections—hookworm infections and schistosomiasis. These are the two key infections affecting women living in poverty in Africa and elsewhere today. Nearly 40 million women of childbearing age and 7 million pregnant women per year are infected, leading to increased maternal, neonatal and infant mortality, not to mention increased morbidity. Further, more than 10 million women suffer from genital schistosomiasis. Apart from causing much pain and distress, this condition also is linked to horizontal transmission of the HIV/AIDS virus and is a possible major factor in the AIDS epidemic. Hence, it is important for the control of HIV/AIDS, particularly in Africa.

It is believed from research carried out that highly vascular and CD4+ cell-enriched patches in the cervix or elsewhere in the female genital tract may provide host entry routes for sexually transmitted HIV, although other mechanisms are plausible. There is an urgent need for expanded studies. If this is shown to be true, it would be a major case, allowing millions of young women who are infected to control HIV/AIDS. Such findings are therefore critical for designing potential intervention strategies of the future.

A recent publication by Hotez and Whitham in the American Journal of Obstetrics & Gynaecology—I am an honorary fellow of the college—highlights in detail the problems and the solutions. An urgent expansion of mass drug administration, not only to children but to women of childbearing age, for the eradication of hookworm and schistosomiasis is needed. Current programmes hardly reach a third of the children in Africa and less then 10% of young girls, particularly women. Millennium development goals post 2015 should include new policies and advocacy of neglected tropical diseases, including the elimination of helminth infection, which is possible, and better alignment. Control of these infections to HIV/AIDS and malaria control is what is required, hence the need for the inclusion of neglected tropical diseases in the millennium development goals post 2015. I hope the Minister will ensure that the UK will support that.