By: Bruno Alves Pereira (IC-FAPERJ), Nayane Abreu do Amaral e Silva (Doutoranda PPGQ-UFF), Drª. Daniela de Luna Martins (PPGQ-UFF)
The expression Neglected Diseases (NDs) was proposed in 1970 to describe parasitic or infectious diseases that affect poor people in vulnerable situations. [1]
Over time, this term has been related to several definitions. At the beginning, it was used to describe diseases neglected by funding agencies, that is, through the use of this term, the aim was to draw attention to the low financial investment of research development agencies in themes related to ND. Afterwards, the term was used as a reference to designate diseases for which the pharmaceutical industry did not develop drugs. The World Health Organization (WHO) has already used this term for diseases caused by poverty, coming to the understanding that these diseases are also the cause of poverty. [2]
In 2021, WHO listed the following diseases as neglected tropical diseases: Chagas Disease, Sleeping Disease, Leishmaniasis, Filariasis, Schistosomiasis, Leprosy, Dengue and Chikungunya, Ascariasis, Trichuriasis, Necatoriasis and Ankyleriosis, Haceriosis, Dracunculiasis, Dracunculiasis food-borne, Buruli ulcer, Mycetoma and other deep mycoses; Onchocerciasis, ectoparasitosis and also snakebite poisoning. [3]
For information on some neglected diseases, see table 1.
Table 1 - Examples of NDs and their etiological agents and number of affected [3]
Neglected diseases (NDs) are endemic in poor regions of Africa, Asia and the Americas. Although they are considered public health problems, there is still little investiment by large pharmaceutical companies in the search for new drugs and therapies for these diseases. The low purchasing power of affected populations may explain the positioning of pharmaceutical industries, due to the low expectation of financial return. [3]
Within the context of difficulties associated with NDs, in 2003, a non-profit research and development organization was created with the aim of offering new treatments for this set of diseases: Drugs for Neglected Diseases Initiative (DNDi). DNDi's regional office in Latin America is headquartered in Rio de Janeiro and the organization has a partnership with the Oswaldo Cruz Foundation (Fiocruz). [6]
According to DNDi, in the period 2000-2011, only 4% of the new therapeutic products approved were aimed at NDs. [4] In addition to the prevalence of Chagas Disease, Leishmaniasis and Leprosy, the country also has high rates of infections by other diseases such as HIV, Tuberculosis [5] and Malaria. [2]
More than 1 billion people are affected by these diseases. In addition to pain and disability, the NDs can cause death. [7]
Brazil represents 90% of the burden of NDs in Latin America and the Caribbean, with a prevalence of Chagas Disease, Leishmaniasis, and Leprosy. [2]
Eradicating neglected diseases is one of the challenges of WHO to be achieved worldwide by 2030, being the goal 3.3 of the Sustainable Development Goals of the 2030 Agenda. In target 3.3, it was established that: “By 2030, end the AIDS epidemics, tuberculosis, malaria and neglected tropical diseases, and fighting hepatitis, waterborne diseases, and other communicable diseases.” [8]
References:
[1] W. Souza; Doenças negligenciadas; Academia Brasileira de Ciências; Rio de Janeiro, 2010.
[2] Fiocruz's website. Available in: https://portal.fiocruz.br/noticia/fiocruz-debate-doencas-negligenciadas-e-agenda-2030. Accessed: June 02, 2021.
[3] World Health Organization (Ending the neglect to attain the Sustainable Development Goals A road map for neglected tropical diseases 2021–2030). Available in: https://www.who.int/publications/i/item/9789240010352. Accessed: July 29, 2021.
[4] Fiocruz News Agency website: https://agencia.fiocruz.br/doencas-negligenciadas. Accessed: June 22, 2021.
[5] About tuberculosis, check out our blog post: https://www.danielamartinsgroup.com.br/post/tuberculose (Portuguese). https://en.danielamartinsgroup.com.br/post/tuberculosis (English).
[6] Drugs for Neglected Diseases Initiative (DNDi) website. Available in: https://www.dndial.org/. Accessed: June 27, 2021.
[7] Pan-American Health Organization. Available in: https://www.paho.org/pt/noticias/29-1-2021-oms-lanca-plano-10-anos-para-acabar-com-sofrimento-causado-por-doencas-tropicais . Accessed: June 27, 2021.
[8] United Nations website in Brazil. Available in: https://brasil.un.org/pt-br/sdgs/3. Accessed: June 02, 2021.