Chapter 27 Neglected Tropical Diseases: Public Health Control Programs and Mass Drug Administration
A principle approach to the control of some of the major neglected tropical diseases(NTDs), including lymphatic filariasis (LF), onchocerciasis, schistosomiasis, soil-transmitted helminth infections, trachoma, and yaws, has relied on mass treatment of populations at risk for these infections, together with key donations of essential NTD medicines from multinational pharmaceutical companies. Known as mass drug administration (MDA) or preventive chemotherapy, this approach is now yielding important public health gains. Beginning in 2006 access to essential NTD medicines in resource-poor nations was accelerated through integration of MDA programs (by combining these medicines in a package of interventions), along with expanded financial support from the governments of the United States and United Kingdom, and coordination by the World Health Organization. As a result we have seen dramatic reductions in the global prevalence of LF, onchocerciasis, and trachoma, and as such some of these NTDs could be eliminated in the coming decade, whereas for soil-transmitted helminth infections or schistosomiasis we may need to revise current approaches or introduce improved control tools. Still for other NTDs, including the major kinetoplastid infections, intensified disease management through case detection, treatment, and vector control will be required. Better drugs or new vaccines will also be needed for optimal control for many of the NTDs.