Concentration on the "big three" diseases of Aids, tuberculosis and malaria has diverted resources from half a dozen easily treated illnesses that have a greater impact on healthcare and economic development in Africa, three leading medical specialists have recently warned.
In a paper published in the online journal PLoS Medicine, David Molyneux from the Liverpool School of Tropical Medicine, Peter Hotez from George Washington University and Alan Fenwick from Imperial College London call for the launch of a "small costs, huge impact" public health programme in sub-Saharan Africa.
"We are not saying give less to the other diseases, but let's have a better balance," said Prof Fenwick, who stressed that treatment of several "neglected diseases" would also reduce the risk of contracting serious malaria and TB.
While much academic effort and political support have gone into research programmes to find treatments for the high-profile big three, the authors point to the high costs and the failure to significantly reduce transmission even with substantial international funding.
By contrast, they argue that only $200m a year over five years to distribute four existing drugs could effectively treat 500m people, rapidly reducing poverty and helping achieve seven of the United Nations' eight Millennium Development Goals and the targets of the Commission for Africa.
With the pills themselves already offered free or very cheaply by existing manufacturers, they estimate that only 40 US cents per patient each year would cover the costs of both medicines and wide-ranging distribution for lymphatic filariasis, schistosomiasis, intestinal helminths, onchocerciasis and trachoma.
That compares with treatment costs of more than $200 per person per year for life for HIV/Aids, $200 for each tuberculosis treatment and more than $7.0 for each case of malaria, which can often recur five to 10 times each year.
Intensified efforts to raise extra short-term funding to implement proven treatments would mirror the support the newly launched International Financial Facility had provided for immunisation, with likely greater compliance because of the easier logistics and more rapid effect of taking medicines.
Prof Fenwick stressed that the drugs were safe and effective, and could be given in combination with each other and throughout a population.
The drugs are Mectizan, donated by Merck, Albendazole, donated by GlaxoSmithKline, Zithromax, donated by Pfizer, and Praziquantel, produced cheaply by companies in China. Several are already manufactured for profit in the developed world for the treatment o infections in animals.
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