One year on and accelerating work to overcome neglected tropical diseases
Sustained vector control has largely contributed to reducing transmission of Chagas disease in Latin America and has helped save millions from chronic impairments. Between 2007 and 2010, 2 million nifurtimox tablets were distributed for second-line treatment of Chagas disease. During the same period, 30 000 patients in endemic countries received benzidazole as a first-line treatment. Moreover, WHO is leading a global awareness campaign in response to the spread of Chagas disease outside Latin America. An informal non-endemic countries initiative for addressing this problem was established in 2007.
Immediate intervention by WHO in providing medicines, logistics and support during an outbreak of visceral leishmaniasis in South Sudan in 2010 and early 2011 enabled the treatment of 60% of the total 12000 patients; the case-fatality rate was 5% compared with that of 95% in the 1990s. Early and appropriate treatment averts death from visceral leishmaniasis or the stigma of cutaneous leishmaniasis. Regional control programmes, particularly on the Indian subcontinent, have strengthened capacity building, access to medicines and surveillance over the past five years. Similar programmes have now been launched in the Region of the Americas, the Eastern Mediterranean Region and the European Region.
Today, dengue ranks as the most important mosquito-borne viral disease in the world, with nearly 3 billion people at risk in over 100 countries. A WHO survey in 2010 revealed that since 2005, the WHO-recommended policy of integrated vector management has been adopted in 68 of 110 participating countries with vector-borne diseases. This integrated vector management approach for dengue has benefitted over 20 million people in three WHO regions (the Western Pacific Region, the South-East Asian Region and the Region of the Americas). WHO also supports capacity building for clinical management of severe dengue cases in all Regions.
WHO advocates Integrated Vector Management as an approach to control dengue fever, Chagas disease and lymphatic filariasis. In early 2011, WHO published a position paper on Integrated Vector Management for lymphatic filariasis and malaria, which promotes the integrated use of effective vector control measures to control and eliminate lymphatic filariasis in areas in central Africa where Loa loa is concurrently endemic.
Management of pesticides used in public health is a priority for WHO as Integrated Vector Management emerges as the major component of a strategy to facilitate the sustainable use of pesticides and the reduction of associated health risks. Between 2008 and 2010, the WHO Pesticide Evaluation Scheme (WHOPES) supported 13 WHO Member States to develop national action plans for sound management of pesticides for public health. Furthermore, standards of pesticide quality developed by WHOPES are currently being used in 96 countries where vector-borne diseases are endemic.