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. 2016 May 12;10(5):e0004560.
doi: 10.1371/journal.pntd.0004560. eCollection 2016 May.

Between-Country Inequalities in the Neglected Tropical Disease Burden in 1990 and 2010, with Projections for 2020

Wilma A Stolk  1 , Margarete C Kulik  1   2 , Epke A le Rutte  1 , Julie Jacobson  3 , Jan Hendrik Richardus  1 , Sake J de Vlas  1 , Tanja A J Houweling  1
Affiliations

Between-Country Inequalities in the Neglected Tropical Disease Burden in 1990 and 2010, with Projections for 2020

Wilma A Stolk et al. PLoS Negl Trop Dis. .

Abstract

Background: The World Health Organization (WHO) has set ambitious time-bound targets for the control and elimination of neglected tropical diseases (NTDs). Investing in NTDs is not only seen as good value for money, but is also advocated as a pro-poor policy since it would improve population health in the poorest populations. We studied the extent to which the disease burden from nine NTDs (lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminths, trachoma, Chagas disease, human African trypanosomiasis, leprosy, visceral leishmaniasis) was concentrated in the poorest countries in 1990 and 2010, and how this would change by 2020 in case the WHO targets are met.

Principal findings: Our analysis was based on 1990 and 2010 data from the Global Burden of Disease (GBD) 2010 study and on projections of the 2020 burden. Low and lower-middle income countries together accounted for 69% and 81% of the global burden in 1990 and 2010 respectively. Only the soil-transmitted helminths and Chagas disease caused a considerable burden in upper-middle income countries. The global burden from these NTDs declined by 27% between 1990 and 2010, but reduction largely came to the benefit of upper-middle income countries. Achieving the WHO targets would lead to a further 55% reduction in the global burden between 2010 and 2020 in each country income group, and 81% of the global reduction would occur in low and lower-middle income countries.

Conclusions: The GBD 2010 data show the burden of the nine selected NTDs in DALYs is strongly concentrated in low and lower-middle income countries, which implies that the beneficial impact of NTD control eventually also largely comes to the benefit of these same countries. While the nine NTDs became increasingly concentrated in developing countries in the 1990-2010 period, this trend would be rectified if the WHO targets were met, supporting the pro-poor designation.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. World map showing the GNI classification of countries in 2010.
Fig 2
Fig 2. Burden of disease by country income group for nine NTDs, in 1990, 2010 and 2020.
Fig 3
Fig 3. Burden of disease by NTD, region and calendar year.
Fig 4
Fig 4
Time trend in the total burden of disease caused by the nine NTDs from 1990 to 2020, (A) globally and (B) by gross national income per capita.
See this image and copyright information in PMC

References

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