Tiaji Salaam-Blyther
Specialist in Global Health
The term “neglected tropical diseases” (NTDs) was coined by the World HealthOrganization (WHO) in 2003 to describe a set of diseases that are ancient,worsen poverty, and typically impair health and productivity whilecarrying low death rates. Some NTDs are easily treatable; others are not.While the use of the term “NTDs” has helped to raise awareness about theselongstanding health challenges, its use risks simplifying a complicatedhealth challenge. Health interventions to address the array of NTDs vary,but a common factor to an enduring solution to these illnesses is economicdevelopment. Industrialized countries, including the United States, havecontrolled these diseases in their territories by combining drug treatment withthe construction and use of improved sanitation, modernization ofagricultural practices, and utilization of improved water systems.Neglected tropical diseases are diseases that primarily plague the poorestpeople in developing countries. Changes in the environment and population flows,however, make industrialized countries, including the United States,increasingly vulnerable to some NTDs, particularly dengue haemorrhagicfever, for which there is no cure.
Congressional interest in NTDs has been growing. Appropriations for NTDprograms have steadily increased from $15 million in FY2006 to $89 millionin FY2012. The Administration requested $67 million to support NTDprograms in FY2013. In addition to raising spending for NTDs, Congress hastaken other actions to demonstrate support for tackling NTDs. In October 2009,for example, the House Malaria Caucus expanded its purview to include NTDs. TheSenate Malaria Caucus did the same in September 2012.
The international community has made substantial progress in combating selectNTDs, though some have been tackled more effectively than others. Guineaworm disease, for example, is on the cusp of eradication. More generally,expanding access to mass drug administration is contributing to decreasesin prevalence of several NTDs, particularly across Latin America. Despitethese advances, WHO cautions that these diseases cannot be banished withoutimproving global access to clean water and sanitation, strengthening localhealth capacity (veterinary as well as human), and intensifying casedetection and management. Making improvements in these areas will requirelong-term investments that are complex and may entail facing thorny issues suchas addressing corruption, transferring ownership of health programs fromdonors to recipient countries, and evaluating the impact of political andeconomic policies on health programs (e.g., international lendingrequirements).
The United States has played an important role in combating NTDs, and PresidentBarack Obama has prioritized tackling NTDs. Recommendations forcongressional action may largely reflect broader arguments aboutcongressional engagement in improving global health. Analysts who supportcongressional directives that set programmatic targets, outline the types ofactivities to be implemented in U.S. global health programs, and mandatereporting requirements would probably argue for the 113th Congress to take similar steps. Observers who maintain that thesesteps make U.S. global health programs less effective by minimizing thecapacity of implementing agencies to adapt global health programs to localconditions would likely argue for limiting congressional support forcombating NTDs to appropriating sufficient resources. This report discusses the prevalenceof NTDs, U.S. and global actions to address them, and options the 113th Congress might consider. For additional background on NTDs,including photographs and discussions about transmission of NTDs,descriptions of activities to combat NTDs by other agencies, and additionalpolicy issues, see CRS Report R41607, Neglected Tropical Diseases:Background, Responses, and Issues for Congress, by TiajiSalaam-Blyther.
Date of Report: January 22, 2013
Number of Pages: 23
Order Number: R42931
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