For neglected tropical diseases, $0.40 goes a long way (Part 2)

The Clinton Global Initiative, UN Summit on Millennium Development Goals, and TEDxChange are only one week away. We present this series of five daily blogs on Neglected Tropical Diseases as an example of an area where philanthropists can make a big social impact. This is the second in a series of five posts that look at the impact of neglected tropical diseases and why philanthropists focused on health may be interested. In the previous blog, we introduced you to neglected tropical diseases and their devastating impact on the poor. Now, we’ll examine some of the inexpensive treatments that are already available.

In order to control neglected tropical diseases, we need both short-term interventions as well as long-term investments in health infrastructure such as clean water and sanitation systems.

Neglected diseases are often referred to as “tool ready” or “tool deficient”.1 Tool ready diseases have treatments that are available now. They are often inexpensive and simple. In addition, implementation strategies are feasible, but are not being adequately implemented. Tool deficient diseases do not yet have readily available treatment options that are safe and effective and more research is required.

Cost-effective medical treatment for “tool ready” diseases:

NTDs can be relatively easy to treat. For as little as $0.40 – $0.79 per person per year, people can be treated with a four drug combination to treat multiple infections.2 Unlike HIV/AIDS which requires daily treatment for life, some of these diseases can be cured with one dose of medication if reinfection does not occur. This type of disease management is said to be among the most cost effective global health initiatives.3,4

Treatments of NTDs have been found to be a great value for the price. DALY, or disability adjusted life year, is a metric that considers both death and disability. School based deworming programs for children, using the drug albendazole, costs US$2 – $9 per DALY averted.5 That means for less than ten dollars, a year healthy life can be sustained by averting the damaging health impact of intestinal worms. Programs targeting disabling diseases, such as most NTDs, have shown to be extremely high value investments, averaging a 15-30% rate of return.6

NTD Snapshot7

Available but not received:

Some of the most treatable diseases are those affecting children. Intestinal worms cause children to be ill, miss school, and experience developmental delays. Through “de-worming” programs children can be given the necessary medicine to help them shed these parasites. Sadly, in 2005 only 20% of at risk school age children were being treated.8 Partnerships exist where drug companies provide medications free of charge, and government or community based groups distribute the pills to rural villages. Philanthropists can help finance community education and the distribution of these drugs.

Takeaway message for philanthropists:

  • For some NTDs the treatment options are established, but require support to get them to the communities in need.
  • Opportunity for action/Strategic gap to fill: As several drug companies often donate drugs to treat these diseases, philanthropists can play a significant role in funding the delivery of medicine to the rural villages where they are often needed in most.
  • Investors in this area can see immediate results in the lives of those they help.

In the next blog we’ll look at another tropical disease, blinding trachoma, and how combining immediate treatment with long term prevention strategies can further reduce disease burdens.

Thanks to the authors, Isobel Harvey, former CHIP researcher and master’s candidate at the Thomas Jefferson University School of Nursing, and Carol McLaughlin, CHIP research director, for their contributions to this series.

1 The Carter Center, The World Health Organization (2008). Integrated control of the neglected tropical diseases. Atlanta, GA.

2 The Carter Center, The World Health Organization (2008). Integrated control of the neglected tropical diseases. Atlanta, GA.

3 Bitran, R., Martorell, B., Escobar, L., Munoz, R., Glassman. (2009). Controlling and eliminating neglected diseases in Latin America and the Caribbean. Health Affairs, 28, 6, 1707-1719.

4 Hotez, P., Molyneax, D., Fenwick, A., Kumaresan, J., Sachs, S., Sachs, J., Savioli, L. (2007). Control of neglected tropical diseases. The New England Journal of Medicine, 357, 10, 1018-1027.

5 Laxminarayan, R., Chow, J., Shahid-Salles, S. (2006). Disease Control Priorities in Developing Countries. Oxford University Press: New York, NY.

6 Molyneux, D. (2004). “Neglected” diseases but unrecognized success-Challenges and opportunities for infectious disease control. Lancet, 364, 380-383.

7 Global Network for Neglected Tropical Diseases (2010). The Seven Most Common NTDs. Retrieved from

8 Children without Worms (2007). Partnership for treating and preventing intestinal worms. Retrieved from