Neglected Tropical Diseases

Diverse Group of tropical infections

Neglected tropical diseases are a diverse group of tropical infections which are common in low-income populations in developing regions of Africa, Asia, and the Americas. They are caused by a variety of pathogens such as viruses, bacteria, protozoa and helminths. These diseases are contrasted with the big three infectious diseases, which generally receive greater treatment and research funding. In sub-Saharan Africa, the effect of these diseases as a group is comparable to malaria and tuberculosis. NTD co-infection can also make HIV/AIDS and tuberculosis more deadly.


Neglected Tropical Diseases (NTDs) are a group of parasitic and bacterial diseases that cause substantial illness for more than one billion people globally. Affecting the world’s poorest people, NTDs impair physical and cognitive development, contribute to mother and child illness and death, make it difficult to farm or earn a living, and limit productivity in the workplace. As a result, NTDs trap the poor in a cycle of poverty and disease.

Develop global policy and guidelines for NTD control programs

CDC collaborates with the World Health Organization (WHO) and other partners to develop a solid science foundation on which to inform policy and craft guidelines for control programs. Using this evidence base, CDC works with the global community toward a consensus on best practices for controlling and, when possible, ending transmission of NTDs. This includes developing guidelines on (1) how best to measure a country’s burden of disease, as interventions are based on this information, (2) how to best measure program impact, (3) how to best deliver programs, including how often and to whom.


Conduct research to improve existing diagnostic and other tools needed to monitor programs

Monitor and evaluate progress toward elimination/control of NTDs

Provide technical assistance to countries and other partners to build capacity and improve programs

Study additional NTDs to identify and develop better tools and approaches to control and eliminate them

Much of CDC’s current work focuses on the seven NTDs – lymphatic filariasis (LF), onchocerciasis, schistosomiasis, infections from soil-transmitted helminths (hookworm, Ascaris, whipworm), and trachoma, that can be controlled or even eliminated by providing safe and effective medicines to individuals in affected communities through mass drug administration (MDA).

Develop policies Helping countries helps the world

Emphasize on Global partnerships

Strengthening national capacity by partnerships between government and private sector

Preventing and responding to international public health emergencies

Develop means to recognize Legal issues and monitoring


Mobilize new investors and private capital to underserved sectors and geographies, to create productive jobs, new economic opportunities, and enhance access to and quality of services – from financial and energy to health and education;

Giving people access to markets, where they can sell their goods and services and play a productive role in their economies;

Making governments more efficient in how they spend their money, to limit waste, strengthen investment and provide better services for citizens;

Improving infrastructure like roads, bridges, water supply and electrical grids, critical to lifting the limits on a country’s growth;

Working with private-sector companies to spur economic development, so that citizens can participate in a vibrant economy that allocates resources wisely; and

Encouraging local channels of financing, empowering entrepreneurs in developing countries to improve their lives and shape their own futures.

Food security

Over 7.5 million children under the age of 5 die from malnutrition and mostly preventable diseases, each year

Environmental Health 

Environmental Health illnesses are Meningococcal, Amoebic dysentery, typhoid and hepatitis A Schigella and Salmonella and Dengue fever requires special preventive programs funded privately or in collaboration with government participation.


What is brucellosis?

Brucellosis is an infectious disease caused by the bacteria of the genus Brucella. These bacteria are primarily passed among animals, and they cause disease in many different vertebrates. Various Brucella species affect sheep, goats, cattle, deer, elk, pigs, dogs, and several other animals. Humans become infected by coming in contact with animals or animal products that are contaminated with these bacteria. In humans brucellosis can cause a range of symptoms that are similar to the flu and may include fever, sweats, headaches, back pains, and physical weakness. Severe infections of the central nervous systems or lining of the heart may occur. Brucellosis can also cause long-lasting or chronic symptoms that include recurrent fevers, joint pain, and fatigue. But brucellosis can be very common in countries where animal disease control programs have not reduced the amount of disease among animals.


Where is brucellosis usually found?

Although brucellosis can be found worldwide, it is more common in countries that do not have good standardized and effective public health and domestic animal health programs. Areas currently listed as high risk are the Mediterranean Basin (Portugal, Spain, Southern France, Italy, Greece, Turkey, North Africa), South and Central America, Eastern Europe, Asia, Africa, the Caribbean, and the Middle East. Unpasteurized cheeses, sometimes called “village cheeses,” from these areas may represent a particular risk for tourists.


How is brucellosis transmitted to humans, and who is likely to become infected?

Brucellosis has many synonyms derived from the geographical regions in which the disease occurs (e.g., Mediterranean fever, Malta fever, Gibraltar fever, Cyprus fever


Humans are generally infected in one of three ways: eating or drinking something that is contaminated with Brucella, breathing in the organism (inhalation), or having the bacteria enter the body through skin wounds. The most common way to be infected is by eating or drinking contaminated milk products. When sheep, goats, cows, or camels are infected, their milk is contaminated with the bacteria. If the milk is not pasteurized, these bacteria can be transmitted to persons who drink the milk or eat cheeses made it. Inhalation of Brucella organisms is not a common route of infection, but it can be a significant hazard for people in certain occupations, such as those working in laboratories where the organism is cultured. Inhalation is often responsible for a significant percentage of cases in abattoir employees. Contamination of skin wounds may be a problem for persons working in slaughterhouses or meat packing plants or for veterinarians. Hunters may be infected through skin wounds or by accidentally ingesting the bacteria after cleaning deer, elk, moose, or wild pigs that they have killed.


Bilharziasis: a parasite infection by a trematode worm acquired from infested water. Also known as schistosomiasis. Species which live in man can produce liver, bladder, and gastrointestinal problems. Species of the schistosomiasis parasite which cannot live in man cause swimmer’s itch. Bilharzia is through water with Snails, causes diarrhea.


Leishmania is cutaneous and intestinal.

Leishmaniasis is caused by protozoan parasites belonging to the genus Leishmania. The parasites are transmitted by the bite of a tiny – only 2–3 mm long – insect vector, the phlebotomine sand-fly. There are some 500 known phlebotomine species, but only about 30 have been found to transmit leishmaniasis. Only the female sandfly transmits the parasites. Female sandflies need blood for their eggs to develop, and become infected with the Leishmania parasites when they suck blood from an infected person or animal. Over a period of between 4 and 25 days, the parasites develop in the sandfly. When the infectious female sandfly then feeds on a fresh source of blood, it inoculates the person or animal with the parasite, and the transmission cycle is completed.


Zika virus is a member of the virus family Flaviviridae. It is spread by daytime-active Aedes mosquitoes, such as A. aegypti and A. albopictus. Its name comes from the Ziika Forest of Uganda, where the virus was first isolated in 1947. Zika virus is related to the dengue, yellow fever, Japanese encephalitis, and West Nile viruses. Since the 1950s, it has been known to occur within a narrow equatorial belt from Africa to Asia. From 2007 to 2016, the virus spread eastward, across the Pacific.


Rotary International works in conjunction with the CDC, World Health Organization, UNICEF, and the Bill and Melinda Gates Foundation as a partner of the Global Polio Eradication Initiative (GPEI). GPEI is a public-private partnership led by national governments. Its goal is to eradicate polio worldwide.Launched in 1988 after the World Health Assembly passed a resolution to eradicate polio, GPEI, along with its partners, has helped countries to make huge progress in protecting the global population from this debilitating disease. As a result, global incidence of polio has decreased by 99.99% since GPEI’s foundation.



Pakistan has a population of 180 million inhabitants of which 177 million are at risk of malaria. With 3.5 million presumed and confirmed malaria cases annually.


Malaria that is the second most reportedly disease in Pakistan with an estimated well over four million cases each year remains the fourth largest preventable cause of death in the country among communicable diseases.


Massive scale-up of malaria interventions since 2001 has helped to save an estimated 7 million lives, according to the World Malaria Report 2018. But an estimated 3.2 billion people, almost half the world’s population across 91 countries or territories, are still at risk of malaria. Malaria was responsible for 435,000 deaths in 2017, mostly among children under 5 years of age in sub-Saharan Africa, and in the same year malaria caused 219 million people to become ill. However, there is progress: In 2017, 46 countries reported fewer than 10,000 cases of malaria, and the number of countries with fewer than 100 cases increased from 15 countries in 2010 to 26 countries in 2017.

The World Health Organization recently proposed conducting in vivo studies in pregnant women with falciparum to evaluate molecular markers for detecting resistance precociously. Malaria spread across borders by migration of refugees.


Pakistan Goal: By 2020, reduce the malaria burden by 75% in high and moderate endemic districts/agencies and eliminate malaria in low endemic districts of Pakistan



  1. To achieve <5 API in high endemic areas of province of Balochistan, Sindh, KPK and FATA region by 2020
  2. To achieve <1% API within moderate endemic districts of Balochistan, Sindh, KPK and Punjab by 2020
  3. To achieve Zero API within low endemic districts of Sindh, KPK and Punjab by 2020


Role of Directorate of Malaria Control (Post 18thconstitutional amendment)

  1. To function as a Principal Recipient for Global Fund supported malaria control specific initiatives
  2. To develop liaisons with national and international donor agencies to provide support to the provincial governments and organizations
  3. To provide technical and material resources to provinces for successful implementation of malaria control strategies, and its surveillance




Worldwide 1.2 billion people live in extreme poverty. This means little or no access to housing, clean water, basic toilet facilities, or any health care.

Education levels are low in poor areas. Poor people have shorter life expectancy than wealthier people. More mothers and children die in poor areas. Each year 9.7 million children worldwide die before their 5th birthday. Infectious disease of all types are present in poor areas. Close contact among persons sharing housing and limited sewage and waste treatment means that infections can spread more easily. They lack preventive health care or means to manage chronic diseases. Low literacy rates contribute to poor health.




Accidents, Fuel leaks, shipwrecks, factory or forest fires


Nuclear proliferation


Impact on public health & resources

  • Immediate
  • Intermediate
  • Long Term


March 11, 2011: A massive magnitude 9.0 earthquake and Tsunami occurred in Japan. Tsunamis can have serious public health consequences. Japan 12,000 missing 2000 dead

Sea water radiation

Radiation in air, water, land, milk, vegetables, fish


Travel Health Precautions:

Cholera in Haiti


Polio Outbreak in Tajikistan, Cases in Russia, Risk of Spread to other Central Asian Countries

Rabies in Bali, Indonesia

Yellow Fever in Côte d’Ivoire

Dengue, Tropical and Subtropical Regions

Yellow Fever in Uganda

Cholera in the Dominican Republic

Yellow Fever in Brazil


Short & Long Term Health Impact of Disasters

Such as Earthquakes and floods have great impact on:


Control of Funds


Language Barriers

Local Community and International Health Impact

Local Customs

Long Term Goals


Safe Transportation

Short Term Issues

Uncertain Reliability

Who is In-charge



  • Access to Care
  • Coordination of Rescue Efforts
  • Cultural Competence
  • Injury Surveillance System
  • Trauma Evacuation
  • Undisclosed Illness


Global Health

The World Health Report 2007 – A safer future: global public health security in the 21st century marks a turning point in the history of public health, and signals what could be one of the biggest advances in health security in half a century. It shows how the world is at increasing risk of disease outbreaks, epidemics, industrial accidents, natural disasters and other health emergencies which can rapidly become threats to global public health security. The report explains how the revised International Health Regulations (2005), which came into force this year, helps countries to work together to identify risks and act to contain and control them. The regulations are needed because no single country, regardless of capability or wealth, can protect itself from outbreaks and other hazards without the cooperation of others. The report says the prospect of a safer future is within reach – and that this is both a collective aspiration and a mutual responsibility.