The neglected zoonoses—the case for integrated control and advocacy

Abstract

The neglected zoonotic diseases (NZDs) have been all but eradicated in wealthier countries, but remain major causes of ill-health and mortality across Africa, Asia, and Latin America. This neglect is, in part, a consequence of under-reporting, resulting in an underestimation of their global burden that downgrades their relevance to policy-makers and funding agencies. Increasing awareness about the causes of NZDs and how they can be prevented could reduce the incidence of many endemic zoonoses. Addressing NZDs by targeting the animal reservoir can deliver a double benefit, as enhanced animal health means a reduced risk of infection for humans, as well as improved livelihoods through increased animal productivity. Advocacy for NZD control is increasing, but with it comes a growing awareness that NZD control demands activities both in the short term and over a long period of time. Moreover, despite the promise of cheap, effective vaccines or other control tools, these endemic diseases will not be sustainably controlled in the near future without long-term financial commitment, particularly as disease incidence decreases and other health priorities take hold. NZD intervention costs can seem high when compared with the public health benefits alone, but these costs are easily outweighed when a full cross-sector analysis is carried out and monetary/non-monetary benefits--particularly regarding the livestock sector--are taken into account. Public-private partnerships have recently provided advocacy for human disease control, and could prove equally effective in addressing endemic zoonoses through harnessing social impact investments. Evidence of the disease burdens imposed on communities by the NZDs and demonstration of the cost-effectiveness of integrated control can strengthen the case for a One Health approach to endemic zoonotic disease control.

Global Distribution of Alveolar and Cystic Echinococcosis

“…However, these figures are likely prone to underreporting and underdiagnosis (Mathers et al, 2007;Welburn et al, 2015). s0160 2.3.3 Middle East Countries, e.g., Iran, Turkey p0460 AE is rare in tropical and subtropical areas of the Middle East (ME).…”

Taenia solium Taeniasis and Cysticercosis in Southeast Asia

“…Lack of education and social stigmatization may also lead to underreporting of symptoms. 34,44 Moreover, appropriate imaging modalities such as computed tomography are not readily available in many rural areas of SEA. Clinical assessment is thus mainly based on the history of seizures, passage of proglottids in stool, and the presence of subcutaneous cysticerci nodules on examination.…”

“…The simplest solution therefore is to stop T. solium transmission from human to pigs by providing latrines and clean water to prevent open defecation, ensuring hygienic animal husbandry practices and also to stop transmission from pigs back to humans through veterinary sanitary measures such as regulation of meat inspection practices and not eating raw pork. 44 Other components of community control strategies are further highlighted in Table 2. However, in practice, it has been difficult to achieve these control measures.…”

“…3,14 In other words, an integrated One Health approach is necessary with political commitment and inter-sectoral collaboration at local, national, and international levels. 29,44,77 However, to date, high-quality evidence on the impact of community-based control strategies is largely lacking. A recent study searched all published literature and analyzed the effectiveness of community-based control strategies, employing either a single or a combination of multiple interventions that used pre-and post-intervention designs.…”

One Health for a changing world: new perspectives from Africa

“…Trypanosomiasis, leptospirosis and brucellosis, for example, undermine the well-being of millions of people, yet do not get the attention of those diseases associated with potential global outbreaks [8][9][10]. The burdens of such neglected zoonotic diseases are concentrated in poorer parts of the world, where health and veterinary services are inadequate, and the toll of such diseases is undiagnosed and hidden from view [11].…”