Millions of the world's poorest people are suffering needlessly from diseases that are being neglected because of the emphasis given to the "big 3" killers, HIV/AIDS, TB and Malaria, says Professor David Molyneux of the Liverpool School of Tropical Medicine.
Writing in THE LANCET, Professor Molyneux outlines how prioritising on dealing with the "big 3" is obstructing public health initiatives to tackle preventable diseases such as viral, bacterial and parasitic infections of the tropics and acute respiratory infections and diarrhoeal diseases of children.
He argues for a renewed public health effort to tackle so called "neglected diseases" which continue to have serious impact in less-developed countries. For example, he argues that conditions like leprosy should receive a bigger share of funding. Such conditions are relatively easy and cheap to treat compared to HIV, he says. Professor Molyneux says that resources are being transferred to interventions against HIV, TB and malaria that have only a limited chance of success.
"I think international organisations tend to set targets that are simply unachievable. If you take HIV, it's going to be extremely difficult to deliver anti-retroviral therapy. The target set by the World Health Organisation is three million (to receive anti-retroviral treatment in Africa) by the end of 2005. That is extremely hard to do," he said. Professor Molyneux believes that money should be directed to tropical diseases in the developing world that are currently under funded yet simple to treat.
"For 25 years there have been several programmes out there for river blindness, Guinea worm etc, all of which have been extremely well controlled with relatively small amounts of money and are cost effective. For the cost of 10 cents in Africa, you can prevent things like river blindness. For less than a dollar a year you can get rid of public health problems forever. If you contrast that with what it costs to provide anti-retroviral treatment for HIV patients, it is probably about 200 dollars per patient per year for the rest of their lives," he said. "But nobody is saying this, nobody is analysing why this is happening. It is inequitable and possibly unethical," he added.