A new voice for the poor.

are a group of tropical infections, such as river blindness, hookworm, lymphatic filariasis, leishmaniasis, and trachoma, which represent some of humankind’s most ancient scourges and possibly our greatest global health disparities. Largely confined to the unseen rural areas of the developing world, the NTDs were for centuries the forgotten diseases of forgotten people [1]. They are chronic, disabling, and often stigmatizing conditions, and their poverty-promoting features provide a genuine reason why parts of Africa, Asia, and the tropical regions of the Americas cannot escape their low-income status. Although these diseases have been overshadowed by better-known conditions, especially the ‘‘big three’’—HIV/ AIDS, malaria, and tuberculosis— evidence collected in the past few years has revealed some astonishing facts about the NTDs. They are among the most common infections of the poor—an estimated 1.1 billion of the world’s 2.7 billion people living on less than US$2 per day are infected with one or more NTDs. When we combine the global disease burden of the most prevalent NTDs, the disability they cause rivals that of any of the big three. Moreover, the NTDs exert an equally important adverse impact on child development and education, worker productivity, and ultimately economic development. Chronic hookworm infection in childhood dramatically reduces future wage-earning capacity, and lymphatic filariasis erodes a significant component of India’s gross national product. The NTDs may also exacerbate and promote susceptibility to HIV/AIDS and malaria. All hope is not lost. Through the provision of a package of preventive chemotherapy, we have a unique opportunity to reduce the health and economic costs of the NTDs, a strategy that cannot be applied to most other disease entities in the developing world. Such a package may also help to tackle the big three diseases. These drug packages are being administered by a group of NTD partnerships that are working together through the Global Network for NTD Control

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