Half of world’s tropical disease cases in India

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With 58 per cent leprosy cases, 40 per cent lymphatic filariasis and 34 per cent of all dengue cases globally, India has the highest burden of neglected tropical diseases (NTDs) in the world.

Also, over half of the 17 World Health Organisation (WHO) classified NTDs are still at endemic levels in the country, which include visceral leishmaniasis (kala azar) and soil-transmitted helminthes.

There is an urgent need, therefore, to accelerate research and development for new tools, medicines and indigenous tests to eradicate the NTDs that affect millions of Indians every year.

It is towards that end that Global Health Progress, Organisation of Pharmaceutical Producers of India (OPPI) and International Federation of Pharmaceutical Manufacturers & Associations (IFPMA) recently came together to launch an initiative called “Partnering for Success — Reducing India’s Burden of Neglected Tropical Diseases,” followed by a report, Action on Neglected Tropical Diseases.

The report estimates that nearly 290 million people are infected, and a significant proportion of those afflicted, especially children, may be simultaneously infected with more than one NTD. “In addition to making life extremely difficult for many of India’s poorest populations, such a tremendous disease burden has the doubly lethal affect of huge economic losses in a population that already lives on less than $2 dollars a day,” it added.

NTDs are a diverse set of bacterial, viral, and parasitic pathogens that collectively cause significant illness and debilitation, primarily in impoverished communities of low and middle-income countries. Traditionally, these diseases have been overlooked or under-resourced compared with other higher-mortality diseases and, as a result, afflicted patients have been under-diagnosed and under-treated.

The WHO has grouped 17 diseases under the NTD banner that collectively affect over one billion people worldwide and are endemic in 149 countries.

The report also said: “Over the past few years, the commitment of the international community in addressing NTDs has grown. Largely catalysed by the WHO’s 2020 Roadmap on NTDs, the 2012 London Declaration and most recently the 2013 World Health Assembly resolution addressing all 17 NTDs, India and other countries have accelerated efforts to address these tropical diseases. However, despite increased commitment, several challenges remain, including those of understanding the full burden of NTDs in the country; reaching the poorest and most marginalised populations with quality tools and services; increasing research and development for NTDs; applying best practices and integrating services; and, building and sustaining political and economic support.”

It further said that many NTDs lack point-of-care diagnostic tools and require laboratory-intensive methods to definitively diagnose. “Increasing R&D for innovative diagnostic tools is essential to improve understanding of the full NTD burden. Furthermore, strengthening existing surveillance programmes will not only help facilitate understanding the true incidence and prevalence of NTDs but can help treatment programmes to effectively reach high burden areas,” the report added.

According to doctors, the neglect towards such diseases is because lack of awareness. Dr Sanjeev Mehta, senior chest physician with Mumbai’s Lilavati Hospital, says, “It is common practice to deal with more common ailments such as tuberculosis than the less common, but equally severe, NTDs.” Also, the common man does not have the right kind of awareness and government schemes or resources never end up reaching him, Mehta adds.

Dr D Suresh Kumar, consultant, infectious diseases in Chennai, says: “Most of these diseases are vector borne and water borne and the problem is that many of them cannot be identified and confirmed through diagnosis since proper laboratories are not available everywhere.” However, he points out that while dengue has been listed as an NTD by WHO, that is not really the case in India because the awareness towards malaria and dengue is much more than other diseases.

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