Congress And President Enact Leahy Measure
Allocating $15 M. To Target World's 'Neglected Diseases'

WASHINGTON (Friday, Jan. 6) -- Sen. Patrick Leahy (D-Vt.) has secured $15 million for treatment of seven of the world's most neglected diseases.  Leahy included his legislation in the recently enacted Foreign Operations Appropriations Bill. 

Signed into law by President Bush on Nov. 14, the bill will fund initiatives to combat intestinal parasites, leprosy, trachoma, schistosomiasis, onchocerciasis and lymphatic filariasis, which cause debilitating and disfiguring illness among hundreds of millions of people in tropical countries.

"Thankfully, Congress has been supportive of efforts to treat and prevent HIV/AIDS, tuberculosis and malaria.  Yet while our attention focuses on these three killer diseases, millions of people across our world are suffering from other diseases that do not exist in our country," Leahy said.  "I am pleased that Congress now has allocated funds to treat and prevent these illnesses that cause immense suffering in the poorest countries, among the poorest of the poor."

The Leahy measure also calls for an integrated approach to coordinate efforts to maximize donor contributions to fight these diseases.

"These are preventable or treatable diseases," Leahy said.  "This new effort will enable us to dramatically improve the lives of millions of people and move us closer to containing, and ultimately eradicating, these diseases."

Leahy is the ranking member of the Subcommittee on State, Foreign Operations and Related Programs (of the Appropriations Committee), which handles the Senate's work in writing the annual budget bill for the State Department and U.S. foreign operations.  For a decade he has led efforts in Congress to target global infectious diseases that kill millions each year and that often also are just a plane flight away from infecting Americans here at home.

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[FYI -- A recent piece by two leading doctors about the problem of 'neglected diseases' and the importance of the Leahy Amendment.] --

Fort Worth Star-Telegram
January 1, 2006

Beating Back Ancient Scourges Of The Poor

By PETER HOTEZ and ERIC OTTESEN
Special to the Fort Worth Star-Telegram

Within the last few weeks, World AIDS Day and the November 2005 Global Health Summit in New York ("The Woodstock of Global Health") focused the nation's attention on the plight of the world's poorest people, who suffer disproportionately from our planet's three greatest medical scourges: malaria, tuberculosis and HIV-AIDS.

Barely mentioned in these discussions is a little-known group of 13 infectious diseases of poverty, appropriately given the moniker "neglected tropical diseases." They represent a group of ancient conditions that have burdened humans for thousands of years, boasting detailed and vivid descriptions in the Bible, Talmud, Egyptian papyrus and other ancient texts.

Together, these conditions -- with their exotic names of African sleeping sickness, kala-azar, Chagas disease, lymphatic filariasis (elephantiasis), river blindness, guinea worm, ascariasis, whipworm, hookworm, schistosomiasis, trachoma, Buruli ulcer and leprosy -- kill more than 500,000 people annually and cause disability and hardship in billions more.

More often than not, an impoverished individual living in sub-Saharan Africa, Brazil, Central America or Southeast Asia suffers from several of these diseases at the same time.

By some estimates, these neglected tropical diseases cause morbidity that is equivalent to each of the "big three," and yet they remain largely forgotten diseases among forgotten people.

One reason is their stigmatizing character -- they are frequently disfiguring and invariably linked with poverty -- so that those afflicted often shun medical attention and almost always any political limelight.

As they are largely confined to remote rural areas of low-income countries, they remain largely unseen by television viewers.

These diseases not only occur in the setting of poverty but also promote poverty -- disabling adults, increasing maternal and infant mortality, and impairing physical and intellectual development in affected children. Thus, their impact on the health of the world's poorest profoundly affects their education and economic development as well.

Despite the long-standing neglect of these diseases that afflict 3 billion people worldwide, there is now unprecedented optimism that their morbidity can be greatly reduced in the coming years.

Why? Principally because scientific breakthroughs have now paid off in practical solutions, and the public and private sectors have joined forces to attack these ancient scourges together.

Since the late 1980s, small groups of scientists, physicians and public health workers have worked to identify and develop new agents and methods to control these biblical diseases. Now, with funding from the Bill and Melinda Gates Foundation and the U.S. government, experimental vaccines for kala-azar and hookworm have been developed and are undergoing clinical testing.

At the same time, it was discovered that four drugs developed by the pharmaceutical industry primarily for human and veterinary use in the industrialized world are also remarkably effective in controlling the morbidity and reducing the transmission of many of these neglected diseases as well.

The four drugs -- ivermectin, albendazole, mebendazol, and azithromycin

-- are not only effective, but they are currently being donated free of charge to those in need by Merck & Co. Inc., GlaxoSmithKline, Johnson & Johnson and Pfizer, respectively.

Together with the low-cost drugs praziquantel and diethylcarbamazine, it may be feasible to integrate efforts to control or eliminate six of these neglected tropical diseases -- lymphatic filariasis, river blindness, ascariasis, whipworm, schistosomiasis and trachoma -- for an extremely modest cost of between 40 cents and 90 cents a person.

Therefore, in sub-Saharan Africa, where an estimated 500 million people are afflicted with these diseases, total annual treatment could be achieved for $200 to $400 million, a fraction of what it would cost to treat any of the big three, and with an enormous return on investment both in personal health and community productivity.

Such efforts also reduce transmission of these diseases to the point of their elimination. In addition, because these infections recently have been recognized to promote increased susceptibility to malaria, HIV-AIDS and tuberculosis, their control may also represent an important ancillary step for controlling the big three.

Identifying the opportunities now available, Congress just announced an allocation of $15 million from the Foreign Operations fiscal 2006 appropriation to spur an initiative for coordinated, cost-efficient programs to control and eliminate those neglected biblical diseases designated as "targets of opportunity" because of the available no-cost or low-cost, effective drug treatment.

Although this amount might seem modest in comparison to the billions of dollars for the President's Emergency Program for AIDS Relief and other initiatives, it still represents an unprecedented commitment for efforts to control the neglected tropical diseases.

Indeed, partly because of the modest costs required for their successful control, if leveraged appropriately the $15 million allocation for integrated control of these biblical diseases could have an impact on health and productivity for the world's most underserved populations in ways that 10 times that amount might not have for other conditions.

We therefore strongly applaud Congress for passing a Foreign Operations bill that embraces such visible support for eliminating these long-neglected ancient scourges of the world's poor.

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Dr. Peter Hotez is professor and chairman of the Department of Microbiology, Immunology and Tropical Medicine at George Washington University and principal scientist of the Human Hookworm Vaccine Initiative of the Sabin Vaccine Institute in New Canaan, Conn. Dr. Eric Ottesen is director of the Lymphatic Filariasis Support Center at the Task Force for Child Survival and the Rollins School of Public Health of Emory University.