Your editorial rightly warns that malaria could be the “canary in the coalmine” for how quickly and severely decades of global health progress might unravel due to the scrapping of USAID and wavering commitment from countries such as the UK (Editorial, 27 October).
Beyond foreshadowing long-term impacts on HIV and tuberculosis, malaria likely signals what’s ahead for a lower-profile but similarly devastating group of pathogens – the “neglected tropical diseases” (NTDs).
The World Health Organization defines NTDs as conditions caused by pathogens that disproportionately affect impoverished tropical communities. These include dengue, leprosy, rabies and several diseases causing blindness, disability and stigma – together affecting more than 1 billion people. Like malaria, many NTDs rely on mosquitoes for transmission and are expected to increase with climate change.
Due to support from the Global Fund, there has been significant progress in reducing malaria since 2000. This funding has saved millions of lives. NTDs have struggled for similar sustained support, relying mostly on pharmaceutical donations, international NGOs and aid from governments including the US, EU, Japan and UK.
Nonetheless, progress has been made thanks to the dedication of communities, healthcare workers and endemic country programmes. A recent World Health Organization report indicated the number of people affected by NTDs fell by 900 million between 1990 and 2021. And 54 countries have eliminated at least one NTD, with the elimination of trachoma picking up considerable pace and dracunculiasis (guinea worm) hovering close to global eradication.
With modest, sustained funding increases, many NTDs could be consigned to history. The impact of funding cuts is harder to quantify than for malaria – many NTDs are so “neglected” that their true burden is underestimated – but the consequences will probably be severe and long-lasting.
To safeguard fragile gains against malaria, NTDs and other diseases, the UK government must maintain its support for international development. Eliminating these scourges is in the UK public’s best interest.
Prof Heather Ferguson
University of Glasgow
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