What harm is caused by this neglect?
The examples of harm from this double neglect are many. Possibly due to
their chronic nature (e.g. many NTDs do not lead to high acute
mortality, but to chronic, debilitating disease), and geographical
distance from high-income countries to populations with NTDs, NTDs are
perceived as infrequent and their complications and long-term sequelae
of little consequence. However, even if many NTDs are not acutely
deadly, (e.g. Chagas disease, cutaneous leishmaniasis, soil-transmitted
nematodes) they have large impacts on individual well-being and
capabilities, local economies and health systems, and have direct
bearing on human flourishing (e.g. as measured by the key metric the
United Nations Human Development Index)).3,4 On the
other hand, some NTDs also have high mortality, particularly
concentrated in neglected populations; for example, the mortality and
morbidity burdens for malaria, TB meningitis and disseminated TB are
centered in children, and Ebola is almost uniformly fatal both to
pregnant women and to their neonates, if left
untreated.5 A large portion of individuals worldwide
who die each year from diarrhoeal disease are children, particularly
with underlying malnutrition.6,7 It is well documented
that there are often altered physiological factors that can affect drug
pharmacokinetics, leading in many cases to related safety and efficacy
concerns in vulnerable populations, such as those with prevalent
co-morbidities–obese adults, pregnant women and young children,
particularly those with malnutrition.8-10