The Opportunity Cost of Neglected Diseases: Responding to Zika Virus in Latin America
Published on Sep 20, 2016
The following article represents the opinions of a medical professional, regarding the recent outbreak of the Zika Virus. Through my time as a medical professional in Latin America, I have observed the investment of public health resources go to immediate and politically prioritized health problems. The inclination is for a health crisis to be addressed, once impact is severe, and funded action for prevention and research is limited. The opportunity losses from our overemphasis on reactive public health decision making may be greatest with the so-called “Neglected Tropical Diseases (NTDs).” These diseases are considered “neglected”, because they are overlooked by drug developers, government officials, and the news media, unless they cause outbreaks that kill and cause suffering among a large number of people. HIV/AIDS in the 80s and 90s, Ebola in 2014, and now Zika in 2016, we have, once again, a “neglected” disease that has been known for 70 years, causing major international impact. This title of “neglect” needs to stop. To start, the number of diseases grouped in the so-called “neglected” category is sizeable. Over 1.4 billion people suffer from them. NTDs perpetuate the cycle of poverty: They blind, disable, and disfigure their victims, trapping them in a cycle of hardship and disease. NTDs are the leading causes of chronic disability in low- and middle-class countries. The indifference status for NTDs is even more dangerous if we consider they are not limited to impoverished ´remote isolated tropical regions´ anymore; in reality, without boundaries, it’s a matter of a few months to be spread globally. Attacking NTDs is important, not because of the people in treatment or admitted in a hospital ward, today. It is important, because of the social, emotional, and economic burden of -sometimes- a whole generation that results from our ignoring it. With the recent Zika outbreak, NTD is causing children to be born with microcephaly, which causes serious developmental disabilities and costs up to USD $2 million during the first years of their lives. Scientists at the University of Texas Medical Branch, studying the Zika virus, have warned it could be a decade before a vaccine is publicly available. So, we have to resort to methods, like delaying or avoiding pregnancies, when we don’t even know if that’s efficient or if it is causing severe ethical dilemmas in a continent, where 56% of pregnancies are unintended. The few times a NTD attracts media attention, I get the feeling I’m reading a basic newsletter on Infectious Diseases: the new notified cases, the geographic area of expansion, the signs and symptoms, the potential treatment, and the emergency funds to come up with a vaccine. There’s a significant lack of funds for research and a general lack of awareness about these diseases, as it simply doesn’t offer a lot of potential profit. And it’s not fair to blame it on Big Pharma, given that developing a new drug costs around USD$800 million. It’s understandable that funds for research are scarce and often invested in countries believed to be the biggest priorities. But when worse comes to worse and rapid action is needed, as now with the Zika emergency, we find ourselves in a situation, where diagnostic testing is difficult and there’s no treatment. Taking on the NTDs is a massive challenge, requiring new types of collaboration. This Zika outbreak is a moment for institutions and research centres of Latin American universities to take a fresh look at their funding options, use the WHO health emergency status to address needed improvements to antiquated and obsolete systems, and commit to stop overlooking Communicable Diseases. We also have a renewed chance to engage in public-private partnerships, by using start-up technologies as an alternative response to reducing costs of caring in both acute and chronic conditions. With the proper funding and collaborative partnerships, innovation can replace outdated systems and mitigate emerging health problems before they reach global tipping points. Only when we understand healthcare as a priority will the public, the private, and the third sector work as partners towards a common goal and be able to make a meaningful impact.
Words by Victoria A bit about Victoria: She is a last year MD candidate at the University of Buenos Aires -currently on her internship year- with four years of experience in academic medicine, basic and clinical research. However, her real passion is the area of Biotechnology and Bioengineering applied to Public Health. She trained in public institutions in Argentina where she got a strong grasp of the main epidemiological problems in her community, and has been part of a multidisciplinary team working in the development of a Clinical Data Management System for public hospitals in the City of Buenos Aires.