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Progress towards tackling neglected tropical diseases (NTDs) will need research to assess uncertainties in how close the scientific community has come to controlling or eradicating them, argues parasitology expert Mark Booth.
New funding agreed last week by non-governmental organisations, aid donors and drug companies suggests that NTDs are getting the attention they deserve, he says, which has created a new "passion" for tackling them. "One senses this passion was based on their sense of certainty … that they [NTDs] will finally face their executioner."
But recent data, which show that the malaria death toll is much higher than previously thought, has introduced uncertainty into eradication goals.
"If we now have to rethink malaria control strategies, then how confident can we be about controlling or eradicating any of the 17 NTDs," notes Booth.
He says that rigorous scientific research is the only way to discover what we don’t know about anything from how human behaviour affects the success of public health strategies, to how climate change might affect the transmission of NTDs. And this means that funding should extend beyond operational research to every aspect of research that can address these uncertainties.
Booth argues that, to be sustainable, the fight against these diseases needs not just the pharmaceutical industry but partners from several disciplines, agencies and countries. And it must tackle the social components of NTD control as well as molecular biology.
For example, preventive chemotherapy is the most effective strategy against the parasitic disease bilharzia (also known as schistosomiasis). But its success depends on other factors, such as how often the patient gets treated or whether water and sanitation strategies are in place.
"There is no easy answer, but what we can do is look at the factors that create uncertainty and re-assess what needs to be done," says Booth.