Neglected tropical diseases are focus of new Baker Institute reports

David Ruth
713-348-6327
david@rice.edu

Jeff Falk
713-348-6775
jfalk@rice.edu

Neglected tropical diseases are focus of new Baker Institute reports

HOUSTON – (March 2, 2016) – Neglected tropical diseases (NTDs) comprise a group of parasitic, viral and bacterial infections — such as the emerging Zika virus outbreak in Brazil — that mainly afflict people living in areas of extreme poverty, including some southern regions of the United States and Mexico. Two new policy reports by experts on NTD and science policy at Rice University’s Baker Institute for Public Policy address the key policy and ethical issues surrounding the diseases and make recommendations for reducing their prevalence in both countries.

Mosquitoes are transmitters of several neglected tropical diseases. Credit: shutterstock.com/Rice University

The first report, “Addressing NTDs in the U.S. and Mexico,” summarizes the findings of the Baker Institute conference “The United States and Mexico: Addressing a Shared Legacy of Neglected Tropical Diseases and Poverty,” which took place Sept. 29-30. The report reviews the impact and prevalence of NTDs in the U.S. and Mexico, addresses key policy challenges and makes recommendations for reducing NTDs in the two countries. It was co-authored by Dr. Peter Hotez, fellow in disease and poverty; Kirstin Matthews, fellow in science and technology policy; and Jennifer Herricks, postdoctoral fellow in disease and poverty.

An estimated 12 million Americans live with at least one NTD. These diseases tend to be chronic, debilitating infections that leave patients malnourished, disabled and disfigured and often socially stigmatized and limited in their capacity to work or attend school.

“Reducing the multifaceted impact of NTDs will require coordinated policies between these two countries that focus on preventive measures and access to therapies as well as the development of new treatments and vaccines,” the authors wrote. “It is the role of the U.S. and Mexican governments to incentivize scientific research on treatment and preventive measures for NTDs.”

The authors recommend measuring the real burden of diseases by increasing surveillance; determining socio-economic determinants leading to increased NTD susceptibility; ensuring access to prevention and treatment; incentivizing research and development, and training community health workers.

“Researchers, physicians, and policy scholars should coordinate with local, state, and national governments; the academic sector; pharmaceutical and biotechnology companies; and civil societies to create guidelines for successful elimination campaigns,” the authors wrote.

The second report, “Ethical Considerations for the Creation of a National NTD Policy,” highlights some of the central ethical issues pertaining to policy development for neglected tropical diseases and argues that policymakers need to address ethical concerns such as what ought to be done and who an NTD policy ought to impact. The report was authored by Matthews and Ana Iltis, professor of philosophy and director of the Center for Bioethics, Health and Society at Wake Forest University and a scholar at the Baker Institute.

In the U.S., addressing NTDs focuses largely on developing safe and effective mechanisms to prevent and treat the diseases, the authors said. They argue that new or existing treatments must be made available to those in need — often people living in poverty or extreme poverty (subsisting on less than $2 a day). “But research, development and delivery of these interventions is costly and relies mostly on funding from the federal government,” the authors wrote. “With pressure to limit government expenditures, decisions regarding the allocation of limited resources entail balancing priorities, which involve many, often unarticulated or implicit, ethical judgments.”

The authors said that the U.S. should develop an NTD policy to further reduce the prevalence and impact of NTDs both within and outside of its borders.

“Policy development regarding NTDs involves a wide range of ethical issues,” the authors wrote. “The claim that NTDs are ‘neglected’ and the claim that ‘something more’ ought to be done to combat NTDs are both normative judgments. Competing moral appeals lead to different accounts of what that ‘something more’ is and how to achieve it.”

The authors recommend goals be established clearly at the outset of developing an NTD policy. These goals will give direction to policy efforts and guide evaluation.

“To gloss over these questions puts policymakers at risk for ignoring important questions and assuming consensus where there is none, both of which can adversely affect the long-term sustainability of policy recommendations,” the authors wrote. “NTD policy must address questions about what ought to be done, by whom, when, in what order and how. These normative questions should not be ignored as part of policy-development efforts. It is not always appropriate for public policy to address them in detail. Nevertheless, policymakers must be careful that they do not assume answers or pretend that these questions can be sidestepped. Without an appreciation that this process involves making normative judgments, policymakers risk inadvertently making unethical choices. And without taking these questions seriously, we risk developing weak policies that have little substantive impact.”

To interview one of the authors, contact Jeff Falk, associate director of national media relations at Rice, at jfalk@rice.edu or 713-348-6775.

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Related materials:

Herricks biography: http://bakerinstitute.org/experts/jennifer-r-herricks.

Hotez biography: http://bakerinstitute.org/experts/peter-j-hotez.

Iltis biography: http://college.wfu.edu/philosophy/people/faculty/ana-s-iltis.

Matthews biography: http://bakerinstitute.org/experts/kirstin-rw-matthews.

Founded in 1993, Rice University’s Baker Institute ranks among the top five university-affiliated think tanks in the world. As a premier nonpartisan think tank, the institute conducts research on domestic and foreign policy issues with the goal of bridging the gap between the theory and practice of public policy. The institute’s strong track record of achievement reflects the work of its endowed fellows, Rice University faculty scholars and staff, coupled with its outreach to the Rice student body through fellow-taught classes — including a public policy course — and student leadership and internship programs. Learn more about the institute at www.bakerinstitute.org or on the institute’s blog, http://blogs.chron.com/bakerblog.