While COVID-19 continues to hit the African nation of Guinea, authorities were forced to declare a new Ebola outbreak on February 14 after the death of three people and at least four more confirmed infections.
Ebola is one example of a disease that has been overshadowed by the COVID-19 pandemic, joining the ranks of other less known viral and parasitic infectious diseases that are no longer receiving the funding and support needed.
“Neglected tropical diseases affect one in five people on the planet,” Julie Jacobson, a medical doctor and the President of the American Society of Tropical Medicine and Hygiene said. “They cause the most common infections in the world and yet are the least likely to be recognized.”
While many of these diseases are easily treatable, the funding that has supported scaling up treatment efforts, community drug administration, prevention and awareness raising, has largely moved to COVID-19, with critical personnel on the ground also shifted to pandemic-related activities, leaving a notable gap.
“The most common neglected tropical diseases can be treated for the total of 50 cents per person per year and several of them can be completely eliminated as well,” added Jacobson.
Neglected diseases consistently underfunded
The field of neglected diseases has expanded to encompass some of the largest public health campaigns globally prior to the COVID-19 pandemic.
“In 2018, we treated a billion people through the Neglected Diseases Program,” added Jacobson. “It’s the biggest public health program in the world.”
While most of the neglected diseases are not new to the medical and research world, many experts agree that the field has witnessed a persistent lack of funding, especially for hard-to-reach areas that are at the highest health risk level, despite the availability of treatment.
“We are slightly luckier with [research on] malaria than other neglected diseases,” said Youssef Idaghdour, Professor of Biology at New York University Abu Dhabi (NYUAD). “But because it's not happening in the developed world, it doesn't get as much attention.”
Historically, the most common response to such diseases entering developed countries has been border health screening.
“One of the most common [neglected diseases] is trachoma – a bacterial infection of the eyes,” argued Jacobson. “In the United States, they screened [refugees and migrants] for it on Ellis Island prior to entering New York City [in the early 1900s]. And if you had trachoma, you were sent back because they did not want the blindness coming into the country.”
While scientists have developed successful treatment for diseases like trachoma, medical experts are still experimenting with treatment for malaria. Some recent attempts include an mRNA vaccine, developed by GlaxoSmithKline (GSK), in combination with other drugs.
“There is so much to learn from malaria because 400,000 [people] die from it every year. It's probably the single most deadly disease in the history of humanity,” added Idaghdour. “We still don't have a functional vaccine for malaria despite decades of research and we want to understand exactly why.”
The COVID-19 pandemic has, however, put a halt on progress made in the research and treatment of neglected diseases, including the re-purposing of on-ground personnel in hard-to-reach areas.
“Parts of our teams [on the ground] have been repurposed to reach communities and give better messages about COVID-19,” added Jacobson. “Those people have been pulled off from working on neglected diseases programs. There is going to be ripple effects of this for a long time.”
Research funding for neglected diseases ‘on ice’ amid COVID-19
While many medical experts and scientists agree that the COVID-19 pandemic has shed light on the importance of public health, there is a lack of consensus regarding its impact on ongoing research efforts on neglected diseases.
“For example, the mRNA technology is working well for infectious diseases. There are studies for malaria and others, but they are funded so little,” said Peter Kremsner, Professor at the University of Tubingen. “It took us five years to start the study on malaria and it never started. With COVID-19, we had lots of money to prepare within two to three months to start the whole research program.”
While the pandemic has created more opportunities for funding academic and lab research on infectious diseases, the momentum has not gained traction with neglected diseases.
“Our research funding for other diseases is rather on ice. Due to the situation, we got massive funding for COVID-19 research. But we did not get more funding for other infectious diseases, certainly not for malaria and tuberculosis,” Kremsner explained.
Despite the lack of consensus on the impact of the COVID-19 pandemic on the overall field, many remain hopeful.
“The pandemic is really a game-changer in terms of how you think about science. What we're hoping for is that the [COVID-19] pandemic would be a shift in the way how developed countries think about infectious diseases,” Idaghdour said. “We've been pushing for funding for malaria and other diseases, including Ebola.”
“There is an opportunity here to take that collaborative action around a common cause because there has been such a disruption in the whole health system. We need to start thinking in a more integrated way,” added Jacobson.