Prevention, control, and elimination of neglected diseases in the Americas: pathways to integrated, inter-programmatic, inter-sectoral action for health and development.
BACKGROUND
In the Latin America and Caribbean region over 210 million people live below the poverty line. These impoverished and marginalized populations are heavily burdened with neglected communicable diseases. These diseases continue to enact a toll, not only on families and communities, but on the economically constrained countries themselves.


CONCLUSIONS
As national public health priorities, neglected communicable diseases typically maintain a low profile and are often left out when public health agendas are formulated. While many of the neglected diseases do not directly cause high rates of mortality, they contribute to an enormous rate of morbidity and a drastic reduction in income for the most poverty-stricken families and communities. The persistence of this "vicious cycle" between poverty and poor health demonstrates the importance of linking the activities of the health sector with those of other sectors such as education, housing, water and sanitation, labor, public works, transportation, agriculture, industry, and economic development.


CONCLUSIONS
The purpose of this paper is three fold. First, it focuses on a need for integrated "pro-poor" approaches and policies to be developed in order to more adequately address the multi-faceted nature of neglected diseases. This represents a move away from traditional disease-centered approaches to a holistic approach that looks at the overarching causes and mechanisms that influence the health and well being of communities. The second objective of the paper outlines the need for a specific strategy for addressing these diseases and offers several programmatic entry points in the context of broad public health measures involving multiple sectors. Finally, the paper presents several current Pan American Health Organization and other institutional initiatives that already document the importance of integrated, inter-programmatic, and inter-sectoral approaches. They provide the framework for a renewed effort toward the efficient use of resources and the development of a comprehensive integrated solution to neglected communicable diseases found in the context of poverty, and tailored to the needs of local communities.
Holveck
John C
JC
Area of Health Surveillance and Disease Management, Pan American Health Organization/World Health Organization, Washington DC 20037, USA. johnholveck@yahoo.com <johnholveck@yahoo.com>
Ehrenberg
John P
JP
Ault
Steven K
SK
Rojas
Rocio
R
Vasquez
Javier
J
Cerqueira
Maria Teresa
MT
Ippolito-Shepherd
Josefa
J
Genovese
Miguel A
MA
Periago
Mirta Roses
MR
D017691:Caribbean Region / Q000453:epidemiology; D003140:Communicable Disease Control / Q000458:organization & administration*; D018672:Community Health Planning; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D004782:Environmental Health / Q000458:organization & administration*; D006291:Health Policy; D006303:Health Services, Indigenous; D040361:Healthy People Programs / Q000458:organization & administration*; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D009937:Organizational Objectives; D011203:Poverty; D011322:Primary Prevention / Q000458:organization & administration*; D012572:School Health Services; D012962:Sociology, Medical