title: Concerted Efforts to Control or Eliminate Neglected Tropical Diseases: How Much Health Will Be Gained?
abstract: BACKGROUND
  The London Declaration (2012) was formulated to support and focus the control and elimination of ten neglected tropical diseases (NTDs), with targets for 2020 as formulated by the WHO Roadmap. Five NTDs (lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminths and trachoma) are to be controlled by preventive chemotherapy (PCT), and four (Chagas' disease, human African trypanosomiasis, leprosy and visceral leishmaniasis) by innovative and intensified disease management (IDM). Guinea worm, virtually eradicated, is not considered here. We aim to estimate the global health impact of meeting these targets in terms of averted morbidity, mortality, and disability adjusted life years (DALYs).
  
  
  METHODS
  The Global Burden of Disease (GBD) 2010 study provides prevalence and burden estimates for all nine NTDs in 1990 and 2010, by country, age and sex, which were taken as the basis for our calculations. Estimates for other years were obtained by interpolating between 1990 (or the start-year of large-scale control efforts) and 2010, and further extrapolating until 2030, such that the 2020 targets were met. The NTD disease manifestations considered in the GBD study were analyzed as either reversible or irreversible. Health impacts were assessed by comparing the results of achieving the targets with the counterfactual, construed as the health burden had the 1990 (or 2010 if higher) situation continued unabated.
  Our calculations show that meeting the targets will lead to about 600 million averted DALYs in the period 2011-2030, nearly equally distributed between PCT and IDM-NTDs, with the health gain amongst PCT-NTDs mostly (96%) due to averted disability and amongst IDM-NTDs largely (95%) from averted mortality. These health gains include about 150 million averted irreversible disease manifestations (e.g. blindness) and 5 million averted deaths. Control of soil-transmitted helminths accounts for one third of all averted DALYs. We conclude that the projected health impact of the London Declaration justifies the required efforts.
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Sake J
authors.initials: SJ
authors.lastname: de Vlas
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Wilma A
authors.initials: WA
authors.lastname: Stolk
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Epke A
authors.initials: EA
authors.lastname: le Rutte
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Jan A C
authors.initials: JA
authors.lastname: Hontelez
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Roel
authors.initials: R
authors.lastname: Bakker
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: David J
authors.initials: DJ
authors.lastname: Blok
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Rui
authors.initials: R
authors.lastname: Cai
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Tanja A J
authors.initials: TA
authors.lastname: Houweling
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.|Center for Tobacco Control Research and Education, University of California at San Francisco, San Francisco, California, United States of America.
authors.forename: Margarete C
authors.initials: MC
authors.lastname: Kulik
authors.affiliation: Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
authors.forename: Edeltraud J
authors.initials: EJ
authors.lastname: Lenk
authors.affiliation: Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
authors.forename: Marianne
authors.initials: M
authors.lastname: Luyendijk
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Suzette M
authors.initials: SM
authors.lastname: Matthijsse
authors.affiliation: Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
authors.forename: William K
authors.initials: WK
authors.lastname: Redekop
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Inge
authors.initials: I
authors.lastname: Wagenaar
authors.affiliation: Bill and Melinda Gates Foundation, Seattle, Washington, United States of America.
authors.forename: Julie
authors.initials: J
authors.lastname: Jacobson
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Nico J D
authors.initials: NJ
authors.lastname: Nagelkerke
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Jan H
authors.initials: JH
authors.lastname: Richardus
mesh_terms: D060740:Disease Eradication / Q000379:methods*; D014943:Global Health; D006801:Humans; D058069:Neglected Diseases / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D019057:Quality-Adjusted Life Years; D014330:Tropical Medicine