- Neglected tropical diseases (NTDs) are a group of parasitic diseases that cause severe (mental and physical) debilitation but rarely result in death.1
- NTDs are extremely common in many parts of the developing world.2
- Proven, cost-effective solutions can treat and prevent NTDs (more).
- Although the programs are proven and we have reviewed several charities, we have not yet found an organization in this area that we can recommend to donors. (more)
"Neglected tropical diseases" (NTDs) are a specific set of chronic infectious diseases found primarily in tropical areas. They include (but are not limited to) a variety of intestinal worms, the painfully disfiguring disease lymphatic filariasis, and the blinding diseases trachoma and river blindness. They do not include such well-known diseases as AIDS, tuberculosis and malaria. While most NTDs do not directly cause death, they can have debilitating consequences such as malnutrition, blindness, disfigurement, anemia, and low energy.3
Fortunately many NTDs are cheaply and safely treatable. For many of the diseases a yearly dose of a combination of drugs administered to all residents of at-risk areas can effectively and inexpensively reduce prevalence.4
How do charities address neglected tropical diseases?
| Program | Result | Cost-effectiveness (best case) | More information |
|---|---|---|---|
| Mass drug administration to control lymphatic filariasis | Program reduces lymphatic filariasis rates | $100 prevents 15-85 total years of lymphedema (swollen limbs) and 25-165 total years of hydrocele (swollen scrotum) | In-depth evidence review |
| Mass drug administration to control river blindness | Program is effective in suppressing the worms that cause river blindness | $100 prevents 2.5-14 years of blindness; 3.5-20 years of irritating skin disease; and 3-17 years of impaired vision | In-depth evidence review |
| SAFE Strategy to control trachoma | Surgery reduces the scarring that leads to blindness, and antibiotics reduce infection rates | Surgeries: $100 prevents 1-30 years of blindness and 1-30 years of low vision. Other components: highly costly or unknown. | In-depth evidence review |
| Combination deworming program | Medications are effective at treating schistosomiasis and soil-transmitted helminths | $3.50 per additional year of school attendance for students | In-depth evidence review |
What are the challenges of finding a great 'neglected tropical disease' charity?
From what we've seen, the major organizations focused on deworming work heavily with developing-world governments. They spend money on both advocacy and subsidies for government control programs. We therefore have the following questions:
- How do the charity's funds break down between subsidies and advocacy?
- For subsidies:
- How much of the total spending on control programs has been covered by the charity, as opposed to the government?
- How has the government been audited to ensure compliance with terms and conditions? Note that the Stop Tuberculosis Partnership serves in a similar role to NTD charities, subsidizing (through drug grants) government tuberculosis control programs, and it has an extremely thorough auditing process to ensure that drugs are used appropriately, that reported statistics are meaningful, etc. It has in the past discontinued funding for noncompliance. How do NTD control charities compare?
- Does the charity intend to keep subsidies at the same level indefinitely, or does it intend for the government to take over activities? If the latter, what is its track record in accomplishing this very difficult task? Note that while we consider "sustainability" optional for some programs, it is crucial for deworming, for reasons discussed here.
- For advocacy activities:
- How much has been spent, what programs (and where) have been advocated, and to what results? What does the future advocacy plan and budget look like, and what might be expected from it? Cost-effectiveness of control programs is one question; the cost-effectiveness of advocacy funds could be another question entirely.
- To the extent that advocacy has succeeded, has it resulted in (a) more government funding for NTD control with no offsetting cuts, i.e., increases in total medical budgets; (b) more government funding for NTD control at the expense of other health spending; (c) more funding for NTD control, contingent on more donor subsidies?
- If (a), how has the increase in funding been financed? If (b), where have cuts been made, and to what extent has funding shifted from other worthy health spending? If (c), what are the answers to the key questions about subsidies (above)?
Where should you donate to fight neglected tropical diseases?
We have not yet found a charity addressing NTDs whose impact we can be confident in.
Two charities we've reviewed that focus heavily on NTDs include:
- The Carter Center, which runs programs dealing with guinea worm, river blindness, trachoma, lymphatic filariasis, and schistosomiasis. For more, see our full review of the Carter Center.
- Deworm the World, which runs deworming programs. For more, see our note on Deworm the World.
- 1.
For background information on NTDs, see our summary of disease facts.
- 2.
The Disease Control Priorities Project estimates that 31% of sub-Saharan Africans are infected with schistosomiasis (parasitic worm), and 3% with lymphatic filariasis. Trachoma and onchocerciasis (river blindness) are significantly less prevalent in Africa overall, but may be highly endemic in certain areas. Data from WHO, "Prevalence for Selected Causes in WHO Regions (2004)" (XLS).
- 3.
More at our disease facts page.
- 4.
See our comparative summary of proven programs, which includes programs to combat NTDs. Additionally, see our full reviews of drug distribution programs for lymphatic filariasis, drug distribution programs for river blindness, the SAFE program for trachoma, and deworming programs.
