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Open Access Highly Accessed Debate

Prevention, control, and elimination of neglected diseases in the Americas: Pathways to integrated, inter-programmatic, inter-sectoral action for health and development

John C Holveck1, John P Ehrenberg1, Steven K Ault1*, Rocio Rojas2, Javier Vasquez3, Maria Teresa Cerqueira4, Josefa Ippolito-Shepherd5, Miguel A Genovese6 and Mirta Roses Periago7

Author Affiliations

1 Area of Health Surveillance and Disease Management, Pan American Health Organization/World Health Organization (PAHO/WHO), 525 23rd Street NW, Washington D.C. 20037, USA

2 Area of Technology and Health Services Delivery, Pan American Health Organization/World Health Organization (PAHO/WHO), Av. Amazonas 2889 y Mariana de Jesús, Quito, Ecuador

3 Area of Technology and Health Services Delivery/Area of Legal Affairs, Pan American Health Organization/World Health Organization (PAHO/WHO), 525 23rd Street NW, Washington D.C. 20037, USA

4 Field Office, US-Mexico Border, Pan American Health Organization/World Health Organization (PAHO/WHO), El Paso, Texas 79912, USA

5 Area of Sustainable Development and Environmental Health, Pan American Health Organization/World Health Organization (PAHO/WHO), 525 23rd Street NW, Washington D.C. 20037, USA

6 Veterinary Public Health, Pan American Foot and Mouth Disease Center (PANAFTOSA), Avenida Presidente Kennedy 7778, Sao Bento, Duque de Caxias, 25040-004, Rio de Janeiro, Brasil

7 Pan American Health Organization/World Health Organization (PAHO/WHO), 525 23rd Street NW, Washington D.C. 20037, USA

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BMC Public Health 2007, 7:6  doi:10.1186/1471-2458-7-6

Published: 17 January 2007

Abstract

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.

Discussion

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.

Summary

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.