03029nas a2200325   4500000000100000008004100001100001200042700001200054700001600066700001500082700001300097700001200110700001000122700001900132700001200151700001100163700001600174700001700190700001500207700001500222700001500237700001700252700001700269245010700286856007700393300001300470490000700483520219900490022001402689       2016                            d1 aVlas SJ1 aStolk W1 aLe Rutte EA1 aHontelez J1 aBakker R1 aBlok DJ1 aCai R1 aHouweling TA J1 aKulik M1 aLenk E1 aLuyendijk M1 aMatthijsse S1 aRedekop WK1 aWagenaar I1 aJacobson J1 aNagelkerke N1 aRichardus JH00aConcerted efforts to control or eliminate neglected tropical diseases: How much health will be gained?  uhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4758649/pdf/pntd.0004386.pdf  ae00043860 v103 a<p><strong>BACKGROUND: </strong>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).</p>

<p><strong>METHODS: </strong>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.</p>

<p><strong>PRINCIPLE FINDINGS/CONCLUSIONS: </strong>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.</p>
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