In an article in the Lancet, David H Molyneux, of the Liverpool School of Tropical Medicine, challenges current priorities for spending on health issues. He argues that considerable societal benefits can be achieved by focusing attention on diseases that are currently less politically popular, but nonetheless tractable from the standpoint of improving human health outcomes. Here is an extended excerpt:

“The Millennium Development Goals and a plethora of initiatives have focused on the control of HIV/AIDS, tuberculosis, and malaria. However, a large group of diseases has been confined to the “other diseases” category by health policy makers and politicians. These so-called neglected diseases are the viral, bacterial, and parasitic infections of the tropics (often vector borne), together with acute respiratory infections and diarrhoeal diseases of children. Despite the availability of cost-effective, stable, and successful control or elimination interventions, large numbers of the world’s poorest people remain afflicted or are at risk from this group of diseases. The focus of health policy makers on HIV/AIDS, tuberculosis, and malaria, as well as emerging or reemerging diseases causes funding for neglected diseases to be overlooked, with deleterious effects on the social and economic wellbeing of the poorest quintile of populations in the least developed and low-to-middle income countries…

If we are to ensure the efficient use of the substantial resources needed to reduce morbidity and mortality associated with HIV/AIDS, tuberculosis, and malaria, then a small investment in proven, cost-effective interventions against “other diseases”—preferably from the Global Fund resources—will bring sustainable public-health benefits, integrate well with and strengthen the health system, reduce disabling conditions, and bring collateral benefits to the health of the poorest nations. Policy makers are ignoring scientific and operational evidence that interventions against “other diseases” are effective. By concentrating on so few agents, current policies could perpetuate inequity, disrupt health financing policies, divert human resources from achievable goals, and deny opportunities for impoverished health systems to improve. Current policy also raises ethical issues. Resources are being transferred to interventions against the big three that, realistically, have only a limited chance of success as they are reactive and do not adequately control transmission—a pre-requisite for any public health impact. The proactive pro-poor interventions against neglected diseases succeeded by aiming to reduce transmission. Allocation of a small fraction of the Global Fund resources to “neglected” diseases would be likely to achieve broader public health goals.”

The whole article can be found here.