A report on Neglected Tropical Diseases released by the World Health Organisation this week has outlined the breathtaking economic cost that developing countries such as India face in coping with diseases such as hookworm infection, lymphatic filariasis and visceral leishmaniasis, commonly known as kala-azar.

In the report WHO Director-General Margaret Chan underscored the linkages between such NTDs and poverty, saying, "Neglected tropical diseases have traditionally ranked low on national and international health agendas." She added that currently impaired the lives of an estimated 1 billion people, mostly in remote rural areas or urban slums and shantytowns.

According to Dr. Chan, NTDs usually caused massive but hidden and silent suffering, and frequently killed those infected, but not in numbers comparable to the deaths caused by HIV/AIDS, tuberculosis or malaria. She also noted that the presence of these debilitating illnesses also often went unnoticed by health authorities as those affected or at risk generally had "little political voice."

Speaking to The Hindu, Peter Hotez, President of the Sabin Vaccine Institute and a spokesperson for the Global Network for Neglected Tropical Diseases, corroborated the WHO's assessment of the current state of NTDs, including the possibility that these diseases frustrated the achievement of health in the Millennium Development Goals.

Touching on the scene in India in particular Dr. Hotez said, "India still remains the epicentre for NTDs," noting for example that there were currently close to 70 million cases of hookworm infection. This was "of great concern" because childhood infection reduces future wage earning by 40 per cent, according to a 2007 study mentioned in the report.

Given the disproportionately large impact of such NTDs on the lower strata of the population, the vaccines for these NTDs are known as "antipoverty vaccines," Dr. Hotez explained. He said that the reason such diseases received less official attention was because they "do not kill, but cause high morbidity and economic loss, and this is killing India."

Citing the case of lymphatic filariasis - also know elephantiasis - Dr. Hotez quoted another study which indicated that India faced "almost a billion dollars loss per year, economically," from the disease.

While the WHO report said that India had undertaken national efforts to reduce the impact of leishmaniasis and filariasis, Dr. Hotez warned that "for hookworm infection it is too widespread to even consider elimination at this point." He noted that for this disease there was a need for a vaccine and the Sabin Institute was working on such a vaccine,

In the international arena, Dr. Hotez said, the contributions of European governments and developing country governments did not come anywhere near the major efforts of the U.S. to control NTDs worldwide, with the United Kingdom's Department for International Development being a notable exception. "Other countries should be doing more to help control NTDs at the global level," he said.