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The Disease Domino Effect

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Public health expert Josh Ruxin cautions that intestinal worms can raise the rate of HIV/AIDS infection.

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Josh Ruxin:

Dr. Josh Ruxin is an Assistant Clinical Professor of Public Health at the Mailman School of Public Health at Columbia University and Founder of Rwanda Works.

Dr. Ruxin's work focuses on comprehensive approaches to fighting poverty with emphasis on scaling up national health programs and investing in Rwanda’s private sector. He is based in Rwanda where he directs several initiatives including Rwanda Works and the Millennium Village Project.

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TRANSCRIPT:

Question: What leads to the proliferation of neglected tropical diseases?

Josh Ruxin:The neglected tropical diseases are diseases which you can tell by their name are terribly neglected. It means that they have not received the level of interest, investment or intervention that they deserve over the years, and yet by some estimates they actually the largest disease burden on the planet today.

One of the most common neglected tropical diseases are intestinal worms. These are worms which embed themselves in the bowel. They can result in malnutrition, vitamin deficiencies, diarrhea, and ultimately making children and adults as well more susceptible to other diseases.

This is really important take away on the NTDs as they’re called, the neglected tropical diseases. Some of them appear to actually be linked to other diseases. Recent data just out in the past couple of months shows that one of these NTDs, schistosomiasis, can raise the rate of HIV/AIDS infection by threefold in women.

How does that happen? Schistosomiasis is a particularly pernicious disease carried by snails and the parasite can actually result in vaginal lesions which make a woman more likely to contract HIV/AIDS during sexual intercourse.

Preventing these diseases and treating these diseases is critical. What does it take to treat them? We already know that. It cost between 35 and 50 cents for well known treatments, many of which are available by donation, to treat kids and to treat adults for these diseases. But treatment alone is not the answer. What else is needed is actually access to clean water, basic hygiene and sanitation and basic hygienic practices in order to avoid the transmission of these NTDs in the first place.

This is probably one of the areas of global health where we can have the most bang for a buck. A lot of people are extremely critical of vertical solutions, just focusing on one disease or another disease. But in the case of neglected tropical disease, this is something that can be done through schools. It can be done through existing health centers. There is not a massive incremental cost. It doesn’t take a lot more time to do. And yet it actually has a domino effect on taking out other diseases downstream and overall improving lives and improving productivity.