Reshaping TB care in low-resource settings (MSF Scientific Days International 2022)

Neglected tropical diseases (NTDs) impact nearly 1.7 billion people each year, causing serious illness or lifelong disability among many—often leading to stigma and exclusion—and killing an estimated 200,000. The vast majority of sufferers live in the world’s poorest countries.

The World Health Organization’s NTD roadmap 2021-2030 aims to address 20 tropical diseases through prevention, control, elimination, and/or eradication. But despite some progress, reaching all its targets will take better, far more accessible diagnostics and treatments along with more robust strategies, political commitment and resources.

To mark World NTD Day, this collection spotlights work by MSF and collaborators on improving approaches to snakebite envenoming, kala azar and noma. One study presents an innovative artificial intelligence-based snakebite diagnostic tool, while others evaluate shorter, less toxic drug regimens or different models of care. Several commentaries advocate for national/regional strategies adapted to contexts ranging from remote villages to active conflict zones. Another crucial factor is the climate crisis, which is intensifying the transmission and geographic spread of many NTDs.

Every year 2 million or more people fall victim to snakebite envenoming, mostly in poor, rural communities of Africa, Asia and Latin America. Between 83,000—138,000 of them die, while hundreds of thousands more suffer debilitating long-term complications or disabilities.

Although some antivenom medicines are highly effective when used promptly and appropriately, many snakebite victims get no treatment at all. Those who do may receive antivenoms which don’t work against the type of snake that bit them, or were not rigorously tested for safety and effectiveness.

To mark World Snakebite Awareness Day on September 19th, the Collection linked below brings together recent MSF work on this highly neglected disease. Several articles and conference presentations help fill evidence gaps on the burden of disease and its impacts or on treatment outcomes with specific antivenoms. Others examine how to tackle the formidable challenges of availability and affordability, the absence of regulatory oversight for making, testing and registering antivenoms, and the anemic R&D pipeline for new products—all of which impede access for patients to safe, effective treatment tailored to local snake species.