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A Turning Point in the History of Humanity's Oldest Diseases: Guest Commentary by WHO Director-General Margaret Chan

The launch of PLoS Neglected Tropical Diseases marks yet another turning point in the long and notorious history of some of humanity's oldest diseases.

The values and principles embodied in primary health, the United Nations Millennium Declaration, and initiatives such as PLoS Neglected Tropical Diseases are all about fairness, solidarity, collective responsibility, participatory approaches, and a duty to take care of vulnerable groups. Equity is a fundamental principle of health development. Access to life-saving and health-promoting interventions should not be denied for unjust reasons, including an inability to pay. The free availability of leading research articles will benefit decision-makers and diseases control managers worldwide. It will also motivate scientists, both in developing and developed countries.

The prospects for reducing the enormous burden caused by neglected tropical diseases have changed dramatically in just the past few years. We can identify a succession of well-planned actions, firmly rooted in evidence, which have paved the way forward. These actions hold lessons for other areas of public health, and deserve to be widely publicized.

Strongly associated with poverty, these diseases frequently overlap geographically. They tend to cluster in places where housing is substandard, drinking water is unsafe, sanitation is poor, access to health care is limited or non-existent, and insect vectors are constant household and agricultural companions.

This geographical overlap means that people are often affected by more than one disease. It also means that strategies developed to deliver interventions for one disease can rationally be used to deliver interventions for others. This opens opportunities for integrated approaches, for simplification, cost-effectiveness, and streamlined efficiency. We must not forget that we are dealing with neglected populations, as well as neglected diseases; populations usually living in areas not covered by formal health services, which are often extremely difficult to reach.

When these diseases are viewed together, we gain critical mass. We get a better grip on the scale of the economic and social consequences as well as the health burdens. Arguments for giving these diseases higher priority become more powerful, more persuasive. In addition, grouping these diseases together creates opportunities for sharing innovative solutions, especially as most control programmes face similar operational constraints.

Persuasive arguments have come from additional lines of evidence. Research continues to reveal the intricate damage caused by these diseases. I am convinced that PLoS Neglected Tropical Diseases will generate more evidence, spearhead innovation, and help to disseminate knowledge, experiences, and achievements.