Neglected tropical diseases

Chengdu Declaration on cestode infections calls for global collaboration into research and control

13 December 2017 | Chengdu | Geneva –– Delegates from 13 countries have signed the Chengdu Declaration, calling for the establishment of an international collaboration network to address global challenges posed by infections arising from echinococcosis and taeniasis/cysticercosis – two groups of diseases that are responsible for a significant burden and mortality among humans.

Echinococcosis and taeniasis/cysticercosis are groups of parasitic diseases that are closely associated with poverty and with people who keep animals for subsistence,” said Dr Bernadette Abela-Ridder, Team Leader, Neglected Zoonotic Diseases unit at WHO. “One of the reasons these diseases have not been prioritized is because of a lack of data and their being localized in populations with little political voice. Great benefits to the health and well-being of these people, especially children, can be achieved with modest investments in their control.

©Dr. Liu Yang/the Sichuan Centre for Disease Control and Prevention

The Chengdu Declaration aims to establish a network for global cooperation and capacity-building to accelerate the control and elimination of echinococcosis and taeniasis/cysticercosis, in line with WHO’s roadmap on neglected tropical diseases and the global momentum harnessed to support the targets of the United Nations Sustainable Development Goals in achieving universal health coverage.

The Declaration also aligns well with the objectives of the Chinese Belt and Road Initiative1 – a plan to build a network of land and ocean silk trade routes between Asia, Europe and Africa to help increase trade and improve transport logistics. This initiative has the potential to develop “rural and marginalized” areas across over 60 nations that largely depend on agriculture and livestock. Health cooperation is one important aspect of it.

The rate of infection is high in many countries which are part of this Initiative,” said Dr Abela-Ridder. “As animals and the environment are involved in the cycle of transmission, the control of these diseases can improve nutrition and economic gains, contributing directly to development and poverty reduction”.

Taeniasis/cysticercosis is estimated to cause more than 28 000 deaths (and 2.79 million disability-adjusted life years, or DALYs). Two types of echinococcosis – cystic echinococcosis and alveolar echinococcosis – are responsible for 2225 and 17 118 deaths (and 0.18 million and 0.69 million DALYs) respectively, according to a study supported by the WHO foodborne burden of disease study. 2

Cestode infections, particularly echinococcosis, are among the high priority diseases in China,” said Dr Xiao-Nong Zhou, Director of the WHO Collaborating Centre for Tropical Diseases and the National Institute of Parasitic Diseases affiliated with the Chinese Center for Disease Control and Prevention. “The Belt and Road Initiative provides a crucial platform for enhanced communication, coordination and cooperation that are crucial for the control of echinococcosis and taeniasis/cysticercosis in different countries.

Part of the public health interventions to prevent and control these risks requires consideration of powerful interventions in animals, food and the environment that break the cycle of transmission. In addition, conditions must be created to provide early diagnosis and management of people infected with these parasites.

Reaching these populations with means of treatment and control contributes to strengthening of health systems and universal health coverage

Also launched was a Belt and Road Network for the Elimination and Control of Echinococcosis and Cysticercosis (B&R-NEC) to promote and share current data on epidemiology and burden of echinococcosis and taeniasis/cysticercosis as well as strategies and tools to control and eliminate these two diseases.

The meeting – the International Symposium for Cestode Zoonoses Control – was held in Chengdu, China on 15–16 November 2017. Delegates discussed the potential of new scientific and research advances that need to be well documented, standardized and quality assured to assure confidence in their uptake for programmes around the world. Satellite data analysis, to support efforts in controlling transmission of these zoonotic diseases, can have high potential in planning and implementation of their control and elimination.

The symposium was co-organized by the WHO Collaborating Centre for Tropical Diseases at the National Institute of Parasitic Diseases, Shanghai, which is affiliated to the Chinese Center for Disease Control and Prevention, the WHO Collaborating Centre for Prevention and Care Management of Echinococcosis, Urumqi, and the Sichuan Center for Disease Control and Prevention, Chengdu.

1The land-based projects are the belt. The road is the maritime routes that will connect China’s southern provinces to south-east Asia and the east coast of Africa with ports and railways.
2Torgerson PR, Devleesschauwer B, Praet N, Speybroeck N, Willingham AL, Kasuga F et al. World Health Organization estimates of the global and regional disease burden of 11 foodborne parasitic diseases, 2010: a data synthesis. PLoS Med. 2015;12(12):e1001920.

Ashok Moloo
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