In recent news, the World Health Organization (WHO) has added Noma to its list of neglected tropical diseases (NTDs), emphasizing the urgent need to address this severe health challenge. Noma, also known as cancrum oris or gangrenous stomatitis, is a severe gangrenous disease primarily affecting children aged 3-10 in impoverished communities. The disease leads to the death of body tissues due to lack of blood supply, a condition referred to as gangrene.
Understanding Noma and Its Impact
The term Noma, derived from the Greek term “nomē,” means to devour. The disease manifests as severe gangrene of the mouth and face, and it’s believed that its cause can be traced back to certain bacteria found in the mouth. This non-contagious disease exploits weakened immunity and claims the lives of around 90% of those affected. Children living in extreme poverty and malnutrition are at high risk, especially those with poor oral hygiene.
Noma is most prevalent in developing countries, particularly sub-Saharan Africa. It can also be traced back to concentration camps during World War II but has since been eradicated in the Western world due to economic progress. Survivors of Noma often suffer from facial disfigurement, jaw muscle spasms, and speech problems, and early detection is crucial for successful treatment.
A Deep Dive into Neglected Tropical Diseases (NTDs)
Neglected Tropical Diseases (NTDs) refer to a group of communicable diseases prevalent in tropical regions, closely associated with poverty and insufficient healthcare services. They are caused by a variety of pathogens including viruses, bacteria, protozoa, and parasitic worms. The term “neglected” is used to indicate the lack of attention they receive in terms of resource allocation for research and treatment, in comparison to diseases like tuberculosis, HIV-AIDS, and malaria. Examples of NTDs are snakebite envenomation, scabies, and Leishmaniasis among others.
The Global and Indian Impact of NTDs
NTDs affect over a billion individuals globally and are preventable as well as treatable, with about 20 NTDs impacting over 1.7 billion people worldwide. In India, the burden of at least 11 of these diseases is considerable, with parasitic illnesses like kala-azar and lymphatic filariasis affecting millions nationwide. However, the country is close to eliminating Kala-Azar, having achieved this goal in 99% of Kala-Azar endemic regions.
Initiatives Towards Combating NTDs
The WHO’s New Roadmap for 2021–2030 serves as the guiding framework for global efforts in combating NTDs in alignment with the United Nations Sustainable Development Goals. The London Declaration on NTDs was also implemented in 2012 to acknowledge the global burden of NTDs.
In India, the Accelerated Plan for Elimination of Lymphatic Filariasis (APELF) was launched in 2018 to bolster efforts towards the elimination of NTDs. A regional alliance supported by WHO was established by India, Bangladesh, and Nepal in 2005 to expedite diagnosis and treatment of the most vulnerable populations and to improve disease surveillance. The country has successfully eliminated several NTDs, including guinea worm, trachoma, and yaws. Regular preventive measures, such as the Mass Drug Administration (MDA) rounds and Indoor Residual Spraying, are undertaken in endemic areas, and wage compensation schemes have been introduced for those suffering from Kala-Azar and its sequela known as Post-Kala Azar Dermal Leishmaniasis.
