Health Programs Should Integrate Malaria, Neglected Tropical Disease Interventions, Lancet Letter Says

Although the global health community has "identified potential synergies between control programs for malaria and for neglected tropical diseases, to date, such opportunities have gone largely untapped," David Molyneux of the Liverpool School of Tropical Medicine and colleagues write in a letter published in the journal Lancet. According to the authors, malaria and neglected tropical diseases are "co-endemic geographically" and "can affect patients concurrently." Therefore, integrated health programs could be "highly cost-effective" by sharing delivery systems, community health workers and interventions, the authors write.

According to the authors, tropical diseases can "exacerbat[e] malaria-related anemia, resulting in growth and learning impairments in children and increased maternal morbidity and mortality and low birthweight." Therefore, "there is a strong rationale" for combining treatment and prevention programs for malaria and neglected tropical diseases, the authors write. They continue that linking disease control efforts would provide significant opportunities to advance public health, particularly "in terms of the potential for substantial increases in access to and coverage with artemisinin-based combination therapy," insecticide-treated nets and intermittent preventive treatment for pregnant women.

The authors write that the Global Fund To Fight AIDS, Tuberculosis and Malaria should take advantage of community-directed approaches to coordinate simultaneous malaria and neglected tropical disease interventions. Although "further research might be needed" on integrated disease efforts, the authors argue that "the evidence for combining these two approaches is sufficiently mature to scale up combined neglected tropical disease and malaria control initiatives immediately in most of the co-endemic countries." In addition, increased funding would "not only enable further expansion of neglected tropical disease coverage but would also result in rapid increases in coverage with malaria control interventions," the authors write. They continue that the Global Fund, the United Nations and members of the global health community "should now recognize the weight of evidence supporting the integration of malaria and neglected tropical disease control interventions at the community level." The authors conclude that the potential to meet the targets defined in the Global Malaria Action Plan and the United Nations' Millennium Development Goals "is an opportunity that cannot be missed" (Molyneux et al., Lancet, 1/24).

The letter is available online.