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Vol. LXII, No. 8
April 16, 2010

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Lifting the Bottom Billion
Defeating Neglected Diseases Is Focus of LaMontagne Lecture

  Dr. Peter J. Hotez  
  Dr. Peter J. Hotez  

The world’s “bottom billion”—subsistence farmers, urban poor and all those who live on less than a dollar a day—have suffered the consequences of extreme poverty for generations. The most destitute are not only poor, says Dr. Peter J. Hotez, they are also chronically ill. A group of infectious illnesses, collectively termed neglected tropical diseases, are largely to blame for keeping the bottom billion in poverty. But recent attention to these previously neglected maladies is beginning to pay off, says Hotez, distinguished research professor and chair of George Washington University’s department of microbiology, immunology & tropical medicine.

Hotez, who also serves as president of the Sabin Vaccine Institute, will describe advances in combating neglected tropical diseases and outline the challenges that remain in the 2010 John Ring LaMontagne Memorial Lecture. The lecture will be held in Lipsett Amphitheater, Bldg. 10, on Thursday, Apr. 22 at 2 p.m.

Unlike HIV, TB or malaria, says Hotez, the seven most common neglected tropical diseases typically do not kill people. Instead, these chronic infections, including six caused by parasitic worms, tend to debilitate victims, degrading quality of life for years on end. The effects are both individual and societal, he explains. Intestinal parasitic worms, for example, infect many hundreds of millions of people worldwide. The parasites—roundworms, whipworms and hookworms—stunt the physical and intellectual growth of children and make it difficult for adults to work.

Another kind of parasitic worm causes schistosomiasis, which can damage the liver, bladder, kidneys and other organs. Schistosomiasis and some of the other neglected diseases also can damage the repro-ductive tract, making it more vulnerable to infection with HIV or other microbes. Aside from causing profound suffering in individuals, the neglected diseases also hold back entire economies, says Hotez. In India alone, he says, the disfiguring and disabling parasitic disease called elephantiasis is estimated to cause worker productivity losses totaling $1 billion annually.

“That’s the bad news. The good news is we can treat neglected diseases, often at very little cost per treated person,” Hotez says. Safe and effective anti-worming medications have been successfully used in nationwide mass administration efforts, he adds. Drugs have forced down rates of schistosomiasis in eight African countries, for example.

More remains to be done, however, according to Hotez. In his lecture, he will describe some of the current projects of the Sabin Vaccine Institute, including initiatives aimed at developing vaccines against hookworm and schistosomiasis. If successful, such vaccines could do much to alleviate disease and destitution among the bottom billion.

The lecture honors contributions to NIH and public health made by LaMontagne over the course of a 30-year career with NIAID. He was the institute’s first influenza program officer and the director of its Division of Microbiology and Infectious Diseases. LaMontagne was NIAID deputy director from 1998 until his death in 2004. NIHRecord Icon

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