Tropical Infectious Diseases: Still Here, Still Raging, Still Killing

American Journal of Tropical Medicine and Hygiene
Volume 105 (2021): Issue 6 (Dec 2021)


Open access
Tropical Infectious Diseases: Still Here, Still Raging, Still Killing
Peter J. Hotez
In our time of COVID-19, practically every public health agency—from local and state health departments, to the U.S. CDC, to the WHO—has concentrated its efforts on slowing SARS-2 coronavirus transmission. This occurred initially through nonpharmaceutical interventions and then, in the second year of the pandemic, through administering vaccinations. Despite these efforts, the consequences of the COVID-19 pandemic of 2019–2021 have been devastating. The most recent estimates from the Institute of Health Metrics and Evaluation at the University of Washington indicate that up to 6.5 million people will have lost their lives from COVID-19 by the end of 2021.1

Tragically, the deaths and disability-adjusted life years (DALYs) lost over this period will extend beyond the direct effects of SARS-2 coronavirus. For instance, in the United States and globally, the ensuing social disruptions slowed or even halted childhood vaccination programs.2,3 Although childhood vaccinations are rebounding as waves of the COVID-19 epidemic pass, one worry is that all of the antivaccine aggression now directed at COVID-19 vaccines may spill over to other programs. In such a case, we might not achieve pre-pandemic immunization levels for many months or even years; we might experience resurgence of measles and other vaccine-preventable infectious diseases.4

Another concern is the diversion of global health programs toward COVID-19 at the expense of tropical infectious diseases such as the neglected tropical diseases (NTDs) and malaria. Since 2000, with the start of Millennium Development Goals programs, there have been enormous strides made in disease burden reductions for these conditions. For the NTDs, donor support from the governments of the United States and United Kingdom and operational research from the Bill & Melinda Gates Foundation, together with an ecosystem of nongovernmental development organizations (NGDOs), health ministries, and the WHO, have contributed to enormous reductions in the prevalence of NTDs through mass drug administration and preventive treatments.5 This is also true for global infection control programs supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria; the U.S. President’s Emergency Plan for AIDS Relief and Malaria Initiative; as well as efforts to unify these programs under the banner of universal health coverage.6

Two new papers in the American Journal of Tropical Medicine and Hygiene (AJTMH) examine the consequences of the COVID-19 pandemic and its adverse impact on global efforts to control tropical infectious diseases in Africa.7,8