TROPICAL DISEASES AND THEIR TREATMENT IN FINLAND

Tropical Diseases and their Treatment in Finland

Chapter Three: Methodology

Sample Selection

Neglected Tropical Diseases (NTDs) constitute one of the most serious public health burdens, affecting primarily people living on less than US$2 per day. An estimated one billion people are infected with one or more NTDs. Social stigma, extreme poverty of afflicted populations, and relatively low mortality are some of the reasons for the neglect of these diseases.

Since the late 1990s, developing countries have received increasing amounts of official development assistance (ODA) for health purposes. However, not all diseases have benefited equally from this increase. Until recently, aid for disease control has been aimed primarily at fighting HIV/AIDS, malaria, tuberculosis and polio. A comprehensive analysis of research and development (R&D) spending on neglected diseases which were defined as including HIV/AIDS, malaria, tuberculosis and diarrheal diseases shows a low share of funding for NTDs such as helminthiasis, kinetoplastid diseases (trypanosomiases, leishmaniases), Buruli ulcer and trachoma. HIV/AIDS, tuberculosis and malaria, however, accounted for more than 76% of the US$2.56 billion invested on R&D on neglected diseases in 2007.

The lack of funding for NTD control programs has been noted by the World Health Organization (WHO), academics and non-governmental organizations. However, the specific amounts of ODA committed to NTD control have not been evaluated empirically. This paper attempts to do so by analyzing ODA commitments for infectious disease control derived from the OECD Creditor Reporting System (CRS) database.

The goal of our analysis is to identify ODA dedicated to health causes and specifically to NTD control for the period 2003 to 2007. We base our analysis of ODA on the OECD CRS database which collects ODA data from donors, including all 22 members of OECD's Development Assistance Committee (DAC) and — on a voluntary basis — from non-DAC countries and multilateral agencies such as The Global Fund to Fight AIDS, Tuberculosis and Malaria. We focus on donors' commitments instead of disbursements as, for the period considered, ODA commitments are nearly 100% complete in the database while disbursements are only about 90% complete.

Following the categorization used by the OECD report Measuring Aid to Health, we included all ODA commitments that were made in the sector 'Health and Population Policies/Programmes and Reproductive Health' as ODA for health (Table 1). In order to identify ODA for NTD control, we studied annual ODA commitments for infectious disease control in detail.

Outcome Measures of Neglected Tropical Disease Management     

We included only RCTs that used cure rates, incidence, or prevalence (eg, when interventions were at the community level) as outcome measures because these measures could be studied uniformly across all 7 neglected tropical diseases. We also recorded the population eligible or excluded from each trial. Successful treatments of neglected tropical diseases may have beneficial effects on a variety of other important morbidity measures, such as growth parameters in children (height and weight), hemoglobin levels, and school performance. We recorded morbidity measures reported in these studies.

Definitions of NTDs used by different institutions and authors ...