The preoccupation of rich countries with threats to their own health is crippling efforts to care for easy-to-cure diseases in poor countries, says a tropical disease expert in The Lancet. David Molyneux, of the Liverpool School of Tropical Medicine, outlines how interest in “the big 3” infectious diseases — HIV/AIDS, TB, and malaria — is obstructing public-health initiatives to tackle preventable diseases such as the viral, bacterial, and parasitic infections of the tropics, and acute respiratory infections and diarrhoeal diseases of children.

Professor Molyneux comments: “The emphasis on the big three killers and the derogatory assignment to the category of ‘other diseases’ of those that can so easily be controlled or even eliminated neglects the proven success of a range of interventions. An investment of a fraction of the annual requirements of the Global Fund (for disease) would bring long lasting benefit to the millions that still remain disabled, reduce morbidity, and prevent disablement in future generations.”

He concludes: “Current policy also raises ethical issues. Resources are being transferred to interventions against the big three that, realistically, have only a limited chance of success as they are reactive and do not adequately control transmission — a pre- requisite for any public-health impact”.

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