MbShea@PWP@English@UMCP

Abstract:
There are 20,000 to 30,000 deaths and 900,000-1.3 million new cases of leishmaniasis each year (WHO, 2016). However, according to Jorge Alvar, the head of the Visceral Leishmaniasis, Drugs for Neglected Diseases initiative, countries’ reported incidence of leishmaniasis fall short of the actual values. In Alvar’s 2012 paper in PLoS One, the actual incidence may be as great as 10-fold higher for cutaneous leishmaniasis and 8-fold higher for visceral leishmaniasis. Additionally, climate change is expected to increase incidence of leishmaniasis through niche expansion of Leishmania’s vector—phlebotomine sandflies—and human movement through regions with Leishmania transmission (WHO, 2016). PolicyCure’s G-FINDER report, states 2014 funding for kinetoplastids increased 14% and 7% for leishmaniasis, specifically. However, overall funding for kinetoplastids is considered stable and is only 4% of global R&D funding. Kinetoplastids are the ninth highest cause of mortality and tenth highest cause of morbidity from neglected tropical diseases (NTD) (Moran, et al., 2015). Leishmaniasis prevention and treatment is lacking in several areas (ie. effective preventative measures and treatments and diagnostic tests that can detect early-stage disease). According to Uniting to Combat NTDs, NTD may have a total economic burden as great as more deadly diseases (ie. HIV/AIDs and malaria). NTD prevent victims from attending work or school, even when they do not kill (McNeil, 2015). Regions affected by leishmaniasis are expected to increase in response to climate change; investing resources in to leishmaniasis research for prevention and treatment now will reduce disease burden in the future.

Reader’s profile:
The reader I imagine is skeptical of the need for increased funding and research into leishmaniasis, as opposed to other neglected tropical diseases (especially the “big killers” HIV/AIDs, malaria, and tuberculosis).

Reader’s response:
I know the paper states leishmaniasis incidence is increasing, but how about the incidence of diseases that are more notorious killers—HIV/AIDs, malaria, tuberculosis—will they increasing in response to climate change? Also, won’t increasing funding for leishmaniasis take funding away from other important areas of research? I understand that research into leishmaniasis is important. The question is, which diseases is it most important to study now?

References:
Alvar, J., Vélez, I. D., Bern, C., Herrero, M., Desjeux, P., Cano, J., Jannin, J., Boer, M. D., and
the WHO Leishmaniasis Control Team. (2012 May 31). Leishmaniasis Worldwide and Global Estimates of Its Incidence. PLoS ONE, 7(5). doi:10.1371/journal.pone.0035671
McNeil, D.G. (27 July 2015). Fight Against Tropical Diseases is Framed as Efficient. New York
Times.
Moran, M., Chapman, N., Abela-Oversteegen, L., Chowdhary, V., Doubell, A., Whittall, C.,
Howard, R., Farrell, P., Halliday, D., and Hirst, C. (2015). G-FINDER 2015 Report. PolicyCures.
World Health Organization. (2016, September). Leishmaniasis: Fact Sheet. WHO.
http://www.who.int/mediacentre/factsheets/fs375/en/.

V, looks like a great plan. We always have these trade-offs in science funding (which make me sad, actually). You can write a good paper; I am just concerned for all of us that science funding is entering a very bleak time.....