This week 115 cardinals will enter the papal conclave in order to select a new pope. Some newspaper accounts, including those in The New York Times, highlight the proceedings as a contest between cardinals who reside in the Vatican (‘the Romans’) versus the ‘reformers’ who include several prominent cardinals from developing countries. Almost certainly, in its deliberations the conclave of cardinals will consider a number of difficult and well-publicized problems now facing the Catholic Church. However, one issue I have not seen mentioned in the press is one I first wrote about in 2011 – namely a huge burden of disease and poverty facing some of the world’s Catholic-majority countries, especially from the neglected tropical diseases (NTDs). While many of the Catholic-majority nations include wealthy Western European countries and Canada, they also include some of the world’s poorest nations such as Bolivia, Haiti, Honduras, Nicaragua, and Paraguay in the Americas; Angola and Democratic Republic of Congo (DRC) in Africa; and Philippines in Asia. Large middle-income Catholic-majority countries such as Argentina, Brazil, and Mexico also have huge pockets of extreme poverty.
Poverty goes hand-in-hand with NTDs and in my 2011 analysis I estimated that the Catholic-majority countries disproportionately suffer from many of those diseases. Roughly one-quarter of the world’s soil-transmitted helminth infections occur in Catholic-majority countries led by nations such as DRC, Brazil, Philippines, while 14-16% of the cases of scistosomiasis are also found in those same countries in addition to Angola. Lymphatic filariasis (LF) and onchocerciasis are widely prevalent in many Catholic-majority countries, and most of the global Chagas disease burden occurs in the Catholic-majority Latin American nations, in addition to Spain and Portugal.
The new Pope will need to consider a hidden burden of NTDs, especially soil-transmitted helminth STH infections, schistosomiasis, LF, onchocerciasis, and Chagas disease now affecting the world’s 1.2 billion Catholics. In contrast to his predecessors, this new Pope will have at his disposal a new set of tools to tackle these diseases. They include a ‘rapid-impact’ package of medicines that simultaneously target up to seven NTDs – the three STH infections, schistosomiasis, LF, onchocerciasis, and trachoma – and which can be administered for as little as $0.50 per person annually. In some cases this approach is leading to the elimination of LF, onchocerciasis, and trachoma as public health problems. Most of the public support for these treatment packages is provided by the governments of the United States and United Kingdom but there is no reason why the Catholic Church cannot promote a similar low-cost program for many of the worst-affected Catholic-majority countries. Similarly the Vatican’s Pontifical Academy of Sciences could become active in promoting research and development of NTD technologies, including new drugs, diagnostics, and vaccines. I would like to see a particular commitment for Chagas disease currently affecting 10 million people in Latin America and the southern United States, in addition to Spain and Portugal.
The NTDs have been shown to cause poverty because of their deleterious effects on worker productivity and child development. They are increasingly recognized as the most common infections of girls and women in low- and middle-income countries. Thus NTD control and elimination represent a major advance in improving global health and lifting the poorest people, including hundreds of millions of Catholics, out of poverty.
We should anticipate that the new Pope will reaffirm his commitment to the world’s poor. I hope that a component of his outreach will include an unprecedented endorsement for global NTD control and elimination efforts as a highly cost-effective and cost-efficient means of tackling disease and poverty.
Peter Hotez has no competing interests to declare.