Booker Introduces Legislation to Address ‘Neglected Diseases of Poverty’

Lilo H. Stainton | October 24, 2019 | Health Care
Commonly found in developing countries, parasitic infections and contaminated drinking water can sicken residents of underserved communities in the U.S.
Giant roundworm parasiteCredit: Wikimedia
Giant roundworm parasite

Presidential candidate and U.S. Sen. Cory Booker (D-NJ) has proposed a first-of-its-kind national plan to address — and possibly eliminate — parasitic infections and other diseases associated with poverty, conditions he said affect an estimated 12 million Americans.

The legislation Booker introduced Wednesday would target what are considered “neglected diseases of poverty” that, while commonly associated with developing countries, also sicken residents of underserved communities in the United States and take a disproportionate toll on racial minorities.

According to the George Washington School of Medicine’s Research Center for Neglected Diseases of Poverty, these include certain sexually transmitted diseases and infections caused by parasites, including several that are transmitted from animals. All are more likely to flourish in neighborhoods without clean water or sanitary sewer systems.

Sens. Cory Booker and Bob MenendezCredit: menendez.senate.gov
Sens. Cory Booker and Bob Menendez (both D-NJ) visiting Rutgers University earlier this year

“Across the poorest parts of our country people are facing appalling realities that would shock the consciousness of many Americans,” Booker said. “This is an injustice that has been largely hidden from most Americans and highlights a gross inequality, where large swaths of this country are regularly exposed to raw sewage and contaminated drinking water.”

(While Newark, where Booker served as mayor, is now grappling with some evidence of high lead levels in one of its water systems, officials have not suggested the drinking water is otherwise contaminated.)

Parasitic ‘kissing bug’

Because these diseases are not well monitored in the U.S., it is hard to know their prevalence nationwide, let alone in New Jersey, Booker’s staff noted. But cases of roundworm and Chagas disease, a parasitic infection caused by the so-called kissing bug, have been reported in Delaware and New York City, they said.

A 2017 report by the Guardian found that hookworm was now endemic in the American south. And numerous studies have shown that low-income communities frequently have higher rates of certain chronic conditions — like asthma and diabetes — and higher mortality rates than more affluent areas.

Former New Jersey health commissioner Dr. Shereef Elnahal, who is now president of University Hospital in Newark, the state’s only public acute-care facility, said clinicians there face these cases. The hospital is near Newark Airport, a busy international hub, and treats many recent immigrants from countries where these diseases are common, as well as vulnerable local residents.

“Unfortunately, University Hospital sees neglected diseases of poverty all too often,” Elnahal said. “Senator Booker’s bill calls for both a national strategy and resources to tackle this problem, both of which could help Newark tremendously.”

Devastating consequences

Neglected diseases of poverty are considered chronic conditions that can have devastating impact on child development, adult productivity and family structure, according to experts, but they don’t receive much attention from the medical profession, including pharmaceutical companies. And because they are thought to be eradicated, physicians are not required to report their diagnoses to the federal Centers for Disease Control and Prevention, further obscuring their impact, Booker said.

The senator’s plan — the STOP (Study, Treat, Observe and Prevent) Neglected Diseases of Poverty Act — calls for an interagency task force to work with local communities to develop recommendations for the federal government on how to better address these conditions. It would also give states funding to implement public-health surveillance networks; require federal officials to develop a public education program about these diseases; and encourage research on relevant diagnostic tools and treatments.

“People who live in extreme poverty are suffering from diseases that many thought had been eradicated because their communities lack the proper resources. We need to address this challenge by raising awareness and boosting investment in research and monitoring,” Booker said.

According to the legislation, neglected diseases of poverty affect more than 1 billion people worldwide, including millions who are sick and don’t know it — allowing them to easily transmit infection to others. These conditions also place a huge financial burden on families and communities, it notes, and many have a high mortality rate and are likely to cause other issues, like asthma, blindness or seizures.

Limited funding

While there have been other federal proposals to address neglected diseases from a global perspective, Booker’s team said his is the first to focus on this issue in the U.S. alone. Currently, funding for research, preventive strategies and treatments is limited, the bill notes.

“This legislation fills an important void in terms of health disparities in America. It is among the first comprehensive pieces of legislation to address the previously hidden poverty-related neglected diseases in the United States,” said Dr. Peter Hotez, professor and dean of the National School of Tropical Medicine at Baylor College of Medicine in Texas. “These illnesses are not rare; in fact, they are common, but seldom diagnosed, treated or prevented because they occur almost exclusively in Americans living in extreme poverty.”

Booker’s staff said the bill builds on his environmental justice work as a senator and as Newark mayor. He co-founded the Senate’s first Environmental Justice Congress and worked with environmental-justice advocates in Newark to clean up the Passaic River and create a waterfront park. He has also sponsored federal legislation to address environmental injustices within communities of color.