Lessons from Madagascar: implications of neglected tropical diseases for Northern Philippines

The article Neglected tropical diseases in East Africa on the example of Madagascar by Wilczyńska et al. [1] emphasizes how (1) weak health systems, (2) extreme poverty, and (3) ecological vulnerability, drive the burden of neglected tropical diseases (NTDs) in Madagascar.As a full-fledged professor in ecology and conservation biology based in the Philippines, I find valuable and interesting parallels between Madagascar and remote regions in Northern Philippines, particularly in the Cordillera Administrative Region and in the Cagayan Valley.The authors reported that diseases like soil-transmitted helminthiases (STHs) and schistosomiasis affect over 90% of local groups in some parts of Madagascar due to proximity to contaminated environments, unsafe water, and open defecation [1].Disturbingly, similar socio-economic and environmental conditions exist in the rural areas of Northern Luzon, Philippines.According to the Department of Health (DOH), STHs persist, endemic among children of school age, despite nationwide deworming, due to sanitation gaps and reinfection risks [2].Schistosomiasis, while frequently linked with sub-Saharan Africa, is a tenacious threat in Philippine provinces like Leyte, Samar, and various parts of Northern Luzon, where irrigation and snail habitats abound.Like Madagascar, these endemic zones also face health-seeking behaviors and limited health infrastructure [3].Madagascar's mass drug administration (MDA) exertions and vector control programs, despite inadequate resources, serve as a resilient model for integrated interventions.Wilczyńska et al. [1] rightly underscore that beyond medication, sustainable NTD control necessitates