March 1, 2024

Lukmaan IAS

A Blog for IAS Examination




THE CONTEXT: Noma, also known as cancrum oris or gangrenous stomatitis, has been officially recognized by the World Health Organization (WHO) as a neglected tropical disease (NTD).


  • This severe gangrenous disease affects the mouth and face, exhibiting an alarming mortality rate of approximately 90%. (Gangrenous: Decaying of a part of body because the blood has stopped flowing there.)
  • It is closely associated with extreme poverty, malnutrition, and poor sanitation and oral hygiene, further exacerbating its impact on vulnerable communities.

Characteristics and Impact

  • Primarily affecting children between the ages of 2-6 years, Noma displays a severe lack of awareness, with unreliable estimates of cases due to its occurrence in marginalized populations.
  • It is named after the Greek word “nomē,” signifying “to devour,” as it progressively consumes facial tissues and bones if left untreated.

Causes and Risk Factors

  • The disease is linked to various risk factors, including poor oral hygiene, malnutrition, weakened immune systems, infections, and extreme poverty.
  • Although not contagious, Noma preys on individuals with compromised immune defenses.
  • It typically initiates with gum inflammation, likely caused by bacteria present in the mouth.

Geographical Prevalence and Historical Context

  • Noma predominantly affects children in developing nations, especially in sub-Saharan Africa, where it is primarily observed among impoverished children aged 3-10 years.
  • Historical studies indicate that the disease may result from oral contamination by specific bacteria and microbial combinations.

Medical Implications and Challenges

  • Early detection is crucial due to Noma’s high mortality rate.
  • Basic hygiene, antibiotics, and nutritional support can significantly slow its spread.
  • The disease often originates as an ulcer on the mucous membrane, following illnesses like measles.

Consequences and Survivorship

  • Survivors of Noma face profound consequences, including severe facial disfigurement, jaw muscle spasms, oral incontinence, and speech impairments.
  • Effective treatments such as sulphonamides, penicillin, and surgical interventions remain inaccessible to many due to economic disparities.

Historical Perspective and Eradication Efforts

  • Noma was prevalent in earlier centuries but diminished in the Western world with improved nutrition and disease prevention measures.
  • Its occurrence in concentration camps during World War II highlights its historical impact.

WHO’s Recognition and Future Prospects

  • The inclusion of Noma in WHO’s list of neglected tropical diseases signifies a crucial step toward addressing this overlooked health challenge.
  • Médecins Sans Frontières / Doctors Without Borders emphasizes the need for increased attention and resources to combat Noma.
  • The WHO aims to raise global awareness, stimulate research, secure funding, and implement comprehensive strategies to control the disease.

Conclusion and Future Endeavours

  • Recognition of Noma as an NTD seeks to leverage global attention and multidisciplinary approaches to combat the disease.
  • Efforts targeting underserved populations are critical, contributing not only to disease control but also to achieving universal health coverage.
  • The WHO’s acknowledgment emphasizes the urgency of addressing Noma and underscores the need for collaborative, multifaceted interventions to mitigate its devastating impact on vulnerable communities.


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