Recently the medical journal Nature published the genomic sequence (decoding) of the organism which caused the plague ("Black Death") that killed half the population of Europe in the middle ages. The bacteria was reconstructed from remains of medieval plague victims. Genome sequencing of many organisms has happened rapidly, but has this basic science enhancement of our knowledge helped us in a practical sense for countries like Nepal?

Ten years ago genomic sequencing of the typhoid bacteria (pictured) was carried out. Many scientists at that time wrote ecstatically about how this sequencing would lead to revolutionary changes in typhoid fever treatment. Sadly ten years hence there has been no obvious progress in taking care of typhoid patients. The academic thrill of discovery did not translate to more effective patient outcome.

Because typhoid can affect anyone in Nepal (from highly-placed officials to high-altitude climbers to school children), we all continue to suffer from the lack of prompt, proper diagnosis and treatment for this ubiquitous disease despite a huge gain in theoretical knowledge. What happened?

After scientists sequenced the typhoid bacteria they moved on to other unchartered areas of sequencing. And because diseases like typhoid have no spokesperson or lobby groups and are considered "biblical" diseases confined to the developing world, there is clearly no incentive to take advantage of the sequencing to make cost-effective, accurate diagnostic tools to help with patient care.

Compare typhoid with HIV, which continues to make important gains in prevention and treatment. This bias towards diseases like HIV is obvious in the funding pattern of the US National Institute of Health (NIH) and the Bill and Melinda Gates Foundation.

So it was indeed good news when a new organisation called the Coalition against Typhoid (CaT) pledged to help deal with this neglected disease. At the core of CaT's mission is a responsibility to provide a voice for the communities impacted by typhoid fever, to better define and increase awareness of the burden of typhoid at the global, regional and national levels, and to foster use of existing vaccines. CaT does not have a substantial operating budget but relies upon the collective, cooperative activities of its members to support its work plan.

If we had clean drinking water and improved sanitation typhoid would disappear, but that needs political will. In the meantime we need to increase awareness and have more effective diagnosis and treatment even to inhibit transmission of typhoid.