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Powerful Testimonies Urge Action on Neglected Tropical Diseases



Earlier this month, The Senate Appropriations Subcommittee on State, Foreign Operations and Related Programs, chaired by Sen. Lindsay Graham (R-SC), conducted a hearing on Global Health Programs highlighting U.S. investments in significant  global health efforts  such as the President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund).

Powerful testimonies were delivered from dedicated global health advocates, including Ambassador-at-Large Deborah L. Birx, M.D., Coordinator of the United States Activities to Combat HIV/AIDS and Special Representative for Global Health Diplomacy, U.S. Department of State; Dr. Mark Dybul, Executive Director, The Global Fund; Sir Elton John, Founder, Elton John AIDS Foundation; and Dr. Rick Warren, Pastor, Saddleback Church.

While discussing the financial and programmatic difficulties of working to combat diseases such as HIV/AIDS, tuberculosis and malaria, Ranking Member Leahy (D-VT) underscored the importance of investing in prevention stating that “Many of these diseases can be prevented for just a few dollars.” As we have learned from the recent Ebola outbreak in West Africa, investing in preventative measures is much more cost-effective than attempting to contain a major outbreak. The Senator added:

“Very few Americans suffer from malaria, polio, Dengue fever, or river blindness. Can you imagine if they did? You’d have people lined up out here saying ‘What are you spending, let’s do something about it!’…This goes beyond politics or economics…we can do better.”

Dengue fever and river blindness are neglected tropical diseases (NTDs) transmitted to humans through bites of infected blackflies and mosquitoes, respectively. Dengue fever can cause severe joint, muscle and bone pain, and river blindness, also known as onchocerciasis, can lead to visual impairment and permanent blindness. Globally, 1.9 billion people are at risk for NTDs. These diseases result in severe physical disabilities and they prevent children from attending school or adults from working – resulting in an endless cycle of economic hardship.

By adding NTDs to the conversation, Sen. Leahy drew attention to a critical link between NTDs and other infectious diseases such as malaria, for example. In many parts of the world, NTDs are a result of inadequate water supply, limited access to sanitation facilities and poor hygiene. Mosquitoes breed in areas with stagnant water and can transmit not only malaria, but also NTDs including dengue fever, lymphatic filariasis and chikungunya.

Synergies such as these stress the importance of partnerships and building more resilient health systems. One way that initiatives such as the Global Fund and PEPFAR work to strengthen health systems in countries and communities is by investing in community health workers.

The Global Network thanks Chairman Graham and Sen. Leahy for holding this productive hearing. The testimonies from this panel of experts underscore the critical role the U.S. Government plays in combating global health issues. Because we have made such enormous strides in the fight against many infectious diseases, including NTDs, we cannot risk reversing the results we have achieved so far.  Those living in extreme poverty around the world are counting on our help.

Funding for the U.S. Agency for International Development’s Neglected Tropical Disease (USAID’s NTD) Program is at risk due to the President’s proposed budget of $86.5 million for FY2016 – a $13.5 million drop  from the $100 million allocated by Congress for FY2014 and FY2015. The USAID NTD Program is an extremely successful and cost-effective public-private partnership that has reached more than 465 million individuals in 25 countries with life-saving treatments.

The Global Network’s END7 campaign is taking action against the proposed budget cuts with its “Call to Action” petition. To get involved and speak out, add your name here.

“Worm Index” Reveals Association Between NTDs and Human Development


A new “worm index” developed by Sabin President Dr. Peter Hotez and Baylor College of Medicine’s Dr. Jennifer Herricks reveals a strong association between neglected tropical diseases (NTDs) and human development.

The index was based on the disease burden of major worm (or helminth) infections: intestinal helminths, lymphatic filariasis and schistosomiasis, which can lead to diarrhea, anemia, disability, disfigurement and even death. Increasing evidence over the last decade links the most common NTDs to significant adverse impacts on both human and economic development.

Hotez and Herricks created the worm index (see map below) using World Health Organization (WHO) data on disease burden for these worm infections in the world’s 25 most populous countries. Countries’ worm indices range from 0-1, with higher indices indicating a higher disease burden.

Heat map for worm index of the 25 most populous countries:
Worm Index Map

Hotez and Herricks then compared their worm index to the United Nations Development Programme (UNDP) human development index (HDI), which measures a country’s achievement in education, standard of living and years of life lived in good health.

This side-by-side comparison uncovered a strong negative correlation (see graph below).

Comparison of HDI to worm index in the 25 most populous countries:

It is tempting to conclude from these results that worm infections hold back human development, but it could just as easily be that situations of poverty (poor healthcare infrastructure and lack of access to clean water and sanitation, for example) result in worm infections. “It is possible or even likely that the causes and effects flow in both directions,” the researchers state.

That said, evidence illustrating this relationship abounds. Hotez and Herricks cite studies from Kenya showing that deworming led to improvements in school attendance and participation, and the effects of deworming could still be seen into adulthood—adults who received deworming treatments as children were more productive, both in hours worked and wages earned. Higher wages and more schooling are critical tools for achieving the Sustainable Development Goals (SDGs).

“Given the strong associations between helminthic and other NTDs and mental, physical, and economic human development, vulnerable and excluded populations, and HDI, in the coming months and years it may become essential to give due consideration to eliminating helminth infections as a means to achieve SDGs. Of course, poverty, “Water, Sanitation and Hygiene” (WASH), and nutrition play an important role in health outcomes. As we look to reduce poverty and increase WASH and nutrition, we must also focus on chronic diseases such as helminth infections that reinforce the cycle of poverty and malnutrition. Therefore, we suggest that the NTDs need to be an important consideration in any discussion about the SDGs, and helminth control and elimination as proposed by the 2012 London Declaration for NTDs must be embraced by the SDGs and the sustainable development community.”

No matter which came first—poverty or worms—the fact is that these infections impact millions of people every day, disabling communities’ workforces and further limiting economic growth where it’s needed most.

Snapshot of the Diplomatic Courier’s Interview with Dr. Mirta Roses Periago, Director Emeritus, Pan American Health Organization


By Whitney McInvale and Alex Gordon

Earlier this this year, Director Emeritus of the Pan American Health Organization (PAHO), and Special Envoy for the Global Network for Neglected Tropical Diseases, sat down with the Diplomatic Courier  – a leading global affairs magazine – to discuss her experience as the first female Regional Director of the World Health Organization (WHO), and her thoughts on the post 2015 development agenda and the Ebola crisis.

During her interview, Dr. Roses shared interesting insights from her distinguished career as a public health champion.

 On being the only woman in the room…

“In my time at medical school, women were the minority. … And of course, almost all of the professors were male. Also in the hospital environment—with the exception of nurses, who were all female—the doctors were all male. That was the gender division of labor. But I think that my generation was the generation of change. We started occupying some of the positions that had never been occupied by women before.”

Dr. Roses elaborated that once men were ready to challenge gender norms, male bosses and mentors began to open doors for her. These opportunities, combined with her skilled and tireless work, led her to become the first woman regional director of the WHO. And now, more and more woman are taking top positions in the WHO, she explains.

“Today, we can say that we have a Regional Director in the Euro-region, also the first woman. The first female Regional Director in Southeast Asia, and the first female Regional Director for Africa was just elected in November. We also have a female Regional Director that succeeded me in the Americas. So now there are four female Regional Directors…and we have a female Director General, Dr. Margaret Chan.”

On her passion for eliminating neglected tropical diseases (NTDs)…

“I am also a Special Envoy for the Global Network for Neglected Tropical Diseases. [There is a] big coalition of many organizations working for the elimination of neglected tropical diseases in the world by 2020.

[NTDs] are mostly parasitic diseases that have been [with] humanity for thousands of years. Today, we have all the tools and knowledge to eliminate them. …they are still so related to poverty, to vulnerable people, and to excluded communities that we call them ‘neglected.’”

On the Post 2015 Development Agenda…

As the Millennium Development Goals (MDGs) come to a close, the Diplomatic Courier asked Dr. Roses to discuss her thoughts on what the forthcoming post-2015 development agenda will – and should – focus on:

“I think that the struggle is, again, to find a short list that will focus the attention of all countries on what the world requires to become more peaceful, more equitable, safer and more sustainable. I think that the concern about the environment is now right at the top. I think that the environment, along with peace, security and human rights, will become [more important] than they were in the MDGs.”

Dr. Roses has also voiced her support for the inclusion of NTDs in the post-2015 development agenda, stating that:

“If NTDs are not clearly identified in the final post-2015 development agenda and the corresponding sustainable development goals, they will once again remain as forgotten and invisible as the people and communities affected by them.”

On the Ebola crisis…

“There are also many lessons learned, particularly the fact that we need to strengthen health systems where the people are. If the people don’t have tools for everyday problems, including the delivery of babies, accidents, and so on, no one will be looking at the problem and no one will be able to respond to the problem.”

To read the full interview, click here.