Training Session Improves Prevention and Treatment of Podoconiosis for People of Cameroon

 

A podoconiosis patient practices good hygiene. Credit: Footwork

A podoconiosis patient practices good hygiene. Credit: Footwork

Guest blog post by Wendy Santis, Footwork Executive Director 

Twenty-five members of Cameroon’s Ministry of Health, and nurses and leaders from Mbebah Vigilantic Farming and Development Association — a community development NGO in Northwest Cameroon — received training this past December in podoconiosis diagnosis, prevention and mitigation.

Podoconiosis, a type of elephantiasis spread by chronic exposure to irritant soils, has been reported in over 15 countries across tropical Africa, Southeast Asia, and Latin America in volcanic highland zones, and is an important cause of tropical lymphedema. This neglected tropical disease (NTD) is primarily found in remote rural areas where subsistence farmers typically work in the fields barefoot. It causes progressive bilateral swelling of the lower legs. It is not infectious — no virus, bacterium or parasite is responsible.

The exchange training visit in Cameroon, which aimed to strengthen the Northwest region’s ability to control podoconiosis, was funded by Footwork: The International Podoconiosis Initiative (a project of New Venture Fund, a 501c3 public charity), Brighton and Sussex Medical School and International Orthodox Christian Charities (IOCC). Participants included three IOCC staff who are involved in podoconiosis prevention and treatment programs in Ethiopia: Hari Desta, Tsige Amberbir and Abreham Tamiru. They, plus Footwork Executive Director Wendy Santis, worked with Professor Samuel Wanji’s team from the University of Buea/Research Foundation for Tropical Disease and Environment.

podo2Since 2009, IOCC, in collaboration with Gail Davey, Professor of Global Health Epidemiology at Brighton and Sussex Medical School, and Footwork’s founder, has developed a scalable model to address podoconiosis with an aggressive prevention and treatment program in Ethiopia, where more than three million people suffer from this debilitating disease of the feet and legs and another 38 million are at risk. Through this IOCC model, more than 300,000 children and adults have been assisted through awareness, prevention and treatment efforts.

Data and recommendations are being shared with Cameroon’s Ministry of Health planners to inform policy decisions regarding community-based management of morbidity due to podoconiosis with the goal of eliminating podoconiosis in the region and the country. A Northwest region podoconiosis advocacy committee has been formed to further these efforts.

This work is extremely important, considering two million people (10 percent of Cameroon’s population) are at risk of podoconiosis. Mapping in Northwest Cameroon has demonstrated that podoconiosis is endemic in this region. Several thousand people are affected with a mean prevalence of 1 percent. Further mapping is planned.

To learn more about Footwork and podoconiosis, visit: www.podo.org.

In addition to Cameroon, Footwork is active in Ethiopia and plans to work in Uganda and Rwanda, among other countries. It encourages integration of podoconiosis control into efforts to eliminate other NTDs, and works with those active in other related diseases of the foot and leg.

  • Our shared goal is to eliminate podoconiosis within our lifetimes.
  • Our vision is a world free of podoconiosis in our lifetimes.
  • Our mission is to bring together public and private partners to support prevention and treatment of, and advocacy for, podoconiosis.

A New WHO Report Brings Fresh Data and Ideas on Ending NTDs

 

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More than 100 million people are affected by one or more neglected tropical diseases (NTDs) in the Latin America and Caribbean (LAC) region. As a former Director of the Pan American Health Organization, I’ve seen the suffering caused by these diseases first-hand. At the same time, I have also learnt what can be achieved when endemic countries and international partners put NTDs – and the people affected by them – front and center in their policies.

The World Health Organization’s Third Report on NTDs, released last month, rightly puts a strong emphasis on equity and shared prosperity – themes that are at the very core of tackling NTDs.

The report, “Investing to Overcome the Global Impact of Neglected Tropical Diseases,” charts a new course by outlining the investments needed to reach the WHO Roadmap goals– a critical guide for the global effort to control and eliminate NTDs by 2020. Importantly, it also examines what needs to be done to achieve universal coverage of all people in need by 2030.

The new WHO report calls attention to progress made, including in the LAC region, which is a source of pride and hope for all involved. The region’s milestones can serve as a model for other endemic countries and show the world what’s truly achievable:

  • In 2013, Colombia became the first country in the world to reach WHO-verified elimination of onchocerciasis (river blindness), followed by Ecuador in 2014.
  • Guatemala and Mexico are on track to eliminate transmission of onchocerciasis, leaving just one border area between Brazil and Venezuela with ongoing transmission of the disease.
  • More than half of the region’s countries with endemic Chagas disease have eliminated transmission by the disease’s principal domestic insect vector, and 20 of 21 endemic countries have implemented universal blood screening for Chagas.
  • Costa Rica, Suriname, and Trinidad and Tobago are no longer endemic for lymphatic filariasis as of 2011. More than 7 million people were treated for this disease in 2013, most of them in Haiti.

 

Landmark commitments like the 2012 London Declaration on NTDs and the 2013 World Health Assembly NTD resolution have helped sustain political will towards this effort. These commitments have influenced further action in the Americas, where commitments from the Organization of American States and the Council of Ministers of Health of Central America and the Dominican Republic accelerated the fight against NTDs.

Globally, over 800 million NTD treatments were delivered in 2012 alone– an outstanding result achieved through strong partnerships with pharmaceutical companies, endemic countries, affected communities, bilateral and multilateral organizations and implementing partners.

But, we still must finish what we’ve started and accelerate progress towards the 2020 goals. This will help set the stage for success as we look ahead to achieve universal coverage of everyone in need by 2030.

Many of the people affected by NTDs live in middle income countries, and the report calls for more domestic resources to be mobilized and more equitably distributed, including among the poorest and most marginalized people. Similarly, there is significant scope for development banks and donors, as well as emerging players like the BRICS, to finance NTD efforts by employing innovative models and leveraging public-private partnerships. Cross-sectoral collaboration with the WASH (water, sanitation and hygiene); nutrition; maternal and child health; and education communities is increasing access to NTD interventions, while also enhancing impact and ensuring sustainability.

The WHO report endorses the fact that controlling and eliminating NTDs paves the way for poverty alleviation and shared prosperity for all. As I’ve said before, targets to control and eliminate NTDs must be included in global efforts to address poverty and inequality, including the post-2015 development agenda and the corresponding Sustainable Development Goals.

I encourage you to read the full WHO report here.

Water is Crucial to Ending Blinding Trachoma

 

Photo from International Trachoma Initiative

Photo from International Trachoma Initiative

By Elizabeth Kurylo
Communications manager, International Trachoma Initiative

Every morning and every night, I turn on the hot and cold water taps, adjusting them so the temperature is just warm enough to wash my face. I take for granted that the water will flow. I would be shocked if it didn’t. This easy access to water is a luxury not enjoyed by hundreds of millions of people around the world.

As we mark World Water Day, it is worth noting that 748 million people do not have access to an improved source of drinking water and 2.5 billion do not use an improved sanitation facility. For them, the lack of water can mean poor health, disability and even death.

Water and sanitation is especially important in the prevention and control of trachoma and other neglected tropical diseases (NTDs). Trachoma is an ancient eye disease caused by a bacterial infection. Left untreated, it can lead to blindness. But we can stop it with the World Health Organization-endorsed SAFE strategy – Surgery, Antibiotics, Facial cleanliness and Environmental improvement.

Water is crucial to facial cleanliness, and key to ending blinding trachoma.  But in many places where trachoma is endemic, water is scarce, and rationed for uses other than hygiene, such as cooking. Face washing is not a priority.

The global trachoma community has made much progress since 1998, when Pfizer began donating the antibiotic Zithromax®, which treats and prevents trachoma. More than 444 million doses of Zithromax® have been shipped to trachoma endemic countries to date. And seven countries have reported reaching their elimination goals.

Under the leadership of WHO and the Alliance for the Global Elimination of Blinding Trachoma by the year 2020 (GET 2020), national trachoma programs have steadily scaled up implementation. In 2014, WHO’s Weekly Epidemiological Report (WER) said trichiasis surgeries and antibiotic distribution were tenfold higher in 2013 compared to 2004.

The International Coalition for Trachoma Control (ICTC) has galvanized the global trachoma community’s commitment to reaching elimination by 2020.  Collaboration on game-changing initiatives with governments, health officials and trachoma endemic communities has led to the mobilization of more than 150 million dollars of new funding from DFID, USAID and the Queen Elizabeth Diamond Jubilee Trust.  That is in addition to the national government domestic budget allocations and support already provided by many non-governmental development organizations as well as other donors such as the Lions Clubs International Foundation, Conrad N Hilton Foundation and the Bill & Melinda Gates Foundation.  The WASH sector also is collaborating with the NTD sector to achieve shared goals of improving health and eliminating disease.

Still, there is much work to do. An estimated 232 million people in 51 countries live in trachoma endemic areas. Globally, 31 countries are implementing the SAFE strategy to eliminate trachoma, which signifies that 20 countries are still in need of help.

In 2015, ITI plans to ship 115 million doses of Zithromax®, donated by Pfizer. That is more than twice the amount approved for shipment in 2014.  ”We are doing everything we can to accelerate access to Zithromax® needed by people who are at risk of blindness from trachoma,” said Dr. Paul Emerson, Director of ITI. “We are empowering national programs so that those at risk of going blind from trachoma can be treated.”

Empowering people in trachoma endemic communities to prioritize water for hygiene also has lasting benefits. I saw this in Ethiopia, where I met Amarech Haluka, the mother of three young girls, one of whom had experienced the pain of trachoma. Health workers introduced the SAFE strategy to Amarech’s community, which received donated Zithromax® and education about the importance of using latrines and keeping their faces clean to avoid trachoma. Amarech and her husband got a loan to install a water pump in their back yard, and she now routinely washes her children’s faces twice a day. Even though she cannot adjust the temperature of the water that flows from her pump, her children’s faces are clean, and her family is free of trachoma.

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