During the month of October, END7 student supporters are celebrating NTD Success Stories from Haiti, India, Sierra Leone and the Philippines. Each country we are spotlighting has overcome their own challenges, ranging from earthquakes to the Ebola epidemic, to make sure communities receive NTD treatment and progress towards disease control and elimination. The examples of these four diverse countries help communicate not just the scope of the suffering caused by NTDs, but the hope we have of ending these diseases for good. Last week, we celebrated Haiti’s inspiring progress towards the elimination of lymphatic filariasis, and this week we’re looking across the globe to India, a historic leader against that and many other NTDs.
India’s diverse population has experienced rapid economic growth over the past two decades, but the country still faces significant health challenges due to its size and high burden of disease. Almost half of the 1.2 billion people at risk of lymphatic filariasis (LF) infection globally live in India. Additionally, NTDs such as soil-transmitted helminths (STH) negatively impact hundreds of millions of children in the country, causing delays in cognitive and physical development. These NTDs take a heavy toll on economic productivity and chronic infections perpetuate the cycle of poverty. However, the Indian government has one of the largest and most successful NTD programs in the world, and treatment scale-up is paving the way towards the elimination of LF and the control of STH infections on the subcontinent.
The Indian government first launched a pilot program to tackle LF in 1949. Over the next four decades, the government supported important research and demonstration studies that became the technical backbone of the World Health Organization’s Global Programme to Eliminate LF, launched in 2000. India’s experience with LF provided the evidence for the operational and technical feasibility of mass drug administration (MDA) to eliminate LF — a strategy that has since been adopted in countries around the world.
Today, India leads the world’s largest MDA program, reaching more than 400 million people with an annual dose of preventative medicine for LF. To date, India is one of only two countries who have achieved MDA coverage at a national level, and the population at risk of LF in the country has been reduced from 600 million to 460 million as a result. The country has also successfully scaled up efforts to control STH infections at the state level, particularly through school-based deworming programs, and recently launched a National Deworming Day to coordinate multiple platforms for deworming into one cohesive push to tackle STH in children under 19. This initiative will encourage coordinated efforts, budgeting, and monitoring to improve the efficacy and reach of deworming programs.
Several districts in India are in the process of undergoing Transmission Assessment Surveys, evaluations designed to register whether LF transmission has been interrupted and annual MDA can cease. Moving forward, bi-annual MDAs will continue in districts with a high burden of LF. Continued efforts aimed at interrupting transmission of diseases, disease surveillance, early diagnosis and response, as well as continued community mobilization and education to change risk behaviors will be critical to reducing the LF burden in India. Managing the disease among existing patients, particularly those disabled by LF with elephantiasis or hydrocele, is also a high priority.
India’s Ministry of Health and Family Welfare worked with the Global Network for Neglected Tropical Diseases in November 2014 to produce a mass media campaign, Hathipaon Mukt Bharat (Filaria Free India) to raise awareness of LF and encourage people to participate in MDAs. The video created for the campaign, entitled Giant Footprints!, won silver at the Cannes Festival of Creativity in 2015. Bollywood star Abhishek Bachchan is also supporting India’s effort against NTDs as the END7 campaign’s first official ambassador in India.
These ongoing social mobilization efforts will be critical to achieving national, regional and global NTD control and elimination goals by 2020. If India’s current NTD efforts can be maintained and expanded, those at risk for NTDs can live free of these diseases of poverty and their devastating effects. And as the leader of one of the oldest and largest programs to tackle NTDs, India can be a leader in assisting other endemic countries hoping to replicate their success around the world.
There’s ample reason to hope that history will repeat itself in India as the country celebrates the elimination of polio and looks towards new goals, like the elimination of LF. The country’s example shows that directing the expertise of different agencies and organizations towards a common goal can be successful even in a country with a large and diverse population. END7 supporters are eagerly following the good news from India — the second success story we’re spreading in a month that’s already offered many reasons to celebrate — and hoping to see it replicated worldwide.