All posts by Neeraj Mistry

Endemic Countries Lead the Fight against NTDs

Nearly 1.8 billion people require treatment for neglected tropical diseases (NTDs). Many of these diseases can be easily prevented or treated, yet only 43 percent of people are receiving the treatment they need for the most common NTDs.

In this time of resource scarcity, our collective commitment to the poorest communities should not wane. Yet, the traditional donor-supported model is not a sustainable solution. Increasingly, the global health and development community has been promoting the concept of country ownership as a critical issue of sustainability for country programs. In order to build programs that will live on past the life of a grant or the passing interest of a donor country, affected nations need independent, self-sustaining systems that are domestically organized and funded. This is not country ownership, but rather country leadership.

This country leadership was solidified when health ministers reaffirmed their commitment to the Addis Ababa Commitment on NTDs at the World Health Assembly (WHA) in Geneva in May. Nearly two dozen African countries signed this declaration in December 2014, pledging to increase domestic investment, promote multi-sector approaches, encourage adoption of data-driven, long-term strategic plans and ensure mutual support of NTD programs and overall health systems.

This Commitment heralds a new development model, where low- and middle-income countries partner together to invest in and lead their own development with support from the global community.

The Addis Commitment exemplifies the partnership required to create a successful health system through political, financial and technical reciprocity between donor countries and endemic countries.  While financial assistance is a critical stepping stone on the road to self-sufficiency, the real value comes from building proficiencies and systems that will last long after the money has been spent.

Eliminating Diseases by Investing in WASH

This blog was originally posted in WASH Advocates.

At the turn of the century, world leaders came together at the United Nations in New York to develop the Millennium Development Goals (MDGs), a set of eight ambitious goals and targets meant to significantly reduce poverty by the year 2015. As the window to achieve these goals closes this year, we reflect on progresses made and look ahead to the sustainable development goals (SDGs) that will shape the development agenda for the next 15 years.

A number of MDG targets have already been met, including efforts to reduce cases of HIVhttp//www.un.org/millenniumgoals/environ.shtml', 'MDG 7');">MDG 7). Moving forward, addressing neglected tropical diseases (NTDs) will be a critical component when working toward meeting both of these goals. NTDs are bacterial, parasitic and viral infections that affect the most marginalized communities across the world and are often the result of inadequate water supply, limited access to sanitation facilities and poor hygiene. Areas with stagnant water are breeding grounds for insects that carry NTDs, notably mosquitoes which transmit malaria, but also dengue fever, lymphatic filariasis and chikungunya. By promoting integrated vector management and improved water control measures in endemic countries, we can simultaneously work to combat HIV/AIDS and malaria, while also working to control and eliminate NTDs.

Since 2000, there has been significant advancement in the fight against HIVhttp//www.undp.org/content/dam/undp/library/MDG/english/UNDP_MDGReport_EN_2014Final1.pdf');">ART has saved 6.6 million lives since 1995. As with malaria, there are additional opportunities for integration that not only have the potential to reduce rates of HIV infection but also significantly improve water, sanitation and hygiene (WASH) conditions. For example, in many developing countries, women remain disproportionately vulnerable to HIV infection due to greater social safety issues, such as lacking access to safe and accessible latrines. By not having access to a safe lavatory, women are forced to use public spaces to openly defecate and manage their menstrual needs, making them increasingly susceptible to infections as well as sexual violence. Globally, more than two billion people lack access to a proper toilet. Many common, poor hygiene practices, such as open defecation and failure to wash ones hands, promote the spread of disease. These factors combined perpetuate the cycle of NTD infections and other serious infections.

The proposed SDGs currently consist of 17 goals with 169 targets that aim to end poverty and hunger, improve health and education, make cities more sustainable, combat climate change, and protect oceans and forests. Goal 3 encompasses a number of health-related objectives and targets, including ending the epidemics of AIDS, tuberculosis, malaria, NTDs and water-borne diseases by 2030. Meeting these targets will go hand-in-hand with Goal 6 achieving access to adequate and equitable sanitation and hygiene for all, ending open defecation, and paying special attention to the needs of women and girls and those in vulnerable situations.

There are many ways that enhancing WASH conditions unswervingly leads to NTD control and elimination. For example, by improving access and quality of water, sanitation and hygiene, we can significantly reduce the number of people suffering from trachoma, an infectious eye disease and leading cause of preventable blindness, which results from limited access to clean water and proper sanitation. By simply providing access to clean water, we can reduce the number of trachoma cases by three times greater chances of contracting HIV. It is estimated that at least 16 million women may be infected with FGS in Africa.

It is evident that WASH interventions have a multiplier effect and positively impact other health issues and development goals. As the window to achieve the MDGs comes to a close this year and we grow closer to confirming the goals and targets that will shape the next 15 years, we must emphasize the important synergies between WASH and the control and elimination of NTDs.

This blog post is part of the WASH and the MDGs: The Ripple Effect blog series, in partnership with here.

LwL: A Life Worth Living

This post was originally published on the Aspen Idea Blog.

What makes a life worth living? For many of us, it’s our relationships with our families and loved ones, the ability to follow our passions, excel at work, and improve opportunities for ourselves and future generations.

While tremendous efforts are underway to prevent deaths worldwide, guaranteeing survival is not enough. We must also strive to ensure that every human lives a life of quality.

Nearly half the world’s population is robbed of the minimum requirements that allow them to reach their full potential. Neglected tropical diseases (NTDs), parasitic and infectious diseases affecting 1.4 billion people worldwide, debilitate entire families and communities. They cause anemia and malnutrition, and can lead to blindness, school absenteeism, disfiguration and the loss of livelihoods. NTDs drastically weaken a person’s health and cause unnecessary suffering.

At the basic level, access to adequate nutrition, the opportunity to be educated, the ability to enjoy human interaction, and the right to prosper and contribute to society all make a life worth living. Yet NTDs rob the billion and a half people living in poverty of these basic needs and undermine other development challenges like maternal and child health. In order to flourish, these needs must be met.

Life isn’t just about the number of days we live, but the quality of those days. Every human, no matter where they were born, has the right to a fulfilled life and the right to determine their own future.

By fighting NTDs, we can help protect the health of the world’s poor and vastly improve their quality of life, increasing opportunity and equality. And it’s inexpensive and easy to do so. For less than 50 cents per person per year, we can control and eliminate NTDs altogether within the decade. 

Solving this global health challenge will require collective action. In an e-world where communication is often reduced to three letter acronyms, LwL – Life worth Living is a way of thinking about and raising awareness of the social, psychological and developmental impacts of NTDs. LwL has universal appeal as self-examination for “haves” and “have-nots” in a broader understanding and value of life. As a concerned global community, we can work together to ensure all people have the tools they need to live their life worth living.

LwL is a symbol that reminds us to be mindful as we go about our daily lives and reflect on what constitutes a life worth living – not only for us in the healthy or developed world, but for those suffering from poor health and poverty as well. If we as a community can reflect on LwL, we can help ensure a healthier and happier life for all.

Abhishek Bachchan Visits with Patients Suffering from NTDs

Bollywood celebrity Abhishek Bachchan visitis a community health center in Odisha, Bhubaneswar, India. (Photo by Vivek Singh)

Shortly after Bollywood star Abhishek Bachchan Church’s Auxiliary for Social Action (CASA) is providing community-based care for patients suffering from, and the community at risk for, lymphatic filariasis (LF) and other neglected tropical diseases (NTDs). Through the work of volunteers and community health workers, the program currently serves more than 20,000 patients with LF and works in partnership with the government to support the distribution of medicine to everyone in the region to protect them from NTDs.

Abhishek met with patients who were suffering from chronic LF, and listened to their stories and experiences. They spoke of the previous hardship caused by the disease and, through the staff and services, had experienced considerable improvement in their quality of life. Yet, among many of them, there was a tangible sadness, which resulted from the stigma and ostracization caused by the disease: in a community where marriage of children is seen as a fulfillment of parenting, many of their daughters remained unmarried because suitors feared that the diseases was genetic.

LF is just one of the NTDs that can be prevented with annual medication. Once the limbs have swollen, there is no cure for LF but further disability can be prevented with proper care. CASA health workers explained and demonstrated morbidity management and disability prevention for patients with LF, which included proper washing and drying techniques, exercise massage and elevation of limbs. Abhishek was moved to join in, helping the CASA staff to wash the limbs of LF patients. Later, he took albendazole pills, one of the two medicines taken to treat and prevent early LF infection.

This visit only confirmed that there is more work to be done. While we control and eliminate these debilitating diseases, we must also improve the mental and social well-being of those suffering from NTDs. This goes beyond medicine and requires engagement of families, local community organizations, and the media and entertainment industry. With the help of organizations like CASA, and champions like Abhishek, we can take a holistic approach to addressing NTDs.

Of the 1.4 billion people in the world affected by NTDs, more than a third live in India. Global progress on NTDs hinges on India’s efforts and successes.

India is a historic leader in ending some of the most devastating diseases of our time, including smallpox and guinea worm, and most recently, polio. Now, India has the opportunity to achieve another significant public health milestone: the control and elimination of five NTDs.