By Deepanjali Jain and Anupama Tantri
Partners from multiple sectors, including development banks, play an important role in the response to control and eliminate NTDs – a point highlighted by the report, “Delivering on promises and driving progress: the second report on uniting to combat NTDs”, released in tandem with the commemoration of the second anniversary of the London Declaration on Neglected Tropical Diseases (NTDs) earlier this month. ,. In a resource-limited environment, the contributions of development banks, such as the World Bank, the African Development Bank, the Inter-American Development Bank and the Asian Development Bank, present unique and innovative models to finance national NTD programs. These models also signal the prioritization of NTDs by endemic country governments and the recognition of NTDs as a cross-cutting issue that is tied not only to health, but also to efforts to improve education, gender equity, agriculture, and water and sanitation.
The World Bank and the African Development Bank have understood this connection for decades—their investments in NTD control and elimination began in the mid-1970s with support for what eventually became the African Program for Onchocerciasis Control (APOC). Onchocerciasis, or river blindness, is a devastating disease that is endemic in 30 African countries. Easily preventable, onchocerciasis is the second leading infectious cause of blindness, just behind another NTD, trachoma. APOC, funded by several public and private donors including national governments, foundations, the private sector, the African Development Bank, and the World Bank– the latter of which also manages the trust fund that pools the resources from all partners–implements an onchocerciasis control program that reaches over 100 million people annually in Africa. Given the success of the APOC model and the overlap between onchocerciasis and lymphatic filariasis (LF), the program is now being expanded to address LF.
This past year, the World Bank committed to expanding its investment in NTDs by working with endemic countries in Africa to access $120 million in International Development Association (IDA) funds to support NTD control and elimination efforts. The investments are part of broader development efforts to address poverty in countries along the Senegal River basin by supporting fisheries, irrigation and water resources management, in addition to NTDs such as schistosomiasis. This effort has also supported NTD efforts in Madagascar, Yemen and the Sahel region.
The Inter-American Development Bank (IDB) is also a strong partner in the NTD response in the Americas. In partnership with the Pan-American Health Organization (PAHO) and the Global Network for Neglected Tropical Diseases, IDB established an initiative to provide technical and financial support for the control and elimination of NTDs in Latin America and the Caribbean. The aim of this partnership is to support projects that employ an integrated, community-based methodology that go beyond short-term curative measures to include longer-term solutions that tackle the social and environmental determinants of disease transmission. In Guyana, IDB supported an integrated project to reduce the burden of LF that included water and sanitation system improvement, gender-equity programming, vector control via the distribution of bed nets and drug administration. Watch the video about this project here and find more details on the initiative here.
In Asia, emerging infectious diseases and nutrition threaten the rapid economic growth and development across the region. Recognizing these links, the Asian Development Bank (ADB) has integrated NTD components into a variety of broader health and development programs. One example is the Greater Mekong Subregion Communicable Disease Control Project which has supported scaling up of LF and STH programs in Cambodia, Laos and Vietnam as part of a program to address vector-borne and other emerging infectious diseases. Pantawid Pamilyang Pilipino Program, a conditional cash transfer program launched in the Philippines with the support of the ADB and the World Bank, includes deworming of children as a condition for families to receive cash assistance, underscoring the links between health and poverty.
Recently, the ADB announced several initiatives in collaboration with the World Health Organization Western Pacific Regional Office (WPRO) that reinforce their commitment to addressing global health and communicable diseases in Asia and present an opportunity to do more on NTDs. Building on the vision of regional cooperation and leadership articulated by the Asia Pacific Leaders Malaria Alliance (APLMA), the ADB created the Regional Malaria and Other Communicable Disease Trust Fund (RMTF) that will help fund communicable disease control projects in recipient countries. ADB has also announced that they will increase their operations in the health sector to between 3 and 5 percent of their annual spending, up from 2 percent from 2008-2012, an opportunity to contribute more resources to support national NTD control and elimination programs.
Although funding for the global NTD response increased in 2013, the funding gap between current resources and those needed to reach the 2020 control and elimination goals is still US$200 million per year. Development bank programs, like those initiated and supported by the World Bank, IDB and ADB, create innovative and sustainable funding models that support endemic country initiative and bolster existing investments in NTD control and elimination programs. The ability to bring together diverse partners and encourage cross-sectoral coordination is a hallmark that is unique to these development banks and is critical to meeting the 2020 NTD control and elimination goals.