STH is endemic to some of the poorest tropical and sub-tropical regions of the world–where sanitation and clean water are scarce. Up to 800 million children are affected by this disease, increasing their vulnerability to malnutrition and other serious infections. STH is preventable and treatable through a comprehensive approach of deworming medication and access to clean water, sanitation, and hygiene education.

“This donation paves the way for CWW to reach more children, who desperately need life-saving drugs and their basic needs met,” said Mark Rosenberg, director of The Task Force for Global Health.” Johnson & Johnson is providing a model for how business, governments, and in-country health providers can unite to address our most serious health issues and improve quality of life for millions of children globally.”

To date, Children Without Worms (CWW), a partnership between The Task Force for Global Health and Johnson & Johnson has worked to treat more than 20 million children per year with mebendazole, and to address the root causes of STH in eight countries: Bangladesh, Cambodia, Cameroon, Cape Verde, Lao PDR, Nicaragua, Uganda and Zambia. In 2001, the World Health Assembly set as a goal to treat at least 75 percent of all school age children at risk of STH by 2010. This partnership and the Company’s contributions of mebendazole are credited as primary drivers leading Cambodia, Cape Verde, Loa PDR, Nicaragua, and Uganda to reach key WHO indicators years ahead of the target date. 

CONTACT: Kim Koporc, Director of Children Without Worms
kkoporc@taskforce.org

About Children Without Worms
Children Without Worms (CWW) supports global efforts to reduce the burden of soil-transmitted helminth (STH) infections in children most severely infected or at high-risk for infection and who have limited access to safe and effective treatment. The program achieves its goal by leveraging the donation of mebendazole from Johnson & Johnson and working with national programs to promote comprehensive and sustainable control of STH. For more information, please visit www.childrenwithoutworms.org.

Established by the United Nations Educational, Scientific Cultural Organization (UNESCO) in 1965, International Literacy Day serves as an important reminder that, one in five adults worldwide is not literate. That’s about 774 million people. Two-thirds of illiterate populations are women and 75 million children are not in school. These staggering numbers themselves indicate that illiteracy is still a major economic threat to developing countries. But in addition to threatening worker productivity, it also has a major impact on health. If people are not able to read and write, they will not be empowered to seek out the appropriate health interventions when they are sick. They will not be able to read the labels on their medicine bottle.

They will not get better.

Students in Paynesville Community School in Monrovia, Liberia. Photo Credit: Glenna Gordon, UNESCO

When someone is afflicted with an NTD for instance, being literate will not only enable them to seek appropriate medical care and understand treatment methods, but also to be educated on control and prevention. A health literate person can then educate family members and others in his/her own community.

It also makes sense that countries with low literacy rates have a high NTD burden. Children who are infected with a soil-transmitted helminth or schistosomiasis have lower school attendance and performance.

According to the United Nations Development Programme Report from 2009, the five countries with the lowest literacy rates are as follows:

1. Mali: 26.2%
2. Niger:  28.7%
3. Burkina Faso:  28.7%
4. Guinea:  29.5%
5. Chad:  31.8%

Africa carries 90% of the global NTD burden. Mali for example has the lowest literacy rate, and it is not surprising that lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiasis and trachoma are all endemic, with 12 million people at risk for contracting one or more of these diseases.

One great way to help educate communities is through access to health campaigns, one of which was recently carried out in India. This specific health campaign was focused around one NTD—lymphatic filariasis—and the campaign itself helped educate those in the community towards a greater understanding about direct ways to treat the disease, such as washing and cleaning procedures and directions on how to take medication. Published results of the campaign indicated that compliance among individuals who were exposed to the educational outreach went from 50% to 90%. It really works.

The health campaign study is just one example, but it’s an important indicator that health literacy programs can empower communities and strengthen existing health systems.

by: Helen Coster

I’m in Washington, D.C. as part of a fellowship with the International Reporting Project. Next Saturday I head to Bolivia, where I’ll be reporting and writing on public health and a number of different topics.

One advantage of spending time in D.C.—in addition to meeting other IRP fellows and running past the White House— is the opportunity to meet with the world-class scientists and policy makers who work here. Yesterday I met with Dr. Peter Hotez, the president of the Sabin Vaccine Institute, a non-profit organization that’s affiliated with George Washington University. The Sabin Institute—named after Dr. Albert Sabin, who developed the polio vaccine— develops vaccines for Neglected Tropical Diseases (NTDs), a group of 13 diseases that affect poor people in the developing world. NTDs include diseases like guinea worm, Chagas disease, kala azar and lymphatic filariasis. Together they impact 1.4 billion people, most of whom live on under $1.25 a day.

Public health experts refer to HIV/AIDS, malaria and tuberculosis as “the big three,” because they impact a disproportionate amount of the world’s population and have powerful backers like the Gates Foundation and groups like ONE and Malaria No More. The NTDs aren’t as well known, and because drug companies lack the commercial incentive to tackle them, scientists like Hotez need to be creative about funding R&D and treatment.

Through the Sabin Institute Hotez cofounded an advocacy program, called the Global Network for Neglected Tropical Diseases, through which he hopes to raise awareness, political will, and funding to control or eliminate the seven most common NTDs. The group’s backers include the Gates Foundation and Legatum, a UAE investment group.

Hotez and his colleague, Karen Palacio, are also developing a “trust fund” for NTDs in Latin America. They’re partnering with the Inter-American Development Bank and the Pan American Health Organization to raise money for health projects that will piggyback on existing development work. If the IDB is working on a water sanitation project in Mexico, for example, the NTD partnership would promote proper hand washing and latrine use as a way of avoiding intestinal worm infection. They’re still looking for donors, so if you’ve got funding to spare, give them a call.

Other organizations like DnDi (which I wrote about here) and the Institute for One World Health do product development for NTD-fighting drugs. Sabin does development for vaccines. Hotez and his team of 35 researchers are currently working on vaccines for hookworm infection and schistosomiasis, a chronic disease caused by parasitic worms.

The Sabin team works in the labs at GWU, where they splice the genes from the parasites and add them to yeast. The genes secrete recombinant protein, which the researchers purify and pass off to two partners in Brazil—FIOCRUZ and Instituto Butantan— which manufacture the vaccines. They also conduct clinical trials in the Minas Gerais state of Brazil, where 68% of people have hookworm and 45% have schistosomiasis. The parties file the drugs with the FDA in the US and the Brazilian equivalent, ANVISA.

Within the next five years, Hotez hopes to prove that the vaccines work. If they’re approved, companies can manufacture them for under $1 a dose. The governments of affected countries would purchase and administer them.

 No one will get rich from the vaccines. But for diseases that occur exclusively in the developing world, the for-profit business model doesn’t work.

1. We announced the beginning of the Global Maternal Health Conference 2010 spearheaded by a partnership between The Maternal Health Task Force (MHTF) and the Public Health Foundation of India
2. We highlighted an upcoming Neglected Diseases Workshop in Boston
3. Alanna Shaikh gave us a lesson on the importance of sound governance structures for successful NTD programs
4. A new editorial in PLoS NTDs called for emerging market economies to join the US, UK, and Japan as partners in neglected tropical disease (NTD) control efforts
5. VOA News featured Dr. Peter Hotez on a segment about the US Global Health Initiative
6. Our Campus Challenge winner and former intern Manuel Claros shared his recent humanitarian missionto Honduras with us

For those of you in the United States, have a great Labor Day weekend!

Experimental vision cure proves successful, Thomas H. Maugh, Los Angeles Times
Global immunizations hit record but miss millions, David Morgan, Reuters
Mystery eye disease spreads across Northern Bahr el Ghazal, Ngor Arol Garang, Sudan Tribune
Lymphatic filariasis in India: Epidemiology and control measures, S Sabesan, P Vanamail, KHK Raju, P Jambulingam, Journal of Postgraduate Medicine

1. The Global Network got an awesome opportunity to showcase a 15 second spot on the CBS Superscreen in New York City! Check out the video and join Alyssa Milano and Text “LIFE” to 30644 to End The Neglect!
2. Our wonderful communications/grassroots intern Linda shared her experience in  Honduras as a student volunteer working on construction projects for impovrished communities.
3. We got a little clinical when discussing Lymphatic Filariasis in our second “Worm of the Week” installment.
4. We got excited about the 30th anniversary of smallpox eradication!
5. Alanna Shaikh talked sandflies and giant sores, with a great article on  leishmaniasis, a horrific neglected tropical disease threatening 350 million men, women and children in 88 countries!
6. The Bill & Melinda Gates Foundation also had some great articles about smallpox this week, so we were excited to reprint them here for your reading pleasure!

By: Dr. Tadataka Tachi Yamada

When I was growing up in Japan, my close friend Keichi Maruyama, who lived right next door to me, was crippled from polio.

Most people today are too young to remember, but it was a disease that struck fear into every family. We knew it could hit home at any time.

Dr. Tadataka Tachi Yamada watches as a boy receives a polio vaccination at Bhairon Mandir Temple. Tachi was there to understand the importance of transit and migratory populations in contributing to polio transmission. New Delhi, India. April 5, 2009. Photo courtesy of the Bill & Melinda Gates Foundation / Prashant Panjiar.

Polio is no longer a threat in most of the world, thanks to a polio vaccine and an enormous global commitment. We are now locked in a mortal battle to completely eradicate the disease and have reduced the fight to just four countries – Nigeria, India, Afghanistan, and Pakistan.

This week I attended a symposium to commemorate the 30th anniversary of smallpox eradication. Thanks to the development and delivery of a vaccine, we achieved one of the greatest global health victories of all time. Vaccines are the most important and cost-effective intervention available to prevent illnesses and death.

I believe the fundamental lessons from smallpox can be applied to many diseases, especially the fight against polio. We need political will, sufficient human and financial resources, and ongoing scientific innovation

Of course there will be challenges along the way. I think the biggest lesson from the smallpox success is that we must approach each new challenge with the spirit of continuous learning and be flexible enough to adjust along the way. We must do the same until the world is polio-free, so that our children’s children will never have to say: “You came this close and gave up.”

Dr. Tachi Yamada, president of the foundation’s Global Health Program, leads the foundation’s efforts to help develop and deliver low-cost, life-saving health tools for the developing world. He oversees Global Health’s grantmaking, which focuses on four major activities: discovery, development, delivery, and advocacy.

It was recently pointed out to me that I’ve never covered leishmaniasis in my posts. I’d hate to make an NTD extra-neglected, so I’ll look at it today. As a quick refresher, you may recall that I named it “giant sores and organ damage disease” in my very first post on this blog. It’s also known as kala-azar.

For a somewhat more formal description of leishmaniasis, we can turn to the World Health Organization (WHO). They’re just issued an information page on the disease. (Which, by the way, is good news. It will help raise the profile of this NTD and all the others as well.) The WHO would like you to know that:

Leishmaniasis is caused by protozoan parasites belonging to the genus Leishmania. The parasites are transmitted by the bite of a tiny – only 2–3 mm long – insect vector, the phlebotomine sandfly.

Photo Credit: CDC

I think they’re kind of burying the lede there. I don’t honestly care about the length of the sandfly that transmits the parasite that causes the huge sores. (Though, on a personal note, sandflies bit the heck out of me last summer and I spent many insomniac hours worrying about leishmaniasis. Working in global health is not always good for the psyche. And I googled; we do have leishmaniasis in Tajikistan, although not in terrible amounts. It’s genetically unique.) They also suggest you watch the trailer of a film on the disease.

If you scroll down the page a little more, here’s the numbers that made an impact on me:

Leishmaniasis threatens about 350 million men, women and children in 88 countries around the world. As many as 12 million people are believed to be currently infected, with about 1–2 million estimated new cases occurring every year.

88 countries (including Tajikistan) is an awful lot of territory. And the WHO page doesn’t get into leishmaniasis control at all. Once you tell me 12 million people have the disease, and 2 million more every year, I want to know how to stop the thing. The WHO does have a leishmaniasis control page, with their chosen five points for fighting the disease (my thoughts in parentheses):

• Facilitation of early diagnosis and prompt treatment (Helps both the people who get treated and keeps them from being a reservoir for the disease.)
• Support for control of sandfly populations through residual insecticide spraying of houses and use of insecticide-impregnated bednets (I wonder if they use the same insecticides used for mosquito spraying? I am going to assume yes, otherwise the bednets situation would be ridiculous.)
• Provision of health education and production of training materials; (What are people being educated on? I guess bednets and spraying and why sandflies are bad.)
• Detection and containment of epidemics in the early stages (Not quite sure how this is different from the first point. I guess it’s based on looking at data at the population level and requires support to government bodies on data collection, as opposed to training individual health care providers.)
• Early diagnosis and effective management of leishmaniasis/HIV co-infections. (That had never even occurred to me – leishmaniasis and HIV. Makes sense though.)

I think the WHO is missing one more tool to fighting leishmaniasis, and all NTDs: poverty reduction. The NTDs are still fundamentally diseases of the poor. Less poverty will mean fewer infections. It’s not exactly the WHO’s field, I admit, but it’s worth pointing out.

Alanna Shaikh is an expert in health consulting, writing about global health for UN Dispatch and about international relief and development at Blood & Milk. She also serves as a frequently contributing blogger to ‘End the Neglect.’ The views and opinions expressed by guest bloggers are not neccesarily the views and opinions of the Global Network.

Ugandan Man Helps Rid His Community of Onchocerciasis, Carter Center
Can Intestinal Parasites Help Crohn’s Disease?, Mary Desaulniers, AutoImmuneDisease
PLoS ONE is launched by the Public Library of Science, Bio-Medicine
Pakistan flood donations top $26m, The Press Association
Struggle for food as Pakistan floods worsen, Sally Sara, ABC News

By: Nathaniel Wolf, Sabin Vaccine Institute

August 20^th is World Mosquito Day.  In 1897, Sir Ronald Ross looked at a mosquito under a microscope and saw that it looked really cool up close.  He declared August 20^th World Mosquito Day and said we should be nice to mosquitoes, if only one day a year. 

Not really.  What Dr. Ross discovered was the link between mosquitoes and transmission of malaria.  He declared World Mosquito Day so that people would become educated about the life cycle of malaria, and in 1902 he won the Nobel Prize in Medicine for it.   In spite of this discovery, today the disease continues to be a threat to approximately 2.85 billion people, afflicting 250 million people around the world and causing an estimated 1 million deaths annually.   

Dr. Ross’ discovery was made possible by another discovery some 20 years prior.  In China, Sir Patrick Manson discovered that the mosquito is a vector for lymphatic filiariasis (LF), a debilitating parasitic disease that currently afflicts about 120 million people around the world.   LF causes a range of symptoms including elephantiasis, hydrocele and extreme swelling of the scrotum.  The economic and social effects of this disease are enormous.  If you’ve ever read James Michener’s Tales of the South Pacific, wherein he talks about a man who, in order to walk, had to push before him a “rude wheelbarrow” in which “rested his scrotum, a monstrous growth that. . .weighed more than 70 pounds and tied him a prisoner to his barrow,” you probably thought Michener was taking poetic license.  He wasn’t.

The 2.85 billion at risk for malaria are also those most at risk from neglected tropical diseases.   As Alanna Shaikh pointed out in her entry on this blog yesterday, malaria “shares territory, climate, and even modes of transmission with NTDs.”  The clinical outcome of childhood malaria and malaria in pregnant women is dramatically higher when combined with one or more NTD, and there is evidence that even susceptibility to malaria is increased by NTDs.

Furthermore, according to an article published in 2008 in PLoS Neglected Tropical Diseases by Drs. Peter Hotez and David Molyneux, the anemia caused by malaria is increased dramatically when combined with an NTD such as hookworm disease, of which there are almost 200 million cases in Africa alone.  More than anything else, this anemia is what makes malaria and NTDs “diseases of poverty”—adults can’t work when they are very sick, and children can’t learn. 

There is good news out there.  In addition to the positive things mentioned by Ms. Shaikh, UK’s Department of International Development (DFID) states that 11 African countries are “approaching elimination” and Rwanda and Ethopia have seen a 50% decrease in malaria cases.  

The Malaria Vaccine Initiative, a program of PATH, is conducting late-stage clinical trials on a vaccine against malaria.  Also, Sabin Vaccine Institute’s Vaccine Development Program, in partnership with Malaria Vaccine Initiative and Johns Hopkins University’s Bloomberg School of Public Health, is working on the development of a very exciting “transmission-blocking” vaccine (yes, I said “exciting,” “vaccine,” and “development” all in the same sentence).  In other words, if a mosquito “bites” a person who has been inoculated with this vaccine, it may render that mosquito unable to infect any other person with the disease.    So maybe some year in the future on August 20^th we can all roll up our sleeves and stick out our arms and be nice to mosquitoes, if just for one day.

 Nathaniel Wolf is an Information Officer for the Sabin Vaccine Institute. He is a fan of the Washington Nationals and is currently working on his first screenplay.