In 2005, an alarming 39 percent of children were stunted in Maharashtra state, the second largest state in India with a population of over 100 million people. By 2012, a survey revealed that this number dropped to 24 percent among children under the age of two. A recent report published by the Institute of Development Studies (IDS) examines why this unprecedented reduction in stunting occurred.
Stunting is a condition that causes irreversible damage and occurs when a child does not receive the right kind of food and nutrients. Stunted children often have weaker immune systems leaving them more susceptible to infections and making them five times more likely to die from diarrhea. Infections caused by neglected tropical diseases (NTDs) are closely linked to malnutrition. Intestinal worms, for example, are among the underlying causes of stunting, anemia, loss of key nutrients like Vitamin A and iron, and overall poor nutritional status. Not only does India have more children suffering from NTDs than any other country in the world, they are home to the highest number of stunted children under the age of five.
Historically, Maharashtra state’s high levels of income inequality have contributed to malnutrition and stunting in children. Even though Maharashtra is one of the wealthiest states in India, children who are stunted are not benefiting from this growth. Stunting impairs a child’s growth and perpetuates poor health and nutrition, preventing them from growing into their full physical and economic potential. Children who are unhealthy and lack access to proper diets, safe water, healthcare and sanitation facilities are trapped in a perpetual cycle of disease and poverty.
According to the authors, a number of key factors, working in tandem, contributed to Maharashtra state’s reduction in stunting. The launch of the state’s Nutrition Mission and the National Rural Health Mission created strong political will to improve nutritional status of young children. Because NTDs can contribute to malnutrition, Maharashtra state’s Nutrition Mission Action Plan ensured that deworming tablets were distributed to children at risk for intestinal worm infections. And promisingly, the number of children receiving deworming treatments more than doubled, increasing from 8 percent to 19 percent. Maharashtra’s efforts towards addressing NTDs is a positive step in the right direction to lower the occurrence of stunted children and subsequent malnutrition among young children.
IDS also noted that other important factors in the reduction of stunting include: a favorable political, social and economic environment; strong economic growth; robust poverty reduction performance; and improvements in women’s empowerment and health. In the same manner, addressing NTDs requires a multi-pronged approach. In addition to deworming, creating an enabling environment for children will amplify the possibilities for the future, particularly by simultaneously improving access to clean water, sanitation and hygiene and delivering key nutrition interventions like Vitamin A alongside deworming treatments.
While the rapid decline in stunting in Maharashtra state was unique, we congratulate them on embracing a comprehensive approach to tackling this issue and remain hopeful that other states endemic for NTDs and malnutrition will feel encouraged to follow their lead.
END7 donations go a long way, especially since 100 percent of donations made go directly to NTD treatment programs in Asia, Africa and Latin America and the Caribbean, the regions with the largest NTD burdens.
This money helps train the community health workers that deliver the NTD medicine to communities, fund educational materials that teach kids how to prevent NTDs, support the delivery of NTD medicine to remote areas, provide clean water to communities and strengthen these country’s abilities to help their own people who suffer daily from NTDs.
These parasitic and bacterial diseases infect 1.4 billion people worldwide, causing unnecessary suffering and trapping families in poverty.
Dedicated partners, including ministries of health and education, governments, regional institutions like the END7 campaign – work hard to support countries around the world that are plagued by NTDs. seventy-four countries in Africa, Asia and Latin America have already developed plans to control and eliminate NTDs. But often these countries lack the money or resources necessary to carry out their plans year after year.
Together, we’re making real progress. Because of the dedicated support of people like you, girls like Pwint Yamone-Thin are healthy, active and free of NTDs; Kids like Neema and Fatuma Kahindi have a brighter future.
See the projects END7 donations supported and the impact they’re are making on the lives of those who needlessly suffer from NTDs.
While we’ve done so much together, we must continue to support those suffering from NTDs. By donating to END7 today, you’ll ensure that more children around the world live happy and healthy lives. Your support means that governments around the world can continue to provide NTD treatment to their most vulnerable populations – and end NTDs once and for all. Donate now.
For one month, countries around the world are gathering to watch arguably the greatest sporting event in the world—the World Cup. Every four years, people from around the world come together to celebrate this epic event that transcends political turmoil, and even wars and conflict. In this time of celebration, we’re taking the time to recognize the World Cup teams advancing to the prestigious Round of 16! In particular, we’re highlighting the progress their countries have made in controlling and eliminating neglected tropical diseases (NTDs).
The hosting nation of Brazil is being tagged as the favorite to win it all. If they do, the Brazilian National Soccer team would have a mind-blowing six World Cup trophies! While Brazil is famous for its passion and love for soccer, Brazil is also gaining public health recognition by taking concrete steps towards eliminating NTDs in their country. In Brazil, nearly 6.8 million people are infected with schistosomiasis and millions are at risk for other common NTDs. To address this problem, Brazil has launched an integrated National Plan of Action for NTDs to combat all seven of the most common NTDs. Last year, the Brazilian Ministry of Health led a campaign to diagnose and treat leprosy and intestinal worms in 9.2 million public schools.
With Argentina having arguably the best player in the world, Lionel Messi, the country’s hopes of winning the World Cup are high. Over the last four years, Argentina made tremendous progress towards preventing NTDs such as Chagas disease and intestinal parasites in at risk populations. In 2011, the Government of Argentina launched the National Institute for Tropical Medicine in an effort to advance NTD research and finding new solutions for lowering the prevalence of NTDs in at risk regions in Argentina.
The Colombian National Soccer team had been M.I.A. (missing in action) in World Cup action for the past 15 years. This year, Los Cafeteros has ended its long hiatus and is finally back on the World Cup stage. While the national team was working hard towards getting to this year’s World Cup, their country was busy accomplishing major NTD elimination goals. In 2011, Colombia became the first country in the Latin America region to eliminate onchocerciasis—a great milestone for Latin America and the Caribbean.
Nigeria’s Supereagles has always had high expectations when entering the World Cup—and rightfully so. The Nigerian National Soccer Team is one of the very few African teams that has ever reached the second round of the knockout stage (Ghana, Senegal, Cameroon, Morocco are the only other teams). Nigeria is known for meeting expectations when it comes to controlling NTDs. This year, Nigeria achieved a major milestone in its fight against NTDs by launching Africa’s first integrated malaria and lymphatic filariasis (LF) elimination plan. Nigeria’s Ministry of Health has also reached 96 percent of communities with onchocerciasis mass drug administrations and is currently scaling up school-based deworming campaigns.
Mexico’s prized forward—Javier “Chicharito” Hernandez from Manchester United—hopes to transform the Mexican National Soccer Team into a serious contender in this year’s World Cup. Mexico has also taken serious strides in preventing NTDs by nearly eliminating onchocerciaisis and trachoma in their country. In 2011, Mexico launched a campaign to treat the last trachoma endemic state—Chiapas. Soon, Mexico hopes to become one of four countries in the region to eliminate trachoma.
In 1990, Costa Rica shocked the world by advancing into the knockout stage. This year, Costa Rica has surprised the world again by advancing into the Round of 16! Costa Rica has already put the global health world on notice by working to receive a certification by the World Health Organization (WHO) stating that they’ve successfully stopped transmission of lymphatic filariasis (LF).
On behalf of END7, we’d like to thank these countries on their continued effort towards eliminating NTDs and wish them the best of luck in this year’s World Cup!
By Romina Rodríguez Pose, independent consultant on international development and lead author for the Health Dimension case studies, Development Progress Project.
Neglected tropical diseases (NTDs) affect the poorest billion people in the world. They cause number of chronic health conditions that largely limit people’s ability to study and work and consequently have a healthy and productive life. The stigma attached to them can also lead to isolation and fear for those who suffer.
Although they have been long ignored within international and national agendas, in the last decades, there has been an increasing awareness of how NTDs can impede endemic countries from achieving public-private partnerships involving major drug donations from key pharmaceutical companies, the development of inexpensive control strategies and a growing number of donors earmarking funding for integrated NTD control.
Cambodia in Asia. In spite of their different contexts and epidemiological profiles, three drivers have emerged in both case studies:
1. Advances in the fight against NTDs have been driven by the availability of earmarked funds and donated drugs. These have been crucial for both resource-constrained countries, since most endemic countries are faced with several competing, and perhaps more urgent, health issues (such as high mortality rates for mothers and children in Sierra Leone and dengue outbreaks in Cambodia). As a counterpart, political will and local engagement to take advantage of global initiatives have been crucial in bringing NTDs within the national agenda. Both governments, through their Ministries of Health, have proactively looked for partners, secured funds and drugs donations and made important efforts to develop local capacity.
2. There is an important transitional role for development partners in providing access to strategies and guidelines on how to deal with NTDs until local capacity is fully developed. In both countries, this was achieved through bilateral, regional and global partnerships that helped build the local knowledge base for endemic countries to find their own solutions and to implement strategies according to the particular context. These dynamics between development partners and NTD programme managers have gradually led to a ‘transfer of ownership’ of the NTD programmes.
3. The integration of NTD activities within an existing government structure has been vital to set up cost-effective NTD programmes. Both countries have integrated the distribution of drugs within health and education systems. In Cambodia, given the main threat is from intestinal worms which particularly affect school-aged children, progress has been achieved by integrating the distribution of drugs into the school system and turning teachers into twice-yearly doctors/pharmacists. In Sierra Leone, given that the entire population is at risk from at least three NTDs, the main strategy involved the engagement and training of community members as drug distributors. Elected by their communities, their work is divided into catchment areas for which they are responsible, reaching the most remote corners of the country.
Despite the increasing awareness of their importance, NTDs still loom large in the cycles of poverty, ill-health and under-development that afflict too many developing countries. Yes, as Sierra Leone and Cambodia show, progress can be achieved in the most difficult contexts and with minimal resources, stressing the importance of including NTD control and elimination targets within the post-2015 sustainable development goals.
All photos by Romina Rodríguez Pose.