This spring, we awarded nearly $400,000 in new grants for neglected tropical disease (NTD) control and elimination activities in 2016.
This funding is made possible by generous donations to END7, an international advocacy campaign that seeks to raise the awareness and funding necessary to control and eliminate the seven most common NTDs. The campaign is managed by the Global Network for Neglected Tropical Diseases and 100% of donations to the END7 campaign go straight to NTD programs. Donations to Sabin Foundation Europe, a partner of the U.S.-based Sabin Vaccine Institute and the Global Network also helped make these grants possible.
The grants will make a significant impact in supporting integrated NTD programs in six countries. All projects are coordinated with Ministries of Health and/or the World Health Organization in each country. Many of the projects include mass drug administration (MDA) for the most common NTDs and training of health care workers. These projects are expected to benefit nearly six million individuals at risk from NTDs and train tens of thousands of health workers and volunteers to lead the NTD control and elimination effort into the future.
Awarded to existing efforts that faced a funding gap, these projects will have a lasting impact on improving and expanding existing programs to reach ambitious NTD control and elimination goals in Africa, Asia and Latin America – the regions with the largest NTD burden:
$50,000 to support integrated MDA for seven NTDs, administered by Sightsavers with the support of the Federal and Kebbi State Ministries of Health. Nearly 5.9 million people will receive donated medicine in Kebbi state, in northwest Nigeria, where all seven NTDs are widespread. Sightsavers will continue their successful MDA in the region and expand to new areas.
$66,200 to support the first integrated MDA in five regions of southwestern Somalia by the new NTD Program of the Ministry of Health and Human Services. The MDA will target schistosomiasis (snail fever), ascariasis (roundworm), hookworm and trichuriasis (whipworm) among school-age children and adults in areas of high prevalence. The NTD Programme was established in 2015; success this year will help scale up the delivery of donated medicine to the rest of the country.
$28,789 to support water, sanitation and hygiene education to prevent NTDs in Cote d’Ivoire, administered by Helen Keller International. More than 7,000 health workers, school teachers and community health volunteers will be trained to reach more than 2.5 million people.
$111,146 to support MDA to eliminate lymphatic filariasis in the most populous region of the country, administered by the Pan American Health Organization and the Ministry of Public Health. Guyana is on track to eliminate lymphatic filariasis (also known as elephantiasis) by 2020. These funds were raised for END7 by the Sabin City Group in London.
$60,546 to assist a local NGO, Churches Auxiliary for Social Action (CASA), to expand their successful efforts to treat and prevent lymphatic filariasis to West Bengal. This grant will enable CASA to train community members to manage the swelling and disability that often results from later stages of lymphatic filariasis. Each infected patient will receive a hygiene kit with soap, a towel and antifungal ointment and be shown how to care for themselves to reduce swelling. CASA will also promote the government’s annual MDA targeting 500,000 people for lymphatic filariasis treatment in West Bengal.
$75,645 to assist the Department of Public Health to determine where MDA for lymphatic filariasis has succeeded and can be concluded. Nine districts with a population of nearly 7 million have already conducted more than five rounds of MDA for lymphatic filariasis. Officials will determine whether transmission has been interrupted.
The Global Network team reviewed 37 proposals from a range of partners tackling NTDs around the world and selected projects with the potential to have the most lasting impact, leverage further investment and bolster country-led efforts to eliminate NTDs.
To date the Global Network has awarded more than US$1 million in grants to 19 partners. From individual donors contributing $5 a month to student groups raising $10,000 over the course of a school year, the END7 campaign has mobilized a diverse and growing community of supporters from countries around the world dedicated to supporting the fight against NTDs. Together, these contributions are moving the NTD elimination effort forward by helping communities set up treatment programs they can run themselves. END7 supporters fill funding gaps in successful NTD treatment programs, highlighting the tremendous impact of this inexpensive treatment and the power of partnership in the fight against NTDs.
According to the World Health Organization (WHO), an estimated 873 million children are at risk of soil-transmitted helminths (STH), including roundworm, hookworm and whipworm. In children, STH infections can lead to malnutrition, anemia and stunting. In both adults and children, they can cause fatigue, intense abdominal pain and chronic diarrhea. In severe cases they can even cause bowel obstruction, rectal prolapse and appendicitis.
To improve health and development in infected communities and reduce the prevalence of neglected tropical diseases (NTDs), WHO aims to control STH and schistosomiasis by 2020. Meeting this goal requires regularly deworming at minimum 75 percent of the preschool-age and school-age children who are at risk of STH or schistosomiasis. To ensure such an ambitious global goal is met, it is paramount that ministries of health, WHO and non-governmental organizations (NGOs) coordinate and share data.
WHO operates the Preventive Chemotherapy and Transmission Control (PCT) Databank, which tracks the number of children given PCT for STH, schistosomiasis and three other NTDs. The databank is populated largely by information reported by ministries of health and helps policymakers and implementers understand where deworming programs are active and where more interventions are needed to meet the WHO target of controlling STH and schistosomiasis by 2020.
However, gaps in the PCT Databank have become apparent. The 2013 STH preschool treatment data was recently revised when supplementary data was submitted by UNICEF. This data caused a 104 percent increase in the recorded number of preschool-age children treated for STH. Clearly, better coordination is needed to ensure the global community meets 2020 goals.
To facilitate better coordination among WHO, ministries of health and NGOs, the Global NGO Deworming Inventory collects data from NGOs administering deworming treatments for STH and schistosomiasis. The data are compiled into a single database with disease-specific information by Children Without Worms (CWW).
After the data are compiled, WHO will merge the CWW database with national program data provided by ministries of health to the PCT Databank. This effort will make deworming dollars go even further by strengthening program monitoring and leading to an efficient use of resources. Ultimately, it will be an important step in controlling STH and schistosomiasis.
You can learn more about the Global NGO Deworming Inventory — and implementers can submit their data — at http://www.deworminginventory.org.
Efforts to fight Neglected Tropical Diseases (NTDs) are truly massive undertakings, since their success hinges upon the ability of national NTD programs to literally reach millions of people and provide each and every person with preventive medications.
Sierra Leone is one of many countries that has risen to this challenge. With a population exceeding 6 million people, the country’s NTD program relies on approximately 30,000 Community Drug Distributors (CDDs) to distribute NTD medications throughout its 12 rural districts.
And if recruiting, organizing and managing that many CDDs weren’t enough of a challenge, there’s one other detail that’s worth noting. Although these 30,000 CDDs must spend days, if not weeks, ensuring that their communities receive drugs that will prevent blindness, kidney and liver disease, malnutrition, and physical deformities, none receive any payment for their services.
In an effort to motivate and reward the CDDs for their important work and to reduce attrition, Helen Keller International (HKI) and the National NTD Program have partnered with TOMS, a US-based, philanthropically minded company that has given away over 45 million pairs of shoes to children in over 70 countries. To date, Sierra Leone has received two shipments of TOMS Shoes—over 300,000 pairs –between 2013-2014 to distribute to the CDDS and their children.
In 2013, each CDD received three pairs of shoes for his or her family; this was increased to five pairs in 2014. Shoes were also distributed to others whose support has been instrumental to the success of the country’s NTD mass drug administration (MDA), such as community leaders, peripheral health unit (PHU) staff, and members of the district health management team.
From a logistical standpoint, ensuring that CDDs receive these shoes is almost as complex an undertaking as conducting the MDAs themselves for Helen Keller International (HKI), the sub-grantee organization that supports Sierra Leone’s NTD Program in partnership with END in Africa’s administrator, FHI360. First, HKI helps the National NTD Program determine the total number of participating CDDs and estimate the total number of shoes needed, as well as the number of pairs per size. An order is then placed with TOMS Shoes.
Once the shoes arrive at the Freetown port several months later, they must be trucked to six distribution points throughout the country. Shoes are then divided up by district; and the districts assume the responsibility for ensuring that their PHUs receive enough shoes for all the CDDs in their areas. Finally, the CDDs receive shoes for themselves and their children.
The children are ecstatic about getting a new pair of TOMS Shoes. Eight-year-old Fatmata remembers the day she received her pair of TOMS Shoes: “My old shoes are worn out and I was thinking if my parents can afford to buy me another pair of shoes before the opening of school.” Her grandfather appreciated their value as well, noting that they’ll not only motivate Fatmata to go to school, but they’ll also help reduce her risk of hookworm infection from walking barefoot.
Despite the challenges, the National NTD Program and HKI officials agree that getting shoes to each of the CDDs is well worth the considerable effort it takes to administer the initiative. After all, the National NTD Program would not be able to conduct MDAs without the CDDs; indeed, their success hinges on the work of the CDDs. Without their commitment and hard work, millions of persons would still be suffering from preventable and treatable diseases.
HKI and Sierra Leone’s NTD Program look forward to continuing to partner with TOMS, and plan to distribute additional TOMS shoes in 2015.
This blog was originally published by End Neglected Tropical Diseases in Africa.
Photo: Wearing her new TOMS shoes, Fatmata gets a hug from her father, a volunteer who distributes medicines to prevent NTDs in Sierra Leone. Credit Helen Keller International