Category Archives: END7

Taking the “neglect” out of “neglected tropical diseases”

NTD-Competitions-BlogImage-1Today we’ve posted an essay by Rice University rising junior Anjali Bhatla, one of five winners of a student competition on raising awareness of neglected tropical diseases (NTDs), a group of parasitic, viral and bacterial infections that afflict mainly those living in extreme poverty.

The writing contest and related outreach competition are associated with a Sept. 29-30 Baker Institute conference on NTDs in the U.S. and Mexico. One winning essay will be featured here each week leading up the conference.

The public is invited to attend the Baker Institute NTD conference, but an RSVP is required. Please click here for more information and to register for the event.

Most people have never heard of diseases such as Chagas, elephantiasis, or ascariasis. However, these illnesses are some of the 17 infectious diseases the World Health Organization has categorized as “neglected tropical diseases” (NTDs). NTDs are said to affect the “bottom billion” of the world’s population, or those who are living on less than $1.25 per day. NTDs, which have a high morbidity, have been shown to perpetuate the cycle of poverty due to their ability to impair physical and cognitive development, negatively affect maternal and child health, and socially stigmatize those who are afflicted. Regardless of the disabling economic consequences of NTDs, they have been largely ignored, continuing to persist in the world’s most marginalized populations. Contrary to popular belief, NTDs do not just exist in developing countries, but rather have been shown to also exist in pockets of poverty in developed countries. Given the neglected nature of NTDs, there is plenty that we as students can do to make a difference in the lives of those living with NTDs. Ending the neglect requires three steps: 1) education, 2) awareness, and 3) advocacy.

Education is a key component in impacting the field of NTDs. Through educating ourselves, we can articulate the importance of NTDs to others. This requires understanding what aspects of NTDs contribute to the neglect they continually face. First, they have a high morbidity, rather than high mortality, rendering them “less important” than diseases such as HIV and tuberculosis. However, morbidity can have just as disastrous consequences as mortality, and NTDs render those infected chronically disabled. Second, NTDs predominately affect those living in impoverished countries, which makes it difficult to communicate the ramifications of the diseases to individuals with the social and political capital to aid endemic countries. Third, the demographics of infected individuals make it unprofitable for pharmaceutical companies to pursue therapies for NTDs. These factors are the reasons why it is of utmost importance for us as students to educate ourselves about NTDs and communicate the value of preventing these diseases to others.

Engaging the public is imperative if we are to mobilize a movement to end NTDs. This requires using our knowledge to disseminate information on the social and economic consequences of NTDs and the need for the public to address these issues through fund-raising and advocacy. A great way for students to increase awareness of NTDs on campus is to start an END7 chapter at their college. END7 aims to increase awareness of the seven most common NTDs and raise funds for mass drug administration, which can greatly reduce the incidence of NTDs in endemic countries. Through a student organization such as END7, undergraduates can exchange ideas on how to address the health disparities prevalent in endemic countries, engage in dialogue with peers on the importance of addressing NTDs, and implement creative events, programming, and social media campaigns to increase understanding of NTDs at a societal level.

The team that will be spearheading END7 at Rice University, of which I am a member, has discussed a number of creative projects, including depicting stories of patients with NTDs, creating an “NTD week” to educate students on the scientific and social aspects of a different disease each day, and sponsoring a 5K with seven water stops, each featuring information on an individual NTD. Utilizing social media can be a way of reaching a much wider audience, and college students are in a unique position to capitalize on the use of technology. A social media campaign in which a person takes a picture of themselves taking action against NTDs and uses the hashtag #nomoreneglect could be a potential way of incorporating a much larger audience into the conversation. Ultimately we want to increase awareness in order to spur action in others, and I believe a great way of doing this would be to create a service-learning grant program in which students could apply for money to implement a project that addresses NTDs in a creative way. These grants could fund projects such as a student policy competition on NTDs or the creation of curriculum to educate K-12 students on NTDs. By funding student projects around the country and world, each person can have a leadership role in taking action against NTDs.

Ultimately, I believe policy structures need to be utilized in order to address the health disparities that cause NTDs. Low socioeconomic status, inadequate health systems, and the need for proper infrastructure for clean water and sanitation are root causes of NTDs. We need to frame NTDs as a social justice issue in health: a realization that elements of society disproportionately contribute to this public health issue and policy should be drafted to aid those in need. Students can have a profound impact on policy by speaking with their local and national representatives about important issues and advocating for certain pieces of legislation. For example, most of the funding for fighting NTDs comes from developed countries, and policymakers are proposing a cut in funding in the current US budget. By calling representatives, writing letters, and signing petitions, it is possible to convince Congress of the importance of retaining funding for NTDs. As students, our voice is incredibly important, and we have a social responsibility to engage in the political process and advocate for NTDs at the governmental level.

More than one billion of the world’s population is suffering from NTDs, a staggering amount of people to be affected by a group of infections few have heard of. We cannot continue to let this injustice occur, and as the next generation we need to be civically minded students. Addressing the issue of NTDs is critical to improving the health and economic productivity of over one-seventh of the world’s population. Through education, awareness, and advocacy of NTDs, we can drive significant social change and work toward taking the neglect out of neglected tropical diseases.

Anjali Bhatla is a rising junior at Rice University majoring in health sciences and policy studies. Bhatla founded the Rice University chapter of the END7 campaign, which aims to raise awareness and funds for the seven most common neglected tropical diseases (NTDs). She plans to pursue an M.D./MBA dual degree and ultimately develop and implement policies that help make health care systems more equitable and efficient.

This essay originally appeared on the Baker Institute Blog.

Measuring the District Health Sister of Kenema, Sierra Leone to determine the appropriate dosage of NTD medicine for her. Photo: FHI360

Down But Not Out: Sierra Leone’s NTD Program Restarts Activities as the Ebola Threat Subsides

It all started a year and a half ago in Guinea, West Africa, when in December 2013, the country reported several cases of the Ebola Virus Disease (EVD). By March 2014, the outbreak had spread to neighboring Liberia. In May, it reached also Sierra Leone, dealing a huge blow the country’s public health system, including its Neglected Tropical Diseases (NTD) program.

Sierra Leone is a poor West African country with poor health indicators. A decade earlier, a twelve-year civil war (1991-2002) had devastated the economy and almost brought the entire health care system to a standstill. Nevertheless, the country made progress in revamping its socio-economic situation after the war, and the outlook appeared optimistic. In the health arena, FHI 360 was in the forefront of assisting Sierra Leone in rebuilding its public health system. Through the USAID-funded END in Africa project, FHI 360 has supported a successful integrated NTD program since 2010 in Sierra Leone that targets 7 NTDs: lymphatic filariasis (LF), schistosomiasis (SCH), trachoma, onchocerciasis (oncho) and three soil-transmitted helminthes (STH).

Shortly after the EVD outbreak began in Sierra Leone, all public health program activities were suspended in the country, including those involving NTDs. Consequently, the NTD Program (NTDP) was unable to provide any mass NTD treatments in Sierra Leone in 2014, as the EVD outbreak had spread to all 14 districts in the country, bringing the country to a virtual stand-still.

Almost an entire year passed before the NTDP was able to resume mass NTD treatments. Even now, three of the country’s 14 districts (the Western Urban, Kambia and Port Loko districts) are still working toward containing the outbreak.[1] However, mass drug administration (MDA) for LF, Oncho, STH and SCH (baseline studies have shown that trachoma is not endemic in Sierra Leone) was successfully resumed in May 2015, on the heels of a recent nationwide malaria MDA and vaccination campaign.

Preparing for Sierra Leone’s 2015 NTD MDA

After a year-long interruption in mass treatment, Sierra Leone’s national NTDP and Helen Keller International (HKI), END in Africa’s sub-grantee in Sierra Leone, carefully planned and carried out many preparatory activities prior to embarking on the country’s 2015 NTD MDA campaign. These included conducting:

  • An NTD stakeholders meeting to plan the resumption of NTD activities in Sierra Leone (February 2015).
  • A national refresher training session for trainers in the Bo district (March 7, 2015).
  • A refresher training for peripheral health unit (PHU) district personnel (March 24 – April 4, 2015).
  • Social mobilization through radio discussions and community meetings in every community targeted for treatment in 12 provincial districts (April 2015).
  • Special advocacy and social mobilization meetings in the 3 districts that failed the last pre-transmission assessment surveys (pre-TAS) for LF conducted in 2013 (Koinadugu, Bombali and Kailahun districts). These meetings targeted paramount, section and village chiefs, people in the community, health workers and community volunteers such as community directed distributors (CDDs).
  • Advocacy and social mobilization meetings led by the district health management teams (DHMTs) under the supervision of the NTDP and partner organizations in all 12 provincial districts (May 2015).
  • Training for the CDDs, led by PHU staff supervised by DHMTs, the NTDP and partner organizations (May 2015).

 

Leading by Example to Regain Trust

As the MDA was getting underway in late May 2015, END in Africa Technical Advisor (TA) Dr. Joseph Koroma visited the community of Komende Luyama in the Kenema district, which was conducting MDA for LF, oncho and STH.

“The MDA in Komende Luyama was just getting started on the day of my visit,” Dr. Koroma said. “Only after Chief Musa Lahai, the village chief, and the village’s two community nurses took the NTD treatment, would the people in the community consent to taking the treatment themselves.” He added that three members of the district health team who had accompanied him to the village, also took the NTD treatment in front of community members to further convince people to take the treatment.

“END in Africa will continue to support HKI and the national NTDP in the process of reestablishing NTD program activities in Sierra Leone, so that the effect of the EVD on NTD control and elimination efforts will be minimal,” he said. While there’s a clear need for special social mobilization in order to convince community members to take the NTD treatment, given the country’s terrible experience with EVD, early indications are that Sierra Leone’s 2015 MDA will ultimately be considered a success.

[1]Sierra Leone cannot be declared EVD-free until every health district in the country has no new cases for at least 42 consecutive days. According to the MOH EVD situation report of June 17, 2015, 11 of Sierra Leone’s 14 health districts have not reported any new EVD cases in the past 42 days or longer. They include: Pujehun and Kailahun, with no new cases for over 6 months; Bonthe and Bo, with no new cases for over 5 months; Kenema, Kono, Tonkolili and Moyamba, with no new cases for over 3 months; and Bombali, Koinadugu and Western Rural, with no new cases in 81, 60 and 55 days, respectively. Three districts still intermittently report new EVD cases (1-3 per day): Western Urban district has gone 18 days without a new case, but Kambia and Port Loko each had 1 new confirmed case during reporting period.

Photo: Measuring the District Health Sister of Kenema, Sierra Leone to determine the appropriate dosage of NTD medicine for her. Credit: FHI360

This blog was originally published on the End Neglected Tropical Diseases in Africa blog.

Introducing Lauren Crossman, March’s END7 Student of the Month

 

LaurenEND7Each month, END7 honors one student who has made a significant contribution to our growing movement of student advocates dedicated to seeing the end of neglected tropical diseases (NTDs). We are very proud to introduce our March 2015 Student of the Month, Lauren Crossman, the END7 Student Advisory Board representative for the University of Cincinnati. Lauren, a third year pre-med student studying Biology at UC, shares:

“A month prior to learning about the END7 campaign last summer, I was on a study abroad trip in Accra, Ghana learning about the prevalence of HIV, malaria, and tuberculosis, as well as the nation’s public health policies and infrastructures. Upon returning from Ghana, a few classmates from the trip and I decided to attend the 5th Annual Consortium of Universities for Global Health conference in Washington, D.C. There, we met Emily Conron, END7’s Student Outreach Coordinator, and we were highly impressed by the campaign’s advocacy efforts and network of passionate students. As a student with a desire to become more involved in global health in a sustainable way, I was more than excited to become a part of the END7 campaign. UC students Malini Ramudit, Paige Craig, Madeline Kincaid, Angelica Hardee and I are thrilled to have started END7 as an official student organization at the University of Cincinnati with the goal of educating the UC community about NTDs through the promotion of advocacy actions to ensure that NTDs remain a political priority, and fundraising to finance the mass distribution of drugs to treat and prevent NTDs.

“This semester, we have given presentations on NTDs and the END7 campaign to several classes and have collected more than one hundred signatures on END7’s petition to protect funding for the USAID NTD Program in the 2016 federal budget. At our meeting this week, we are excited to have a scientist from the Environmental Protection agency (EPA) come in to discuss his experience with water infrastructure in the Caribbean and his current research at the EPA. On World Health Day, we will be co-hosting a global health panel with other student organizations to discuss health inequity and student involvement in global health. I am enthusiastic to continue working with my peers to secure an increase in federal NTD funding and a decrease in NTD prevalence worldwide!”

We are so grateful for Lauren’s continued commitment to END7 and are excited to see our community of student supporters like her grow. If you are ready to get your school involved in END7’s work, contact the END7’s student outreach coordinator at Emily.Conron@sabin.org to learn how you can get started!