by Peter J. Hotez and Neeraj Mistry
The German Bundestag has an opportunity to make unprecedented commitments toward the treatment and prevention of the world’s most common poverty-related diseases — a group of debilitating infections known as the neglected tropical diseases (NTDs). They include ancient scourges linked to poverty such as elephantiasis, river blindness, blinding trachoma, schistosomiasis, roundworm, whipworm and hookworm. Today, these NTDs are among the most common afflictions of the poor, and almost every person living in abject poverty suffers from at least one NTD. New research has shown that these NTDs, because of their long-standing effects on the mental and physical health of children and adults but especially girls and women, now rank among the most important reasons why people cannot escape poverty in the “global south,” including Africa and the Middle East, Asia and Latin America.
For more than 150 years, German science has provided leadership in tropical medicine that makes it possible today to discuss the eventual global elimination of the NTDs. Theodor Bilharz discovered the cause of schistosomiasis (also known as bilharziasis) while working in Egypt in the 1850s; Otto Henry Wucherer conducted studies in Brazil in the 1860s that helped discover Wuchereria bancrofti
Then, in 2005, the Deutsche Gesellschaft für Technische Zusammenarbeit (GTZ) and the World Health Organization organized a landmark conference in Berlin to integrate the control and elimination of the most common NTDs by combining mass treatments for these diseases in a simple “rapid impact package” of medicines. Today those low-cost (less than one Euro per person annually) packages have reached at least 450 million people. As a result, we are now seeing major reductions in the global prevalence of elephantiasis, river blindness and blinding trachoma. Thus, a decade following that historic Berlin meeting, we have the opportunity to eliminate at least these three NTDs.
The Berlin conference also promoted the importance of research and development so that today new interventions are underway including a human hookworm vaccine now in clinical trials in Gabon through a European HOOKVAC Consortium that includes both the Sabin Vaccine Institute’s product development partnership and the Institut für Tropenmedizin, Universitätsklinikum Tübingen. In the 19th century, both Bilharz and Wucherer trained in Tübingen.
The German Bundestag now has a significant opportunity to build on these successes. New legislation to support non-profit product development partnerships to produce new drugs, diagnostics, and vaccines could create a new generation of ground breaking technologies for the world’s poverty related diseases. In parallel, Germany can join the governments of the United States and United Kingdom in supporting the delivery of low-cost rapid impact packages, now recognized as one of the most cost effective global health interventions known.
Earlier this year, Chancellor Angela Merkel also delivered a historic address to the World Health Assembly about the important role the Group of 7 (G7) nations could have in eliminating NTDs. Her call to the G7 to take on NTDs can now be backed with time-sensitive action. The German Bundestag should reassert its historic commitment to these diseases, in the research and development space and for mass treatment. In so doing, Germany can lead efforts to finish the job it began more than a century ago.
Peter Hotez, M.D., Ph.D., is president of the
Neeraj Mistry, M.D., M.P.H., is managing director of the
In September, the Global Network for Neglected Tropical Diseases (Global Network) and the Sabin Vaccine Institute traveled to Berlin to meet with Members of Parliament, German NGO partners and the media to inspire action on the promises to combat neglected tropical diseases (NTDs), made during the G7 Summit held in Germany this summer.
The Global Network, which is committed to seeing the end of NTDs — a group of 17 diverse diseases with distinct characteristics that thrive mainly among the poorest and most marginalized populations — works with partners around the world toward achieving this mission. The momentum to combat these debilitating and disfiguring diseases continues to grow and, during the G7 Summit at Schloss Elmau in June, Germany elevated the profile of NTDs by making “neglected and poverty-related diseases” a key topic for discussion.
The city of Berlin has a unique historical connection to NTDs; it was in Berlin 10 years ago that scientists, the German government and implementing partners first came together and coined the term “NTDs,” an important milestone in defining a collective response against these diseases. Germany is also home to the Institute for Tropical Medicine at the University of Tübingen where two 19th
During this most recent visit to Berlin, the Global Network’s Dr. Maria Elena Bottazzi, participated in one-on-one meetings with Members of the German Bundestag, discussing short- and long-term goals surrounding disease elimination. Globally, nearly 1.4 billion people, including more than 500 million children, are at risk from NTDs and require treatment. Medicines are generously donated by pharmaceutical industry partners, however, the value of the donated drugs is not enough to combat NTDs if the funding falls short to ensure their delivery to communities who need them most.
It is fitting that a decade after pivotal meetings in Berlin created the term “NTDs,” the focus is once again on Germany. The G7 Leaders’ Declaration, published at the culmination of the summit, offers hopeful news for communities across Africa, Southeast Asia and in Latin America and the Caribbean, most marginalized by NTDs by promising to “invest in the prevention and control of NTDs in order to achieve 2020 elimination goals.”
An immediate increase in financing for NTD treatment and prevention programs is essential to build on the progress achieved so far. Opportunities to eliminate elephantiasis, river blindness and trachoma are nearly within our grasp. Countries worldwide, including the G7 nations, can play an important leadership role by helping to close this annual funding gap of US $220 million. If we fail to act now, not only will we reverse many milestones achieved, but one in six people across the world will continue to suffer unnecessarily from NTDs, held hostage in a cycle of perpetual poverty and inequality. Moreover, failure to act now will undermine the efforts of the G7 to demonstrate their accountability and effectiveness as a group.
We certainly applaud the German government for her bold steps taken on behalf of NTDs this year, and we will be watching this week on October 8th and 9th as the G7 ministers for health and research meet once again in Berlin to discuss next steps.
Last week, the Global Network for Neglected Tropical Diseases and the Sabin Vaccine Institute hosted a well-attended parliamentary workshop in Germany to raise awareness and deepen support for the cause of Neglected Tropical Diseases (NTDs).
The event was organized in conjunction with the Global Network’s on-the-ground partners and included presentations from Dr. Neeraj Mistry. Also, participating in the workshop were representatives from civil society and German-based pharmaceutical companies. The event allowed for thoughtful discussion and questions about NTDs, their impact on marginalized populations, and how elimination can be achieved. It also gave participants an opportunity to identify which countries they thought carried the largest NTD burden—many were surprised by the answers.
Hosting a meeting in Berlin was significant because of the history of German engagement in the field of NTDs dating back to the mid-1800s with the discovery of “bilharzia” or schistosomiasis in Egypt in 1851 by German parasitologist, Dr. Theodor Maximilian Bilharz. In addition, the German government under GTZ (now most common NTDs, and, the term “neglected tropical diseases” became a regular part of the global health vernacular.
Since then, the German government has supported research and development for NTDs. The Parliament conducted a hearing on research for neglected and poverty-caused diseases in 2011, and, some aspects of NTD control have been included in German development policy, such as school-based deworming— on a limited scale.
“However, opportunities truly exist now to scale up global engagement on neglected tropical diseases,” says Dr. Mistry. “With the inclusion of neglected and poverty-related diseases as a focus area on the G7 Summit agenda, and as part of the post-2015 Open Working Group’s outcome document, we’re expecting great things for NTDs in 2015—and, we believe Germany could have a major role to play.”
The Global Network plans to return to Germany a few more times this year to continue our engagement working closely with our in-country partners. The German Parliament is already set to another conduct a hearing on NTDs in early February.
German Network against Neglected Tropical Diseases. Stakeholders from civil society, the scientific community and the private sector from across Germany convened in Berlin to participate in a special parliamentary evening introducing the newly-formed alliance, which is dedicated to controlling and eliminating 10 neglected tropical diseases (NTDs) by 2020.
By joining with the United States and the United Kingdom — two leaders in providing funding for NTD programs — Germany has the potential to play a key role in accelerating efforts to control and eliminate NTDs.
The German Network launch event was covered by seven different German media outlets and attended by a broad group of more than 50 participants, including the German government. The Global Network’s Managing Director, Dr. Neeraj Mistry, provided the closing presentation, identifying opportunities for German partners to help fill the current NTD funding gap.
Dr. Jürgen May, professor at Bernhard Nocht Institute for Tropical Medicine Hamburg and spokesman for the Network, expressed his confidence in the new coalition. The members are united by their shared desire to eliminate diseases such as schistosomiasis and African sleeping sickness, which primarily occur in tropical countries and typically thrive in impoverished settings. The Ebola epidemic in West Africa is also now showing how important it is to bolster efforts to fight poverty-related diseases. Many of us have been involved in this arena for a long time. Collaboration between non-governmental organizations, science and industry will make these initiatives even more efficient.”
After participating in the successful launch event, Neeraj Mistry left feeling confident that the newly-formed German Network is well-poised to further advocate for NTD efforts around the world.
Germany is now the second European country to form a coalition dedicated to controlling and eliminating NTDs — following the footsteps of the UK Coalition against Neglected Tropical Diseases. Established in 2011, the UK Coalition has been hard at work raising awareness primarily among UK policy makers, urging for greater cross-sectoral integration of NTD programs with water, sanitation and hygiene (WASH) and education initiatives and increased funding and better coordination for existing NTD control efforts. Thanks to the efforts of the UK Coalition and others, NTDs are now seen as a key barrier to attaining the existing Millennium Development Goals and successfully alleviating poverty within the most marginalized communities.
Both the German and UK coalitions are also crucial partners in advocating for the inclusion of NTDs in the post-2015 development agenda. The impact of NTDs stretches across multiple development sectors, including WASH, nutrition, and maternal and child health. Therefore, long-term sustainable development, poverty reduction and improved health outcomes cannot be successfully achieved without simultaneously addressing NTDs. The NGO, academic and private sector representatives involved in both the German Network and UK NTD Coalition have a unique opportunity to help ensure NTDs remain on the world’s development agenda.
The Global Network congratulates the German NTD Network for its successful launch this fall, and looks forward to its continued progress in advocating for the control and elimination of NTDs. For more information about the German Networks, you may visit their website here.