“I’ve had [lymphatic filariasis] for 18 years” said Bernadette Seenarine –a long time resident of Georgetown, Guyana who operates a small grocery shop from her home. In the short video titled one of four countries in the Americas where transmission of LF still occurs. Seenarine is one of an estimated 68,000 people –approximately 9 percent of Guyana’s population—assumed to have been infected with LF. In Guyana, it is estimated that 310,000 people are at risk of contracting the disease.
Lymphatic filariasis (LF)—also known as “big foot” in Guyana—is a debilitating neglected tropical disease (NTD) caused by microfilaria, a tiny parasite that causes the disease. In Georgetown, Guyana, the disease is predominately spread by the culex mosquito, the vector for the parasitic worm that causes LF. Due to the frequent flooding that occurs in Georgetown and its lack of adequate drainage and sewer systems, large pools of contaminated and stagnant water are formed throughout the city. These pools of water act as breeding grounds for culex mostiqutoes who transmit the LF disease to humans.
LF is extremely painful and causes profound swelling of the legs that can lead to permanent disability. People living with this disease also suffer from financial and social loses and can become stigmatized. “Sometimes people don’t want to come and buy when I have this foot,” Seenarine said when explaining how her swollen leg has caused people from her community to stop buying food from her grocery store. “…It’s really difficult to live with this.”
To tackle this problem, the Latin American and the Caribbean Neglected Tropical Disease Initiative (LAC NTD Initiative)—a partnership that includes the Inter-American Development Bank (IDB), Pan American Health Organization (PAHO) and Sabin Vaccine Institute’s Global Network for Neglected Tropical Disease—are working to scale-up efforts to control and eliminate NTDs within the LAC regions, including Guyana. These efforts include implementing joint community-based deworming campaigns for LF in Guyana’s capital of Georgetown, in addition to integrating social mobilization campaigns to educate Guyana’s population about LF treatment, transmission and prevention. The LAC NTD Initiative is also working to improve the infrastructure of Georgetown’s sewage system to reduce risk factors of contracting LF.
The Sabin City Group, a collaborative partnership with corporate institutions in the United Kingdom and the UK charity Sabin Foundation Europe, is also contributing in the fight to eliminate LF in Guyana by recently launching the group’s ‘Guyana campaign’. The campaign’s goal is to raise funding to support NTD programs in Guyana in an effort to eliminate LF by 2016.
To learn more about NTD projects carried out in the LAC region, we invite you to read this published report titled “It Can be Done: An Integrated Approach for Controlling and Eliminating Neglected Tropical Diseases”. We also encourage you to watch IDB’s documentary on LF in Guyana and the work that is being done to control and eliminate the disease.
While major gains have been made in the fight against neglected tropical diseases (NTDs), the Latin American and Caribbean region’s most poor and marginalized populations still suffer from the pain, disability and social exclusion associated with NTDs — diseases which have been successfully controlled in higher income countries.
However, the Latin America and the Caribbean Neglected Tropical Disease Initiative (LAC NTD Initiative), a partnership between the Inter-American Development Bank (IDB), Pan American health Organization (PAHO) and Sabin Vaccine Institute’s Global Network for Neglected Tropical Diseases, is proving that the control and elimination of NTDs within the region is possible and within reach.
In a recently-published report, titled It Can be Done: An Integrated Approach for Controlling and Eliminating Neglected Tropical Diseases, the IDB draws upon four NTD demonstration projects to provide lessons learned in integrated NTD control projects. The projects, taking place in Brazil, Guyana, Haiti and Mexico, took an integrated approach to addressing NTDs by combining interventions from the water and sanitation and education sectors, and taking advantage of synergies within governments, NGOs and private sectors within the region. This integrated approach stands in contrast to the more traditional approach to addressing NTDs — one which historically involved concentrating on one disease at a time and offering medications and treatments to entire at-risk populations to stop the spread of disease.
The work undertaken by the LAC NTD Initiative is critical; the Latin America and Caribbean region has been plagued by underfunding for NTD control even though more than 100 million individuals in the region are infected by at one or more of these diseases. Yet NTDs can be treated at a very low cost in comparison to other public health interventions. For example, it is estimated that lymphatic filariasis, onchocerciasis and trachoma could be eliminated, and soil-transmitted helminth and schistosomiasis controlled in the Latin America and Caribbean region by 2020 for as little as US$0.51 per person in most countries.
As the world quickly approaches the deadline of the United Nation’s Millennium Development Goals (MDGs), and the Post-2015 Sustainable Development Goals go into effect, we must focus on the world’s poorest and most marginalized communities who suffer from NTDs in an effort to ensure that no one is left behind.
It Can be Done: An Integrated Approach for Controlling and Eliminating Neglected Tropical Diseases seeks to inform policymakers and program managers’ efforts to design, manage, implement and evaluate integrated NTD programs. The report, which presents the first comparative analysis that uses a single methodology to investigate the feasibility of implementing integrated programs, will certainly move the world one step closer to ending the suffering caused by NTDs.
To read the full report, click here.
By: Agustin Caceres
Brasilia, May 29th 2012
In the opening session, hosted by Dr. Joaquin Molina, Representative of PAHO in Brazil, and Dr. Jarbas Barbosa da Silva Jr, Secretary of Health Surveillance of the Health Ministry of Brazil, highlighted that the disease continues to represent an important challenge for the health authorities of Latin America and the Caribbean. In the region, more than 12 million people are at risk of contracting this disease including Haiti, one of the countries most at risk.
“These meetings demonstrate Brazil’s support for the elimination of this disease in the country”, said Dr. Barbosa da Silva. “We are close to the elimination of LF, and that is why this is such an important step. This disease has to remain a top priority and this is why it is key that it is addressed with an integrated approach in collaboration with primary health care services. It is not just about eradication, but also about sustained surveillance.”
Lymphatic filariasis, which is included in the group of the Neglected Infectious Diseases, affects mainly indigenous populations, as well as rural and urban populations that live in pockets of extreme deprivation in several countries in LAC. This is the case of the metropolitan area of Recife, in northeastern Brazil, where the Inter-American Development Bank is supporting a project for the control and elimination of this disease as well as others like leprosy, still present in several areas in Brazil, and geohelminthiasis (intestinal parasites), which has a strong prevalence among children in school age in many municipalities throughout the country.
More than 30 representatives of several countries in the Region are attending this event, such as Costa Rica, Trinidad and Tobago, and Suriname –countries that have certified the eradication of this disease and therefore are no longer considered endemic- together with other countries that are still fighting this disease, including Haiti, Brazil and the Dominican Republic.
The meetings have covered a wide range of topics related to the fight against this disease: from Suriname’s National Plan of Action for the control of NIDs to the experience in Integrated Vector Management in Trinidad and Tobago and the metropolitan area of Recife in Brazil, where activities to monitor and eliminate breeding sites of the culex mosquito –vector for the transmission of LF- are a key component in the strategy to eradicate this disease.
The fight against LF is part of the joint efforts of the Neglected Infectious Diseases Initiative for Latin America and the Caribbean, an initiative that is supporting innovative projects based with an integrated approach in both the fight against multiple diseases as well as the integration with other sectors like water, sanitation, and housing.
Agustin Caceres is a consultant in Communications and Outreach at the Social Protection and Health Division of the Inter-American Development Bank (IDB) in Washington DC.