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 Deepanjali Jain and Anupama Tantri
Partners from multiple sectors, including development banks, play an important role in the response to control and eliminate NTDs – a point highlighted by the report, “Delivering on promises and driving progress: the second report on uniting to combat NTDs”, released in tandem with the commemoration of the second anniversary of the London Declaration on Neglected Tropical Diseases (NTDs) earlier this month. ,. In a resource-limited environment, the contributions of development banks, such as the World Bank, the African Development Bank, the Inter-American Development Bank and the Asian Development Bank, present unique and innovative models to finance national NTD programs. These models also signal the prioritization of NTDs by endemic country governments and the recognition of NTDs as a cross-cutting issue that is tied not only to health, but also to efforts to improve education, gender equity, agriculture, and water and sanitation.
The World Bank and the African Development Bank have understood this connection for decades—their investments in NTD control and elimination began in the mid-1970s with support for what eventually became the African Program for Onchocerciasis Control (APOC). Onchocerciasis, or river blindness, is a devastating disease that is endemic in 30 African countries. Easily preventable, onchocerciasis is the second leading infectious cause of blindness, just behind another NTD, trachoma. APOC, funded by several public and private donors including national governments, foundations, the private sector, the African Development Bank, and the World Bank the latter of which also manages the trust fund that pools the resources from all partnersimplements an onchocerciasis control program that reaches over 100 million people annually in Africa. Given the success of the APOC model and the overlap between onchocerciasis and lymphatic filariasis (LF), the program is now being expanded to address LF.
This past year, the World Bank committed to expanding its investment in NTDs by working with endemic countries in Africa to access $120 million in International Development Association (IDA) funds to support NTD control and elimination efforts. The investments are part of broader development efforts to address poverty in countries along the Senegal River basin by supporting fisheries, irrigation and water resources management, in addition to NTDs such as schistosomiasis. This effort has also supported NTD efforts in Madagascar, Yemen and the Sahel region.
In Asia, emerging infectious diseases and nutrition threaten the rapid economic growth and development across the region. Recognizing these links, the Pantawid Pamilyang Pilipino Program, a conditional cash transfer program launched in the Philippines with the support of the ADB and the World Bank, includes deworming of children as a condition for families to receive cash assistance, underscoring the links between health and poverty.
Recently, the ADB announced several initiatives in collaboration with the World Health Organization Western Pacific Regional Office (WPRO) that reinforce their commitment to addressing global health and communicable diseases in Asia and present an opportunity to do more on NTDs. Building on the vision of regional cooperation and leadership articulated by the Asia Pacific Leaders Malaria Alliance (APLMA), the ADB created the Regional Malaria and Other Communicable Disease Trust Fund (RMTF) that will help fund communicable disease control projects in recipient countries. ADB has also announced that they will increase their operations in the health sector to between 3 and 5 percent of their annual spending, up from 2 percent from 2008-2012, an opportunity to contribute more resources to support national NTD control and elimination programs.
Although funding for the global NTD response increased in 2013, the funding gap between current resources and those needed to reach the 2020 control and elimination goals is still US$200 million per year. Development bank programs, like those initiated and supported by the World Bank, IDB and ADB, create innovative and sustainable funding models that support endemic country initiative and bolster existing investments in NTD control and elimination programs. The ability to bring together diverse partners and encourage cross-sectoral coordination is a hallmark that is unique to these development banks and is critical to meeting the 2020 NTD control and elimination goals.
By: Mia Wise and Raquel Corona-Parra
On Friday August 30, 2013, the Ministry of Health of Guatemala launched its multi-year, integrated, national plan addressing neglected tropical diseases (NTDs) with support from the Pan American Health Organization (PAHO) and the Inter-American Development Bank (IDB). The ambitious plan targets the control and elimination of six NTDs by providing deworming medication to children in prioritized municipalities and improving access to clean water in communities affected by NTDs. Even more, Guatemala’s national NTD plan will be linked the country’s Zero Hunger Plan which tackles hunger and malnutrition in the country.
More specifically, this integrated plan will target the control and elimination of onchocerciasis, soil-transmitted helminths (STHs, or intestinal parasites), Chagas disease, leishmaniasis, trachoma, and leprosy from 2013 to 2015. The Guatemalan Minister of Health Jorge Villavicencio said the increased attention placed on these diseases is essential for reducing malnutrition and poverty in Guatemala as these diseases represent an incredible health burden on communities in the country, trapping already marginalized populations in the cycle of poverty.
Even More Good News…
Guatemala was not the only country focused on NTD treatment and control this summer. The Council of Ministers of Health of Central America and the Dominican Republic ( regional meeting on June 27 and 28 in San José, Costa Rica. The Global Network team was happy to collaborate with COMISCA at this meeting – where they shared information on upcoming challenges and solutions in NTD treatment efforts, and global and regional policy activities.
COMISCA is a political faction of the System for Central American Integration (SICA) comprised of the Ministers and Secretariats of Health of eight Member Countries. The Council strives to ensure the right to health care services to the people of Central America and the Dominican Republic, and is influential in determining health care priorities within the region.
The Global Network was delighted that COMISCA recognized the importance of NTD control and elimination with regards to the 2015 Millennium Development Goals (MDGs) and the 2020 Sustainable Development Goals. The Ministers of Health also approved the addition of NTDs in their closing report – a result that has paved the way for NTD control and elimination action items to be included in the next COMISCA Regional Health Plan.
And More Collaboration…
The Global Network was also invited to participate at the Forum of the Health Sector in Central America and the Dominican Republic (RESSCAD), during its annual meeting held in Guatemala on July 17. RESSCAD meetings serve as another opportunity for integration among the ministers of health of the region.
During the meeting, PAHO Director Dr. Carissa Etienne stressed that NTDs are the clearest example of preventable health inequities. She added that prioritizing these diseases, which affect the most vulnerable and marginalized populations, is a public health, political, and moral imperative. RESSCAD will now be placing a stronger emphasis on intersectoral collaboration and NTD control and will review progress made at the next meeting in 2014.
The launch of Guatemala’s national plan on NTDs and the increased attention to NTDs made by COMISCA and RESSCAD are all great news for the NTD community!
This blog post by Agustín Cáceres was originally posted on Inter-American Development Banks blog.
When I was a child, my school days were sometimes fairly boring. Long classes, presentations, homework… Probably that is why, when I travelled to Chiapas (Mexico) to coordinate a number activities to educate almost 4,000 kids about healthy habits to prevent Neglected Tropical Diseases (NTDs), I only had one thing in mind: Let’s try to make it as fun as possible.
We arrived in the village of Huixtán, in an isolated area in the mountains of Chiapas, and we started setting up everything for a day full of activities. The students of the Benito Juárez Primary School watched us closely, realizing this would not be an average school day. State health workers dressed up to represent a larger than life water drop, hand, and soap bar welcomed students on the playground. The party had started.
In Chiapas, many children live under poor conditions: Illiteracy is 52.37 percent, many people lack access to potable water and sanitation, and many homes don’t have cement floors. Due to these conditions, more than 300,000 people, mostly members of indigenous communities, are at risk of contracting a Neglected Tropical Disease.
At 8 am, a team of health workers speaking in Tzeltal, one of the local indigenous languages, split the excited kids into groups. Younger students in first and second grades started the morning learning the basics of the trachoma -a disease that can cause blindness, still present in rural communities of this Mexican state.
Meanwhile, fifth and sixth graders participated in presentations about these and other NTDs, including leishmaniasis, conducted both in Spanish and Tzeltal. The students learned about the ways these diseases are transmitted, symptoms, and prevention measures such as identifying the tick responsible for transmitting the parasite that causes Chagas in their homes. Over 120 cases of this disease are diagnosed in Chiapas every year.
“We try to make learning about NTDs fun for the kids in these communities. We tailor the messages and the activities to the different age groups and to their cultural context” said Dr. Janet Morales, State Coordinator for Chagas and Leishmaniasis of the Chiapas Health Institute. “We believe that working with these kids is highly effective. While they are playing and having a good time, they learn about NTDs and then transmit all this information to their parents at home, educating their own communities”.
Once these activities came to an end, the students received crayons and coloring books with games and drawings about good habits for preventing these diseases. “Ending the health education activities in this festive manner makes kids think of NTDs with a different perspective. Preventing them is up to them, and it can be fun” said Dr. Morales. One thing is clear: the kids of Huixtán will surely remember this day for a long time to come, and I also hope they will remember how to support the elimination of these diseases in their communities.
Agustin’s work focuses on health and its social conditionings, particularly neglected tropical diseases and other diseases of poverty, health education and youth at risk.