Category Archives: Latin America and the Caribbean

A New WHO Report Brings Fresh Data and Ideas on Ending NTDs

 

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More than 100 million people are affected by one or more neglected tropical diseases (NTDs) in the Latin America and Caribbean (LAC) region. As a former Director of the Pan American Health Organization, I’ve seen the suffering caused by these diseases first-hand. At the same time, I have also learnt what can be achieved when endemic countries and international partners put NTDs – and the people affected by them – front and center in their policies.

The World Health Organization’s Third Report on NTDs, released last month, rightly puts a strong emphasis on equity and shared prosperity – themes that are at the very core of tackling NTDs.

The report, “Investing to Overcome the Global Impact of Neglected Tropical Diseases,” charts a new course by outlining the investments needed to reach the WHO Roadmap goals– a critical guide for the global effort to control and eliminate NTDs by 2020. Importantly, it also examines what needs to be done to achieve universal coverage of all people in need by 2030.

The new WHO report calls attention to progress made, including in the LAC region, which is a source of pride and hope for all involved. The region’s milestones can serve as a model for other endemic countries and show the world what’s truly achievable:

  • In 2013, Colombia became the first country in the world to reach WHO-verified elimination of onchocerciasis (river blindness), followed by Ecuador in 2014.
  • Guatemala and Mexico are on track to eliminate transmission of onchocerciasis, leaving just one border area between Brazil and Venezuela with ongoing transmission of the disease.
  • More than half of the region’s countries with endemic Chagas disease have eliminated transmission by the disease’s principal domestic insect vector, and 20 of 21 endemic countries have implemented universal blood screening for Chagas.
  • Costa Rica, Suriname, and Trinidad and Tobago are no longer endemic for lymphatic filariasis as of 2011. More than 7 million people were treated for this disease in 2013, most of them in Haiti.

 

Landmark commitments like the 2012 London Declaration on NTDs and the 2013 World Health Assembly NTD resolution have helped sustain political will towards this effort. These commitments have influenced further action in the Americas, where commitments from the Organization of American States and the Council of Ministers of Health of Central America and the Dominican Republic accelerated the fight against NTDs.

Globally, over 800 million NTD treatments were delivered in 2012 alone– an outstanding result achieved through strong partnerships with pharmaceutical companies, endemic countries, affected communities, bilateral and multilateral organizations and implementing partners.

But, we still must finish what we’ve started and accelerate progress towards the 2020 goals. This will help set the stage for success as we look ahead to achieve universal coverage of everyone in need by 2030.

Many of the people affected by NTDs live in middle income countries, and the report calls for more domestic resources to be mobilized and more equitably distributed, including among the poorest and most marginalized people. Similarly, there is significant scope for development banks and donors, as well as emerging players like the BRICS, to finance NTD efforts by employing innovative models and leveraging public-private partnerships. Cross-sectoral collaboration with the WASH (water, sanitation and hygiene); nutrition; maternal and child health; and education communities is increasing access to NTD interventions, while also enhancing impact and ensuring sustainability.

The WHO report endorses the fact that controlling and eliminating NTDs paves the way for poverty alleviation and shared prosperity for all. As I’ve said before, targets to control and eliminate NTDs must be included in global efforts to address poverty and inequality, including the post-2015 development agenda and the corresponding Sustainable Development Goals.

I encourage you to read the full WHO report here.

A Wish List for 2015: 7 Achievable Victories in the fight against Neglected Tropical Diseases

 

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By Dr. Mirta Roses Periago

A new year always brings about new hope and renewed commitments. 2015 is a pivotal year for the international community and also for the call to end neglected tropical diseases (NTDs). So, here goes my “wish list” for 2015, which includes seven achievable yet ambitious victories for the global health and development community.

1. A step closer to declaring Latin America and the Caribbean free of river blindness

In 2013, Colombia became the first country in the world, as declared by the WHO to have eliminated river blindness transmission, and Ecuador followed shortly after in 2014. These countries show what can be achieved with unwavering political will and sustained action.

Mexico and Guatemala have stopped transmission of river blindness and are already in advanced stages with the WHO to take the final steps towards verifying elimination.

So, I am confident that Brazil and Venezuela will be successful in targeting the Americas’ final cases of river blindness, located along their borders among the indigenous Yanomami community. Through south south cooperation, they have joined forces to ensure that the all the Yanomami receive access to the treatments they need – tackling the last stronghold of river blindness in the region.

2. Progress towards eliminating lymphatic filariasis in the Latin America and the Caribbean

About 13.4 million people across the Latin American and Caribbean are at risk of lymphatic filariasis (LF), nearly 80 percent of them in Haiti. Despite challenges in recent years, including a cholera outbreak and earthquake, Haiti has been able to reach the entire population – about 10 million people – through mass drug administration (MDA). I hope to see continued support from the Haitian government and partners to interrupt the transmission of LF.

Additionally, I hope to see Brazil eliminate LF from the last active site in the country, located in the state of Pernambuco. Brazil has already eliminated LF in 8 states; this success is a clear reflection of their longstanding commitment and dedication to disease control and public health

3. The Inclusion of NTDs as part of Canada’s Maternal, Newborn and Child Health (MNCH) policies and programs

Many of Canada’s priority partner countries carry significant burdens of malnutrition and NTDs, including Haiti, as well as Indonesia and Tanzania, posing a serious threat to maternal, newborn and child health. NTDs lead to stunting, wasting and the loss of Vitamin A and iron – hindering child growth and causing adverse pregnancy outcomes.

That is why I traveled to Ottawa last fall and called on Canadian policymakers to make sure that they integrate NTDs into their development strategies. Canada can help save lives and make a real difference for women and children by making sure that they have access to NTD treatments. This is a smart policy choice, one that could be financed through the Global Financing Facility for Every Woman, Every Child.

4. Regional Bodies translate promises into concrete action

Canada, Costa Rica and Brazil are among the 35 countries that passed a resolution in the Organization of American States in 2013, pledging to end the suffering of the 100 million people impacted by NTDs in the Americas. Health Ministers from Central America have also recognized the burden of NTDs, most recently at their 2013 regional meeting of the Council of Ministers of Health of Central America and the Dominican Republic (COMISCA).

I hope that the OAS, COMISCA and other regional organizations will leverage these important policy commitments to catalyze greater financial support and partnerships – just as COMISCA did for malaria. In addition to discussing NTDs during their 2013 regional health summit, several countries rallied together to eliminate malaria in the region.

Partners followed suit and the Global Fund invested $10.2 million to support this regional initiative, adding to the national malaria grants already approved.  The results of these commitments are clear: malaria rates have been falling, often times dramatically, across Latin America– and the region is just steps away from eliminating this disease as a public health threat. This is an excellent example of how strong, united regional commitments can accelerate global health efforts – and one that can be applied to the fight against NTDs.

5. BRICS fight NTDs at home and abroad

Last December, the BRICS Health Ministers gathered in Brasilia for the 4th Health Ministers meeting, where they added NTDs to their collective agenda for the very first time. I am very excited to see the BRICS countries work together to help see the end of NTDs by 2020.

I encourage the BRICS to build on this commitment by continuing to prioritize NTDs within their own countries.  I also hope they will explore ways to fight NTDs across the globe. The New Development Bank could offer a venue for the BRICS to finance NTD control efforts as part of their broader sustainable development projects.

6. G7 leaders make financial commitments to end NTDs by 2020

The G7 is off to an excellent start in 2015. Neglected and poverty-related diseases made it onto the G7 agenda for the upcoming June 2015 Summit. This year is critical for the G7 to take immediate action to close the books on their unfulfilled promise to expand access to NTD treatments.

7. Post-2015 Development Agenda Includes NTDs

I’m looking forward to seeing how the post-2015 development agenda takes shape this year. We absolutely must utilize existing global health solutions – including the NTD treatments generously donated by pharmaceutical companies. I am happy that NTDs were included as a health priority in the final Sustainable Working Group framework. However, they were not specifically mentioned in UN Secretary General Ban Ki-Moon’s recent synthesis report. If NTDs are not clearly identified in the final post-2015 development agenda and the corresponding sustainable development goals, they will once again remain as forgotten and invisible as the people and communities affected by them. Let us make them a health priority so that we can see the end of NTDs by 2020.

Ecuador Becomes Second Country in the World to Eliminate River Blindness

 

With help from the Carter Center and the Pan American Health Organization, Ecuador has officially become the second country in the world to achieve elimination of onchocerciasis (river blindness).

To eliminate onchocerciasis in Ecuador, the country had to overcome a major obstacle — Simulium exiguum; the main vector in Ecuador is exceptional at transmitting the disease. Ecuador’s Ministry of Health had been distributing medication in the country since 1990 — halting distribution in 2010 after transmission of the disease was successfully interrupted.

Watch a video from the Carter Center to see how treatment reached some of the most remote communities in Ecuador:

Ecuador is the second country in the world to receive verification from the World Health Organization in eliminating onchocerciasis after Colombia in 2013. The next challenge being undertaken in the fight against onchocerciasis in the Americas is addressing the disease in the scattered and migratory Yanomani population who live in the border area between Venezuela and Brazil.

Read the Pan American Health Organization’s press release here.

Inter-American Development Bank’s Documentary Highlights “Big Foot” in Guyana

 

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“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 “Tackling ‘Big Foot’: A Story of Sanitation and Health in Guyana”, the Inter-American Development Bank (IDB) shines light on how lymphatic filariasis (LF) is negatively affecting communities in Guyana, 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.