Category Archives: Latin America and the Caribbean

New Report: The Neglected Tropical Disease Initiative in Latin America on the Effectiveness of Integrated NTD Programs

 

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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.

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END7 Supports Strengthening and Scaling-Up of Deworming Campaigns in Peru

 

Peruvian health workers are helping end the burden of NTDs in Peru. Photo by INMED Andes

Peruvian health workers are helping control and eliminate NTDs. Photo by INPPACE 

Approximately 3.5 million children are at risk for intestinal worms – including hookworm, whipworm and roundworm – in Peru. Even though Peru has experienced significant economic growth over the past decade, a large portion of its population continues to live in poverty, with four out of ten families still lacking access to clean water. Environments like these promote the transmission of neglected tropical diseases (NTDs) like intestinal worms which can lead to malnutrition and anemia among children.

To address Peru’s NTD burden, the nonprofit organization INMED Partnerships for Children is working in collaboration with regional governments and regional departments of health and education to carry out deworming campaigns to address the burden of intestinal worms in particular. With support from the Global Network’s END7 campaign, INMED recently launched a study to evaluate the impact of these deworming campaigns on addressing intestinal worm infections and the nutritional status of children in Peru’s Ucayali Region. INMED is collaborating with the Peruvian Institute for Clinical and Experimental Parasitology to complete the study.

health workers are trained to measure the height & weight of children. Photo by INMED

Health workers are trained to measure the height & weight of children. Photo by INMED

The study will provide important insights on how to improve the effectiveness of deworming campaigns and will inform the scale up of deworming campaigns across Peru. Peru’s Ministry of Health has called for semiannual national deworming days and with the support of INMED and Johnson & Johnson, Peru will launch a nationwide campaign to treat millions of children living in NTD-endemic areas of Peru at the end of this year.

The END7-supported study will also build the capacity of local health staff. Already, training has been completed for community health workers to deliver deworming medicines, for laboratory technicians to diagnose intestinal worm infections, and for nurses to carry out nutritional assessments such as measuring children’s weight and height and their hemoglobin levels, an important indicator for anemia. By training local staff, INMED is strengthening Peru’s public health sector and creating a sustainable project that will continue to improve the health of Peruvians.

INMED’s efforts to increase access to NTD treatment among the most vulnerable communities in rural areas of Peru are inspiring. Thanks to the generosity of END7 donors, this project will lay the groundwork for future deworming campaigns that will reach more children at risk for intestinal worms in Peru.

South-South Cooperation Moves Forward to Free the Indigenous Yanomami People from Neglected Tropical Diseases

 

Photo by Shaan Hurley

Today marks the United Nations (UN) Day for South-South Cooperation — an opportunity for the global development community to examine how developing and emerging countries can share knowledge, exchange best practices and pursue joint projects to generate tangible solutions to development challenges.

As a young officer in the Ministry of Health of Argentina, I attended the first UN Conference on Technical Cooperation among Developing Countries (TCDC) where I had the opportunity to witness the launching of the Buenos Aires Plan of Action, a blueprint adopted in 1978 that offered guidance and new energy to the concept of south-south cooperation. At the same time, the International Conference on Primary Health Care concluded with the Alma Ata Declaration — a public health milestone that recognized health as a fundamental human right.

It was an exciting time to be a part of these landmarks in public health and see how these principles are being carried out today. A closer look at Brazil and Venezuela’s joint commitment to controlling and eliminating neglected tropical diseases (NTDs) within the Yanomami community —a nomadic indigenous tribe made up of approximately 35,000 people — spotlights the key role of south-south cooperation in reaching all populations in need of key health interventions. Equally important, this successful model can be replicated within the Latin American and Caribbean (LAC) region and across the globe.

The Yanomami territory is a remote stretch of tropical rainforests and mountains on the northern border of Brazil and southern part of Venezuela (approximately 19,000[1] people live on the Brazilian side and 16,000 on the Venezuelan side). The combined border area is over 9.6 million hectares — about twice the size of Switzerland — and represents the largest forested indigenous territory in the world. The entire community is affected or at risk for onchocerciasis, also known as river blindness.

The high prevalence of onchocerciasis  within the Yanomami community represents the last stronghold of this disease in the LAC region, which has made significant strides towards its elimination, in addition to controlling many other NTDs. Several countries across the region have either launched or implemented national plans to control and eliminate NTDs within their borders. In 2014, Colombia became the first country in the world to eliminate onchocerciasis. These successes underscore the strong political commitments made by regional leaders including the Organization of American States (OAS), the Pan American Health Organization (PAHO) and the Council of Ministers of Health of Central America and the Dominican Republic (COMISCA).

While these are impressive milestones, more work needs to be done to address NTDs within the Yanomami community —  as the area occupied by the Yanomami is regarded as the greatest challenge for interrupting the transmission and making LAC an oncho- free region. Because of their nomadic habits plus their isolated and forested environment, health workers must travel by helicopter or boat to reach them. Many logistical and financial challenges need to be overcome to deliver the required series of treatments.

Here is how south-south cooperation can help address these challenges:

Brazil and Venezuela formalized and agreed to join efforts to tackle this problem in May 2014 during the 67th World Health Assembly. Through this commitment, these two countries will coordinate efficiently the provision of continuous integrated healthcare for affected communities in both Brazil and Venezuela. They will work together to train local community health workers and form bi-national humanitarian teams that will also include local residents to treat the last focus of onchocerciasis in the Americas through the development of integral  healthcare to affected communities on both sides of the border.

Furthermore, these teams will support the creation of a bi-national health model to provide work assistance for Brazil and Venezuela. A technical team of the Brazilian Ministry of Health is working with the Venezuelan Ministry of Health team in order to strengthen and integrate public policy to eliminate onchocerciasis in the Yanomami area.

By harnessing their collective experiences and expertise, I am confident that these countries can successfully work together to end the unnecessary suffering of the Yanomami population — and ultimately help the LAC region see the end of onchocerciasis.

Looking ahead, the post-2015 development agenda dialogue, the BRICS Ministers of Health meeting and the UN South-South Cooperation EXPO offer exceptional opportunities for government officials and development partners to showcase south-south cooperation as a critical, sustainable and successful model to address NTDs and other pressing global health and development challenges.


[1] According to Health Ministry of Brazil, in 2012, the Yanomami territory had 293 small villages that contain 4,550 families from five different ethnic groups, most of them Yanomami. There were 21 thousand of indigenous people living in this region, which 11,600 were located in endemic area.

Haiti’s National Program for the Elimination of Lympathic Filariasis Prevails Despite Adversity

 

Photo by Olivier Asselin

Photo by Olivier Asselin

Haiti has made remarkable progress against lymphatic filariasis (LF), a disfiguring and stigmatizing neglected tropical disease (NTD), despite facing many challenges. A recently published PLOS NTDs editorial highlights the perseverance and support displayed by the Haitian government and development partners, resulting in scaled-up mass drug administration (MDA) across the country, integrated programs with soil-transmitted helminths (also known as intestinal worms) and increased morbidity management. With these successes, the Haitian effort to eliminate LF can certainly be a model for other countries.

The Haitian Ministry of Public Health and Population (MSPP) established the National Program to Eliminate LF (NPELF) in 2000 to stop LF transmission and reduce the suffering of infected people. Key partners include the Bill & Melinda Gates Foundation, United States Agency for International Development (USAID), Centers for Disease Control and Prevention (CDC), CBM, Inter-American Development Bank (IDB), Abbott Foundation, PepsiCo, Frank Eck Family Foundation and others.

In the first MDA, conducted in Léogâne in 2000, the NPELF and local partners trained community leaders and health volunteers on medicine distribution techniques and educated them about LF treatment, transmission and prevention. Social mobilization was another integral component, spreading messages by banners, posters, radio and megaphones to increase the number of people participating in MDA.

Efforts then focused on scaling up the program to reach all people in need. However, over the course of many years, natural disasters and political and social unrest challenged expansion of the LF program. Just some examples include random acts of violence, devastating hurricanes and flooding, an earthquake and a vicious cholera outbreak.

Yet, increased advocacy, new funding and reinvigorated planning provided the necessary boosts to scale up and achieve results. One of the meetings that jumpstarted new progress was organized by the Global Network, Pan American Health Organization (PAHO) and IDB. As the PLOS NTDs paper explains, “The partners affirmed their support for NTD control and elimination of LF, and the donor community responded. With new funding for MDA in Port-au-Prince from CDC and others, Haiti was finally poised for the first time to achieve full coverage of the entire country with MDA, with a population in excess of 10 million.”

Now, Haiti has achieved full national coverage, and it must strive for interrupted LF transmission. With strong partnerships and continued political commitment, this milestone is in Haiti’s grasp.

To read the full paper, “Haiti National Program for the Elimination of Lymphatic Filariasis — A Model of Success in the Face of Adversity,” click here.