I can’t wait to spread the news. The Latin American and the Caribbean (LAC) region is one step closer to seeing the end of onchocerciasis (also referred to as river blindness): Mexico has become the third country in the world to officially wipe out this disease!
The drive for progress is much of what motivated me during my time as the Director of the Pan American Health Organization, the WHO Regional Office for the Americas. I am excited to continue celebrating these milestones as Neglected Tropical Disease (NTD) Special Envoy, and a life-long advocate for public health.
Earlier this year, I wrote about 7 achievable victories in the fight against NTDs that I hope to see accomplished in 2015. Many of these wishes are coming true.
This week, I am filled with the joyful sense of pride in the accomplishment of Mexico and its partners as I check off Mexico’s certification of onchocerciasis elimination from my wish list. Mexico’s success builds off of Colombia and Ecuador’s certification in 2013 and 2014, respectively, and gives me even more confidence that we will soon see news of a LAC region completely free of onchocerciasis.
Onchocerciasis is a devastatingly debilitating parasitic disease that causes itchiness, rashes, and eye problems, eventually leading to permanent blindness. The parasite is transmitted to humans by the bite of a black fly, which breeds in fast moving rivers, increasing the risk of blindness in nearby communities. What’s more, the disease causes a terrible ripple effect by pulling kids out of school to care for their blind elders, reducing economic productivity, and causing families to move out of fertile river valleys, decreasing agricultural outputs in already impoverished areas.
This momentous occasion moves the LAC region one step closer to eliminating the disease entirely—Guatemala has already submitted a request to WHO to verify elimination, and I hope to soon see more results from the enormous, highly coordinated, south-south cooperative effort between Brazil and Venezuela to stop transmission in the Yanomami communities along their borders.
We should all celebrate this official announcement, and we must particularly congratulate Mexico and the many partners that have been working to control this problem for decades and moved toward accomplishing elimination with new tools and new partners for the last fifteen years.
Eliminating this disease requires unwavering determination. The first step in the elimination process is at least two years of mass drug administration, in which entire communities who are at risk of onchocerciasis are administered Mectizan (ivermectin) every six months. Merck has made an unprecedented pledge to donate Mectizan to everyone in need, for as long as needed. President Jimmy Carter and the Carter´s Center program (OEPA – Onchocerciasis Elimination Program for the Americas) have been instrumental, joining PAHO/WHO as well as the communities and health workers in a successful dream team. You can see President Carter’s video message here, congratulating partners for their hard-earned accomplishments.
Once large-scale programs are complete, treatments are delivered to individuals on an as-needed basis. Communities are monitored for an additional twelve years to make sure that transmission of this disease has been interrupted. Finally, after treatment and monitoring, countries stop the treatment intervention and watch for three years to ensure that there is no resurgence in transmission, and then apply for WHO certification that elimination has been achieved.
I was thrilled to be able to celebrate the long-term dedication and resulting accomplishment of all partners contributing to this milestone at an event at PAHO Headquarters last week. Health Ministers from the countries that have eliminated or will soon eliminate river blindness, technical advisors, and global policy leaders were specially recognized for the recent successes and spur motivation to run the race through the last mile all around the world. I was particularly moved when Dr. Etienne, Director of PAHO/WHO, invited me to share the frontline when she received the award. The outstanding accomplishment of the countries in the Americas comes at an excellent time, now that NTDs are officially identified in the recently adopted Sustainable Development Goals. The LAC region has hit the ground running.
Dr. Mirta Roses Periago is the Director Emeritus of PAHO/WHO and a Special Envoy for the Global Network for Neglected Tropical Diseases
The Latin American and Caribbean (LAC) region continues to inspire the world, showing how unwavering determination can help achieve public health elimination targets.
For example, earlier this year the Pan American Health Organization (PAHO) and other leading global health experts said goodbye to rubella in the Americas, a virus also known as German measles. This exciting accomplishment is the result of a concerted 15-year initiative to provide widespread provision of the MMR vaccine (measles, mumps and rubella).
Announced on April 30th, this historic achievement generated even more energy and excitement during Vaccination Week in the Americas (VWA), held during April 25th – May 2nd. VWA, a regional flagship initiative of PAHO, is an extraordinary effort led by countries to vaccinate people of all ages against rubella, measles, polio, pneumonia and other diseases. These vaccination campaigns are also used to deliver a package of life-saving health interventions, including Vitamin A supplements to boost children’s immune systems, deworming treatments that rid people of intestinal worms (a type of neglected tropical disease) and distribution of insecticide-treated nets to prevent malaria. The Guardian has highlighted VWA as one of five memorable public health movements that save millions of lives.
We are especially excited to celebrate these recent victories with a public health champion from Córdoba, Argentina, Dr. Mirta Roses, who recently visited the Sabin Vaccine Institute office in Washington, D.C. Holding medical and public health degrees, serving two terms as Director of PAHO and representing the LAC region on the Global Fund Board provides only a small snapshot of her passion for equitable access to health. We are proud to have her serve as Special Envoy for the Global Network for Neglected Tropical Diseases, speaking out on behalf of the hundreds of millions of people suffering unnecessarily from preventable diseases.
Dr. Roses began working at PAHO in 1984 – and became Director 20 years later. She took action quickly as Director, spearheading the first-ever Vaccination Week in the Americas in 2003. This annual campaign was inspired by the Sucre Agreement, signed 23 April 2002 by the Andean Ministers of Health (Colombia, Bolivia, Ecuador, Peru and Venezuela) plus Chile, recommending simultaneous implementation of their national immunization weeks. Following a 2002 measles outbreak in Venezuela and Colombia, this coordinated effort was planned to prevent future outbreaks across the Andean Region.
During the final stages of polio eradication in the Americas in 1991, Dr. Roses witnessed how the power of social communication and community involvement transformed vaccination campaigns into health celebrations. Entire villages, countries, leaders and celebrities were eager to participate, injecting a vibrant, dynamic energy into the campaigns.
Building off the momentum and success of this approach, annual Vaccination Weeks in the Americas helped create an even larger health celebration by sharing educational materials, screening for communicable and chronic diseases and delivering deworming treatments. This platform also helps early detection of NTDs, disabilities and micronutrient deficiencies.
As an example, in Honduras, the Ministry of Health uses this campaign to deliver deworming treatments to children across at the country alongside vaccines and other interventions. Honduras has also integrated water, sanitation and hygiene (WASH) practices, as well as vitamin A supplementation, as part of this effort. Since poor WASH contributes to increased intestinal worm infections, and intestinal worms can worsen and intensify malnutrition, integrating these three health interventions is essential for maximizing the health of children.
This unprecedented model caught the attention of people across the world. One by one, countries from all six WHO regions started employing the same approach – beginning with countries from the Eastern Mediterranean, reaching all the way to South-East Asia. By 2011, the World Health Organization made it official: World Immunization Week will happen every year during the last week of April.
These successes demonstrate the sharp and unwavering determination of people, communities and partnerships in the LAC region. We look forward to celebrating future success with Dr. Roses, PAHO and other partners, and inspiring other countries and regions to learn from lessons learned and best practices.
By Whitney McInvale and Alex Gordon
Earlier this this year, Director Emeritus of the Pan American Health Organization (PAHO), and Special Envoy for the Global Network for Neglected Tropical Diseases, sat down with the Diplomatic Courier – a leading global affairs magazine – to discuss her experience as the first female Regional Director of the World Health Organization (WHO), and her thoughts on the post 2015 development agenda and the Ebola crisis.
During her interview, Dr. Roses shared interesting insights from her distinguished career as a public health champion.
On being the only woman in the room…
“In my time at medical school, women were the minority. … And of course, almost all of the professors were male. Also in the hospital environment—with the exception of nurses, who were all female—the doctors were all male. That was the gender division of labor. But I think that my generation was the generation of change. We started occupying some of the positions that had never been occupied by women before.”
Dr. Roses elaborated that once men were ready to challenge gender norms, male bosses and mentors began to open doors for her. These opportunities, combined with her skilled and tireless work, led her to become the first woman regional director of the WHO. And now, more and more woman are taking top positions in the WHO, she explains.
“Today, we can say that we have a Regional Director in the Euro-region, also the first woman. The first female Regional Director in Southeast Asia, and the first female Regional Director for Africa was just elected in November. We also have a female Regional Director that succeeded me in the Americas. So now there are four female Regional Directors…and we have a female Director General, Dr. Margaret Chan.”
On her passion for eliminating neglected tropical diseases (NTDs)…
“I am also a Special Envoy for the Global Network for Neglected Tropical Diseases. [There is a] big coalition of many organizations working for the elimination of neglected tropical diseases in the world by 2020.
[NTDs] are mostly parasitic diseases that have been [with] humanity for thousands of years. Today, we have all the tools and knowledge to eliminate them. …they are still so related to poverty, to vulnerable people, and to excluded communities that we call them ‘neglected.’”
On the Post 2015 Development Agenda…
As the Millennium Development Goals (MDGs) come to a close, the Diplomatic Courier asked Dr. Roses to discuss her thoughts on what the forthcoming post-2015 development agenda will – and should – focus on:
“I think that the struggle is, again, to find a short list that will focus the attention of all countries on what the world requires to become more peaceful, more equitable, safer and more sustainable. I think that the concern about the environment is now right at the top. I think that the environment, along with peace, security and human rights, will become [more important] than they were in the MDGs.”
Dr. Roses has also voiced her support for the inclusion of NTDs in the post-2015 development agenda, stating that:
“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.”
On the Ebola crisis…
“There are also many lessons learned, particularly the fact that we need to strengthen health systems where the people are. If the people don’t have tools for everyday problems, including the delivery of babies, accidents, and so on, no one will be looking at the problem and no one will be able to respond to the problem.”
To read the full interview, click here.