This spring, we awarded nearly $400,000 in new grants for neglected tropical disease (NTD) control and elimination activities in 2016.
This funding is made possible by generous donations to END7, an international advocacy campaign that seeks to raise the awareness and funding necessary to control and eliminate the seven most common NTDs. The campaign is managed by the Global Network for Neglected Tropical Diseases and 100% of donations to the END7 campaign go straight to NTD programs. Donations to Sabin Foundation Europe, a partner of the U.S.-based Sabin Vaccine Institute and the Global Network also helped make these grants possible.
The grants will make a significant impact in supporting integrated NTD programs in six countries. All projects are coordinated with Ministries of Health and/or the World Health Organization in each country. Many of the projects include mass drug administration (MDA) for the most common NTDs and training of health care workers. These projects are expected to benefit nearly six million individuals at risk from NTDs and train tens of thousands of health workers and volunteers to lead the NTD control and elimination effort into the future.
Awarded to existing efforts that faced a funding gap, these projects will have a lasting impact on improving and expanding existing programs to reach ambitious NTD control and elimination goals in Africa, Asia and Latin America – the regions with the largest NTD burden:
$50,000 to support integrated MDA for seven NTDs, administered by Sightsavers with the support of the Federal and Kebbi State Ministries of Health. Nearly 5.9 million people will receive donated medicine in Kebbi state, in northwest Nigeria, where all seven NTDs are widespread. Sightsavers will continue their successful MDA in the region and expand to new areas.
$66,200 to support the first integrated MDA in five regions of southwestern Somalia by the new NTD Program of the Ministry of Health and Human Services. The MDA will target schistosomiasis (snail fever), ascariasis (roundworm), hookworm and trichuriasis (whipworm) among school-age children and adults in areas of high prevalence. The NTD Programme was established in 2015; success this year will help scale up the delivery of donated medicine to the rest of the country.
$28,789 to support water, sanitation and hygiene education to prevent NTDs in Cote d’Ivoire, administered by Helen Keller International. More than 7,000 health workers, school teachers and community health volunteers will be trained to reach more than 2.5 million people.
$111,146 to support MDA to eliminate lymphatic filariasis in the most populous region of the country, administered by the Pan American Health Organization and the Ministry of Public Health. Guyana is on track to eliminate lymphatic filariasis (also known as elephantiasis) by 2020. These funds were raised for END7 by the Sabin City Group in London.
$60,546 to assist a local NGO, Churches Auxiliary for Social Action (CASA), to expand their successful efforts to treat and prevent lymphatic filariasis to West Bengal. This grant will enable CASA to train community members to manage the swelling and disability that often results from later stages of lymphatic filariasis. Each infected patient will receive a hygiene kit with soap, a towel and antifungal ointment and be shown how to care for themselves to reduce swelling. CASA will also promote the government’s annual MDA targeting 500,000 people for lymphatic filariasis treatment in West Bengal.
$75,645 to assist the Department of Public Health to determine where MDA for lymphatic filariasis has succeeded and can be concluded. Nine districts with a population of nearly 7 million have already conducted more than five rounds of MDA for lymphatic filariasis. Officials will determine whether transmission has been interrupted.
The Global Network team reviewed 37 proposals from a range of partners tackling NTDs around the world and selected projects with the potential to have the most lasting impact, leverage further investment and bolster country-led efforts to eliminate NTDs.
To date the Global Network has awarded more than US$1 million in grants to 19 partners. From individual donors contributing $5 a month to student groups raising $10,000 over the course of a school year, the END7 campaign has mobilized a diverse and growing community of supporters from countries around the world dedicated to supporting the fight against NTDs. Together, these contributions are moving the NTD elimination effort forward by helping communities set up treatment programs they can run themselves. END7 supporters fill funding gaps in successful NTD treatment programs, highlighting the tremendous impact of this inexpensive treatment and the power of partnership in the fight against NTDs.
by Navneet Anand and Anuradha Singh, GreyMatters Communications
Recently Global Network for Neglected Tropical Diseases (GNNTD) partnered with us at GreyMatters Communications to run a media awareness program on Lymphatic Filariasis (LF) in India. We took a group of journalists to two affected villages in Odisha to provide them exposure about the problem as well as help them evaluate challenges towards its complete elimination.
The Global Network for Neglected Tropical Diseases, an initiative of the Sabin Vaccine Institute, works to raise the awareness, political will and funds necessary to control and eliminate neglected tropical diseases (NTDs).
Often falling beyond the purview of mainstream media, like many other compelling problems in the country, LF has severe enormity and has persisted in India as well as other countries of the world for many years.
Not many would be aware that LF is the world’s second leading cause of long-term disability. Although filariasis does not kill, it causes debility and imposes severe social and economic burden to the affected individuals, their families and the endemic communities. According to one estimate at one point in time 120 million people in 83 countries of the world were infected with lymphatic filarial parasites, and it was estimated that more than 1.1 billion (20% of the world’s population) are at risk of acquiring infection. Over 40 million people are severely disfigured and disabled by filariasis and 76 million are apparently normal but have hidden internal damage to lymphatic and renal systems. According to the World Health Organization, India, Indonesia, Nigeria and Bangladesh alone contribute about 70% of the infection worldwide.
Indigenous lymphatic filariasis cases have been reported from 20 States/UTs across 250 districts which were identified as endemic for filariasis with a population of about 600 million at risk. In India, a special program to eliminate lymphatic filariasis was launched in 2004 covering 202 endemic districts in 20 States/Union Territories and subsequently scaled up to cover all the 250 (now 255) endemic districts targeting a population of about 600 million.The population coverage during MDA has improved from 73% in 2004 to 83% in 2013, according to a document on National Roadmap for Elimination of LF by Ministry of Health.
It is rather heartening to note that the overall microfilaria rate has reduced from 1.24% in 2004 to 0.29% in 2013 (Prov.) at national level. Out of 250 districts 203 districts have reported overall microfilaria rate to less than 1%. Out of remaining 52 districts, 31 need high priority for focussed intervention as these districts have been persistently reporting microfilaria rate above 1%. Ganjam and Puri in Odisha, where we travelled, are also among the high-incidence districts in the country.
It was rather painful to come across two cases of Lakhender Swain and Kointa Swain in Kapileshwarpur village in Puri. Afflicted with this distressing disease, the two have wasted their most productive years attending to deal with this disabling disease. “I had a dream for my life but the tyranny of this disease was such that I was rendered helpless. For over 20 years now, I have lived with this heaviness in the leg and associated problems including social taboos and boycotts,” rued Lakhender, who is 45 only. Kointa, in her 60s, recalls how at one point she was extremely active and used to work “effectively” till destiny willed otherwise.
“NTDs like lymphatic filariasis hold people back not just physically, but also socially. Misunderstandings about what causes the disease, how it is transmitted and what its effects are can lead to stigma and social exclusion. This lack of understanding can cause communities to push LF patients to the margins, excluding them from employment or educational opportunities, from community festivals or celebrations and making it difficult to marry. The impact can go beyond the LF patient to also affect family members of LF patients. Self-stigma is also a problem and can impact a patient’s mental health. Social isolation compounds the impact of the infection, keeping people from trying to achieve their aspirations or have hope for the future. Although LF tends to be visible in rural and poor communities, LF is spread through mosquitos, like dengue and malaria, so anyone can be infected,” said Nandini Pillai, Programs and Operations Officer, GNNTD.
However, thanks to some serious and sustained intervention by the government as well as work by agencies like GNNTD as well as NGOs like CASA (Church’s Auxiliary for Social Action), the problem is well contained and India may well be on the verge of soon eliminating the disease altogether.
One of the key programs of the Government is Mass Drug Administration where all those at risk are administered medicine free of cost.
“The treatment is a weight-based dose of diethylcarbamizne (DEC), and a single pill of albendazole, to everyone over the age of 2 years and not ill or pregnant. Both drugs are anti-parasitic medications which prevent and expel parasites. These medicines also protect from intestinal worm infections. The treatment is safe and free and delivered to communities through ASHA workers and other community-based drug distributors. The drugs are donations from major pharmaceutical companies, like GlaxoSmithKline (GSK), or procured in India from WHO approved companies. They are completely safe,” informed Shaliesh Vaite, National NTD Advisor, GNNTD.
The 2015 MDA is underway nationwide from December 14-20.
The medical approach to defeating NTDs is through a set of medications donated by major pharmaceutical companies for free distribution to communities in need. “In India, state governments locally procure some medications and submit their requests for donated drugs to the central government, which then works with WHO to order and deliver the drugs. Community drug distributers are responsible for going door to door to hand out the drugs and ensure that people take them properly. This grassroots method for treating and protecting against NTDs takes the partnership of the whole community working in tandem, and ensures that nobody is left behind,” added Kelly Toves, Communications Officer, GNNTD.
Along with this, if media also undertakes to write more often and inform people about the ways to deal with this scourge, the process of elimination will be faster.
This post was originally published on Communicate, Connect.
Each month, END7 honors one student who has made a significant contribution to our growing movement of student advocates dedicated to seeing the end of NTDs. We are very proud to introduce our October 2015 Student of the Month, Ishmael Tamba Jalloh, a pharmacy student at the University of Sierra Leone College of Medicine and Allied Health Sciences. Ishmael joined the END7 Campus Leaders Council to raise awareness of neglected tropical diseases (NTDs) in Sierra Leone by engaging students at his university in community engagement and outreach to local leaders.
As we reported while profiling Sierra Leone for our NTD Success Stories series last month, six NTDs are found in all 14 health districts in Sierra Leone, threatening nearly the entire population of the country. Strong leadership from Sierra Leone’s Ministry of Health and in-country partners has helped drive tremendous progress against NTDs like lymphatic filariasis (LF), also known as elephantiasis. More than 57 million NTD treatments had been delivered nationwide by the beginning of 2014, putting the country on track to begin the World Health Organization process of verifying the elimination of lymphatic filariasis (LF) in eight of 14 health districts. Unfortunately, when the West African Ebola epidemic reached Sierra Leone in May 2014, all public health program activities were suspended — including mass drug administration (MDA) for NTDs.
One year later, with the Ebola epidemic receding, MDA restarted in Sierra Leone. Just this month, from October 9-13, the Ministry of Health’s NTD Program, through the District Health Management Team, ran an MDA campaign targeting 1.4 million people with drugs for LF and soil-transmitted helminths (STH). Ishmael volunteered to assist with the MDA, putting his pharmacy education at the service of his community. He shares:
“The mass drug administration campaign ran from October 9th to the 13th. Before the start of the campaign, there was a training for all the health workers and volunteers at the Murray Town Community Health Center [pictured above]. After the training, we were divided into pairs (a health worker and a volunteer) and sent to various communities in Ward 390, Constituency 111, in the western part of Freetown, the capital of Sierra Leone.
“At the start of the drug administration, my team targeted a secondary school, the Sierra Leone Grammar School, in the Murray Town community. At the school, we administered albendazole and ivermectin as a prophylactic treatment for elephantiasis to 850 pupils and 50 teachers. For the remaining days of the MDA campaign, I worked in a slum community called Cockle. In that community, we targeted 1,500 residents for drug distribution.
“During the campaign, we used a measuring rod as a guide for the dosage we should give [pictured left]. If the individual’s height was at the 4th mark, we administered 4 tablets of ivermectin and a tablet of albendazole; if the individual’s height was at the 3rd mark, we administered 3 tablets of ivermectin and a tablet of albendazole, and so on with the second and first marks. This made it easy to give everyone the proper dose to keep them safe from elephantiasis.
“During the campaign, I found out that people are only aware of one out of the seven neglected tropical diseases — elephantiasis, which is called ‘Big Foot’ in our local language. Now, I am thinking that more work needs to be done about all of the NTDs in Sierra Leone.
“Also, during the campaign, I met an 18-year-old girl named Isatu who for the past two weeks has been developing signs of elephantiasis. Her family are saying her swollen legs are caused by witchcraft or black magic, but I advised them go to the hospital and have Isatu be tested for elephantiasis. I hope she receives the treatment she needs, and I am glad to have met her during the campaign.
“All in all, our campaign targeted 1.4 million people in Freetown. I hope my contribution to the campaign made a difference.”
Now, Ishamel is working to establish the first END7 chapter in Africa at the University of Sierra Leone. We are so grateful for Ishmael’s commitment to the fight against NTDs in Sierra Leone and around the world, and we are excited to see our community of student supporters like him grow. If you are ready to get your school involved in END7’s work, contact the END7’s student outreach coordinator at Emily.Conron@sabin.org to learn how you can get started!