According to the World Health Organization (WHO), an estimated 873 million children are at risk of soil-transmitted helminths (STH), including roundworm, hookworm and whipworm. In children, STH infections can lead to malnutrition, anemia and stunting. In both adults and children, they can cause fatigue, intense abdominal pain and chronic diarrhea. In severe cases they can even cause bowel obstruction, rectal prolapse and appendicitis.
To improve health and development in infected communities and reduce the prevalence of neglected tropical diseases (NTDs), WHO aims to control STH and schistosomiasis by 2020. Meeting this goal requires regularly deworming at minimum 75 percent of the preschool-age and school-age children who are at risk of STH or schistosomiasis. To ensure such an ambitious global goal is met, it is paramount that ministries of health, WHO and non-governmental organizations (NGOs) coordinate and share data.
WHO operates the Preventive Chemotherapy and Transmission Control (PCT) Databank, which tracks the number of children given PCT for STH, schistosomiasis and three other NTDs. The databank is populated largely by information reported by ministries of health and helps policymakers and implementers understand where deworming programs are active and where more interventions are needed to meet the WHO target of controlling STH and schistosomiasis by 2020.
However, gaps in the PCT Databank have become apparent. The 2013 STH preschool treatment data was recently revised when supplementary data was submitted by UNICEF. This data caused a 104 percent increase in the recorded number of preschool-age children treated for STH. Clearly, better coordination is needed to ensure the global community meets 2020 goals.
To facilitate better coordination among WHO, ministries of health and NGOs, the Children Without Worms (CWW).
After the data are compiled, WHO will merge the CWW database with national program data provided by ministries of health to the PCT Databank. This effort will make deworming dollars go even further by strengthening program monitoring and leading to an efficient use of resources. Ultimately, it will be an important step in controlling STH and schistosomiasis.
Efforts to fight Neglected Tropical Diseases (NTDs) are truly massive undertakings, since their success hinges upon the ability of national NTD programs to literally reach millions of people and provide each and every person with preventive medications.
Sierra Leone is one of many countries that has risen to this challenge. With a population exceeding 6 million people, the country’s NTD program relies on approximately 30,000 Community Drug Distributors (CDDs) to distribute NTD medications throughout its 12 rural districts.
And if recruiting, organizing and managing that many CDDs weren’t enough of a challenge, there’s one other detail that’s worth noting. Although these 30,000 CDDs must spend days, if not weeks, ensuring that their communities receive drugs that will prevent blindness, kidney and liver disease, malnutrition, and physical deformities, none receive any payment for their services.
In an effort to motivate and reward the CDDs for their important work and to reduce attrition, TOMS, a US-based, philanthropically minded company that has given away over 45 million pairs of shoes to children in over 70 countries. To date, Sierra Leone has received two shipments of TOMS Shoes—over 300,000 pairs –between 2013-2014 to distribute to the CDDS and their children.
In 2013, each CDD received three pairs of shoes for his or her family; this was increased to five pairs in 2014. Shoes were also distributed to others whose support has been instrumental to the success of the country’s NTD mass drug administration (MDA), such as community leaders, peripheral health unit (PHU) staff, and members of the district health management team.
From a logistical standpoint, ensuring that CDDs receive these shoes is almost as complex an undertaking as conducting the MDAs themselves for Helen Keller International (HKI), the sub-grantee organization that supports Sierra Leone’s NTD Program in partnership with END in Africa’s administrator, FHI360. First, HKI helps the National NTD Program determine the total number of participating CDDs and estimate the total number of shoes needed, as well as the number of pairs per size. An order is then placed with TOMS Shoes.
Once the shoes arrive at the Freetown port several months later, they must be trucked to six distribution points throughout the country. Shoes are then divided up by district; and the districts assume the responsibility for ensuring that their PHUs receive enough shoes for all the CDDs in their areas. Finally, the CDDs receive shoes for themselves and their children.
The children are ecstatic about getting a new pair of TOMS Shoes. Eight-year-old Fatmata remembers the day she received her pair of TOMS Shoes: “My old shoes are worn out and I was thinking if my parents can afford to buy me another pair of shoes before the opening of school.” Her grandfather appreciated their value as well, noting that they’ll not only motivate Fatmata to go to school, but they’ll also help reduce her risk of hookworm infection from walking barefoot.
Despite the challenges, the National NTD Program and HKI officials agree that getting shoes to each of the CDDs is well worth the considerable effort it takes to administer the initiative. After all, the National NTD Program would not be able to conduct MDAs without the CDDs; indeed, their success hinges on the work of the CDDs. Without their commitment and hard work, millions of persons would still be suffering from preventable and treatable diseases.
HKI and Sierra Leone’s NTD Program look forward to continuing to partner with TOMS, and plan to distribute additional TOMS shoes in 2015.
This blog was originally published by End Neglected Tropical Diseases in Africa.
Photo: Wearing her new TOMS shoes, Fatmata gets a hug from her father, a volunteer who distributes medicines to prevent NTDs in Sierra Leone. Credit Helen Keller International
This afternoon, global health leaders new report highlighting gains over the past two years.
Dr. Margaret Chan, Director-General of the World Health Organization; Bill Gates, Co-chair of the Bill & Melinda Gates Foundation; and several other expert panelists including Chris Viehbacher, CEO of Sanofi; Dr. Onésime Ndayishimiye, National Director of Burundi’s Neglected Tropical Disease & Blindness Control Program; and French Minister of Social Affairs and Health, Hon. Marisol Touraine, announced deepened commitments for efforts to control and eliminate the most common NTDs by 2020 including a $120 million pledge from the World Bank, a new collaboration to combat soil-transmitted helminthes (STH) and accelerated research and development efforts lead by pharmaceutical companies in conjunction with nonprofits.
The broad reach and attention of today’s event signals the fact that controlling and eliminating NTDs is embraced by a global community of national leaders, policy makers and donors. In addition, there is broad recognition that addressing NTDs is a crucial component of eliminating poverty and achieving development goals.
Echoing this fact, Dr. Tim Evans, World Bank Director of Health, Nutrition and Population stated during the event that NTDs are major constraints to development and addressing them will boost shared prosperity.
As detailed in the Uniting to Combat NTDs report and score card, progress on NTDs has accelerated quickly over the past two years. Pharmaceutical companies are now meeting 100 percent of requests for drugs, and endemic countries taking ownership of NTD programs. To date, 74 countries – roughly two-thirds of all NTD-endemic countries – have now developed national plans to help guide their control and elimination efforts.
Of particular note, Nigeria and Ethiopia, two countries with high NTD burdens, made national commitments to end NTDs. Nigeria launched its master NTD plan in February with the goal of providing treatment to more than 60 million people annually over the next five years. Ethiopia, the country with the highest trachoma burden, launched its national plan in June 2013. Success in Nigeria and Ethiopia would significantly decrease the global burden of NTDs worldwide.
click to view larger) shows a steady increase in drug donation and delivery, only 36 percent of people in need received all the drugs they needed in 2012. Mobilizing more financial resources to support program implementation, doing more to leverage the value of donated drugs and increasing collaboration across sectors are just a few ways the global community can further accelerate progress.
While donors, pharmaceuticals and NGOs are an integral part of the solution, endemic countries will drive progress forward by continuing to develop, own and implement their programs in a sustainable way.
“I always believe in country ownership, Dr. Margaret Chan said. “Were here to support your efforts.
We applaud the work done by endemic countries, NGOs, pharmaceutical companies, multilateral organizations and the Bill and Melinda Gates Foundation, and look forward to the path towards 2020.
Click to view the full report.
Two years ago, global health leaders convened in London to hold the most significant international meeting on neglected tropical diseases (NTDs) in history. The event galvanized major commitments from a diverse set of partners to eliminate or control 10 NTDs by 2020 – these commitments are now known as the London Declaration.
This Wednesday on April 2nd, The Global Network will once again join this unique group of partners to discuss progress toward the promises made in 2012.
Since the London Declaration on NTDs, The US, UK, and the World Bank have deepened their commitments, and NTDs are now being prioritized in global health and development agendas. In addition, control, prevention and research efforts for NTDs have expanded.
The London declaration also sparked new collaboration between public and private partners. These partnerships are identifying innovative, concrete solutions for delivering good health and strong economic futures to the world’s poorest people.
The progress we’ve seen since 2012 is also due in large part to the work of endemic countries in drafting and implementing national NTD plans. Through their national plans, countries burdened by NTDs are funding and driving their own solutions.
We invite you to tune into a live webcast of the April 2nd event in Paris. You’ll hear from Bill Gates, Co-chair, Bill & Melinda Gates Foundation, Dr. Margaret Chan, Director-General, World Health Organization, along with other distinguished panelists.
Feel free to tweet about the event using the hashtag #NTD progress. The live webcast will run from 12:00 to 1:30 EST. To tune in, click here.