Category Archives: NTDs

National Science Academies Urge G7 Leaders to Address NTDs

 

 

In advance of every G7 summit, the national science academies of the G7 countries prepare policy statements on the priority issues identified by the G7 host country. This year, the national science academies delivered statements on neglected tropical diseases, antibiotic resistance, and the future of the ocean.

In the statement on NTDs, they note that progress on NTDs “would be a major step towards alleviating poverty.”

NTDs affect the world’s poorest people and place an economic burden on low and middle-income countries. The academies called on G7 leaders to support efforts to reach WHO control and elimination targets by 2020:

“In principle, NTDs are preventable, treatable, controllable and some even eradicable. Moreover, most interventions against NTDs are highly cost-effective. To make progress toward preventing, controlling and eliminating NTDs, the G7 Academies of Sciences call for: (1) increasing efforts to empower and build capacity in affected countries to deal with these diseases, (2) intensifying research on NTDs, (3) developing and delivering affordable and accessible treatments, and (4) NTDs to be fully accounted for in the Sustainable Development Goals.

Much more needs to be done with a much greater urgency to reach the 2020 targets for all major NTDs. The specificity of diseases as well as the likely adverse impacts of severe climate events, risks of conflicts, increasing mobility/migration, and political instability need to be taken into account when developing strategies for tackling the NTD challenges. NTDs should be fully accounted for in the Sustainable Development Goals.”

Chancellor Angela Merkel, who carries the G7 Presidency this year, invited representatives of the national science academies to a G7 dialogue forum to share their scientific expertise in advance of the 2015 G7 Summit, to be held in June in Schloss Elmau, Bavaria. The event was hosted by Leopoldina, the German National Academy of Science.

In his keynote speech at the G7 Dialogue Forum Science Conference on April 30th, Professor David Molyneux addressed NTDs and the work still needed to achieve the control and elimination goals outlined at the London Declaration in 2012.  Professor Molyneux is a Sabin partner and professor at the Liverpool School of Tropical Medicine where NTDs are a major focus of research. In his speech, he highlighted the need for increased aid to combat NTDs — only 0.6% of overseas development assistance is allocated to NTDs.

Professor Molyneux said that policy makers must be convinced that NTDs are the markers of poverty, that control of these diseases reflect the capacity of health systems to ensure healthier communities and by default reduce the burden of poverty. He argued that addressing the “chronic pandemic of NTDs” requires capacity at all levels across the broad spectrum of health sciences.

After receiving the statement from the academies, Chancellor Merkel responded with a call to strengthen the WHO’s ability to combat disease. “I will attend the World Health Assembly in May, and neglected tropical diseases are on the agenda this year. This will hopefully help to encourage Member States to persevere in the fight against these terrible diseases, especially since simple treatments and measures are often enough to prevent them.”

As the G7 Summit approaches, we hope world leaders heed the national science academies’ call to develop and deliver affordable and accessible treatments for NTDs, and support multilateral efforts to address NTDs as part of the Sustainable Development Goals and the post-2015 development agenda.

Can We Nudge the Budget? Our Experience at the END7 Student Advocacy Day

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By Anjali Bhatla, Cyrus Ghaznavi and Sri Gopakumar
Rice University Undergraduates 

On a bright spring morning in Washington, D.C., we stood outside the U.S. Capitol in the middle of a whirlwind, 32-hour trip from Houston, Texas.  As we stood in the clearance line to enter the Capitol Visitors Center, we reviewed our materials to prepare for a day of meetings with congressional offices to advocate for a global health issue that each of us has become very passionate about. When we were invited by the Global Network to attend the first-ever END7 Student Advocacy Day on April 22, we realized that this would be a rare opportunity for us to get involved with the political process surrounding the federal budget  and lend our voice in support of neglected tropical disease (NTD) treatment.

This semester, we founded a campus chapter of the END7 campaign at Rice University after we were all separately introduced to the issue of NTDs by Dr. Peter Hotez, President of the Sabin Vaccine Institute, the founding dean of the Baylor College of Medicine National School of Tropical Medicine in Houston and a Baker Institute Fellow in Disease and Poverty at Rice University. Whether it was through working for Dr. Hotez or taking his seminar class, the three of us have been deeply moved by what he has taught us about NTDs – an important but neglected global health issue.

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NTDs have been shown to perpetuate the cycle of poverty by impairing physical and cognitive development, decreasing economic productivity, negatively affecting maternal and child health, and socially stigmatizing those that are afflicted. END7 at Rice is taking a three-pronged approach to addressing the need for greater investment in NTD prevention and treatment through committees focused on marketing, fundraising and advocacy. To increase awareness of NTDs in our community, we plan to implement creative events, programming and social media campaigns across campus.  And, through our END7 chapter, we hope to facilitate an exchange of ideas on how to address health disparities in the developing world.

We are particularly concerned about the funding gap for NTD treatment programs. The United States Agency for International Development (USAID) Neglected Tropical Disease program has been essential in providing NTD treatments around the world – more than 1.2 billion to date – but proposed cuts to the program’s funding in the fiscal year (FY) 2016 budget could stifle and potentially reverse the progress already made by the program to the NTD elimination effort. Having just started Rice’s END7 chapter, we decided that going to DC would teach us valuable lessons we could bring back to Houston and provide us with a greater context for our chapter’s goals.

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On the morning of the event, we gathered in a wood-paneled conference room in the Capitol Visitors Center and received a briefing on the global effort against NTDs from leaders of the Global Network, USAID, RTI International and WASH Advocates. Then we split into small groups for our afternoon meetings in congressional offices with each person taking on a particular role. One student would provide some background for their involvement in the END7 campaign: “I’ve been able to travel to countries including Haiti and India, where NTDs are endemic, and have seen firsthand the socioeconomic impacts these diseases have.” Another would carefully lay out the key statistics: “1 in 6 people are infected with an NTD!…more than one billion people in all!…every $1 of taxpayer funding leverages $26 worth of donated drugs, an incredible return on investment!” A third student would paint a holistic picture of the budgetary issue at hand and hammer in the final message: “Funding the USAID NTD Program is critical to solving this global health problem. Maintaining our momentum is essential and we don’t want to lose the good work we’ve done.” Then we answered questions about NTDs and USAID’s work to educate our leaders and their staff about this key global health issue. We concluded our meetings by inviting members of Congress to join either the Senate Caucus on Malaria and Neglected Tropical Diseases or the Congressional Caucus on Malaria and NTDs (one U.S. Representative joined that same day!) and delivering student signatures on END7’s petition to increase NTD funding to $125 million in FY 2016. (We had collected nearly 200 signatures on our campus alone!)

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At the end of the day, our time on the Hill brought the conversation surrounding NTDs alive for us in a new way. We learned so much during our time in Washington that we didn’t mind missing a few classes (even though finals were just around the corner!). Advocating alongside leaders of the Global Network for Neglected Tropical Diseases and fellow student supporters of the END7 campaign in meetings in congressional offices opened our eyes to the importance of public policy in the fight against NTDs. As aspiring physicians, we hope to become civically minded professionals who can communicate information effectively to our lawmakers. By engaging in the political process during the END7 Student Advocacy Day, we learned the importance of the student voice in advocating for NTD treatment. We genuinely hope that our message was well-received: the USAID NTD program budget is a best buy in global health and increased funding is needed to allow the progress of USAID’s NTD program to continue. We are excited to see that the 24 Hill meetings students participated in on April 22 have already made an impact, with the addition of a new representative to the Congressional Caucus on Malaria and NTDs and positive signs of increased support from key leaders. As students around the country mobilize around this cause, we hope the U.S. government takes a leading role in prioritizing NTD funding in the FY2016 budget and contributes crucial resources toward the NTD fight. We hope to return to D.C. next year to continue engaging in the political process as citizens, students and future medical professionals dedicated to seeing the end of NTDs.

You can support END7’s advocacy to protect and increase the USAID NTD budget by sending a message to your Senator. Learn more in our infographic and this Buzzfeed post created by student supporters and be sure to check out the END7 Student Advisory Board’s op-ed in the Hill!

NTD Article Round-Up

 

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Starting this month, the Global Network will be presenting a round-up of articles on neglected tropical diseases (NTDs). Check back every month for the latest. To suggest an article, you may post a comment below.

1. Unprogrammed Deworming in the Kibera Slum, Nairobi: Implications for Control of Soil-Transmitted Helminthiases

PLoS Neglected Tropical Diseases – Published to PubMed 3/12/15
Julie R. Harris, Caitlin M. Worrell, Stephanie M. Davis, Kennedy Odero, Ondari D. Mogeni, Michael S. Deming, Aden Mohammed, Joel M. Montgomery, Sammy M. Njenga, LeAnne M. Fox, David G. Addiss

“In countries with endemic soil-transmitted helminth infections, deworming medications are widely available from multiple sources, including over the counter. However, in many countries, national programs already provide deworming medications in mass drug administrations to primary school students, as part of World Health Organization recommendations. Evaluations of the effectiveness of such medications at reducing worm burden in children is based solely on the national program’s distribution schedules, primarily because little is known about how frequently deworming medications are obtained from other sources. We investigated sources of deworming medications received by children in a Kenyan slum, finding that more than half of school-aged and preschool-aged children received deworming medications outside of a national school-based deworming program. These drugs were received from multiple sources, including chemists, healthcare centers, and at schools, via the efforts of non-governmental organizations. These data strongly indicate a need to collect data on all sources of deworming medications when evaluating the effectiveness of national school-based deworming programs.”

2. Mass Drug Administration for Trachoma: How Long Is Not Long Enough?

PLoS Neglected Tropical Diseases – Published to PubMed 3/23/15
Violeta Jimenez, Huub C. Gelderblom, Rebecca Mann Flueckiger, Paul M. Emerson, Danny Haddad

“Trachoma, the world’s leading infectious cause of blindness, is scheduled for elimination by 2020. Reaching this elimination target depends on successful implementation of the SAFE strategy (Surgery, Antibiotics, Facial cleanliness, and Environmental improvements). Annual mass antibiotic distributions are key to breaking the cycle of transmission in a community. However, it is not clear how many annual mass treatments need to be carried out in order to achieve elimination. Our study analyzes the effect of mass antibiotic distribution on different baseline prevalence levels of trachoma, in order to assess factors that affect the success of reaching elimination goals. We find that the prevailing belief, which suggests that 3 annual mass treatments can achieve local elimination of trachoma at prevalences between 10–30%, and 5 annual mass treatments for districts above this benchmark, is probably incorrect. In fact, much longer intervals may be required with “business as usual” programmatic strategies, which often include skipped years of treatment. Districts with high prevalence levels may require more intense treatment strategies to eliminate trachoma. Intensified recommendations must be implemented without delay in order to reach the 2020 elimination deadline.”

3. Neglected Tropical Disease Control and Elimination: Is Human Displacement an Achilles Heel?

PLoS Neglected Tropical Diseases – Published to PubMed 3/19/15
Kaylee Myhre Errecaborde, William Stauffer, Martin Cetron

“The United Nations High Commission for Refugees (UNHCR) has estimated that over 40 million people are currently displaced and have variable access to health care in the country in which they reside. Populations displaced by conflict are largely disenfranchised, and high prevalence of neglected tropical diseases (NTDs) has been documented. NTDs generally affect the least advantaged people in poor societies—populations with little voice or representation. These already susceptible people become even more vulnerable when forced from their communities as internally displaced persons (IDPs), refugees, or forced migrants. To further complicate matters, many of these people of concern are under 18 years old. Children experience the greatest risk and suffer the most consequences of NTDs. As marginalized populations flee from conflict or environmental catastrophe, they are often burdened with insidious NTDs ranging from asymptomatic to overt and debilitating disease. Many suffer from chronic consequences such as malnutrition, growth stunting and developmental delays, inhibiting chances for sustainable livelihoods and making it less likely that they will successfully overcome the adversity.”

4. Gut Instincts: Knowledge, Attitudes, and Practices regarding Soil-Transmitted Helminths in Rural China

PLoS Neglected Tropical Diseases – Published to PubMed 3/25/15
Louise Lu, Chengfang Liu, Linxiu Zhang, Alexis Medina, Scott Smith, Scott Rozelle

“Soil-transmitted helminths (STHs) are parasitic intestinal worms that infect more than two out of every five schoolchildren in rural China, an alarmingly high prevalence given the low cost and wide availability of safe and effective deworming treatment. Understanding of local knowledge, attitudes, and practices regarding STHs in rural China has until now, been sparse, although such information is critical for prevention and control initiatives. This study elucidates the structural and sociocultural factors that explain why deworming treatment is rarely sought for schoolchildren in poor villages of rural China with persistently high intestinal worm infection rates. In-depth, qualitative interviews were conducted in six rural villages in Guizhou Province; participants included schoolchildren, children’s parents and grandparents, and village doctors. We found evidence of three predominant reasons for high STH prevalence: lack of awareness and skepticism about STHs, local myths about STHs and deworming treatment, and poor quality of village health care. The findings have significant relevance for the development of an effective deworming program in China as well as improvement of the quality of health care at the village level.”

Training Session Improves Prevention and Treatment of Podoconiosis for People of Cameroon

 

A podoconiosis patient practices good hygiene. Credit: Footwork

A podoconiosis patient practices good hygiene. Credit: Footwork

Guest blog post by Wendy Santis, Footwork Executive Director 

Twenty-five members of Cameroon’s Ministry of Health, and nurses and leaders from Mbebah Vigilantic Farming and Development Association — a community development NGO in Northwest Cameroon — received training this past December in podoconiosis diagnosis, prevention and mitigation.

Podoconiosis, a type of elephantiasis spread by chronic exposure to irritant soils, has been reported in over 15 countries across tropical Africa, Southeast Asia, and Latin America in volcanic highland zones, and is an important cause of tropical lymphedema. This neglected tropical disease (NTD) is primarily found in remote rural areas where subsistence farmers typically work in the fields barefoot. It causes progressive bilateral swelling of the lower legs. It is not infectious — no virus, bacterium or parasite is responsible.

The exchange training visit in Cameroon, which aimed to strengthen the Northwest region’s ability to control podoconiosis, was funded by Footwork: The International Podoconiosis Initiative (a project of New Venture Fund, a 501c3 public charity), Brighton and Sussex Medical School and International Orthodox Christian Charities (IOCC). Participants included three IOCC staff who are involved in podoconiosis prevention and treatment programs in Ethiopia: Hari Desta, Tsige Amberbir and Abreham Tamiru. They, plus Footwork Executive Director Wendy Santis, worked with Professor Samuel Wanji’s team from the University of Buea/Research Foundation for Tropical Disease and Environment.

podo2Since 2009, IOCC, in collaboration with Gail Davey, Professor of Global Health Epidemiology at Brighton and Sussex Medical School, and Footwork’s founder, has developed a scalable model to address podoconiosis with an aggressive prevention and treatment program in Ethiopia, where more than three million people suffer from this debilitating disease of the feet and legs and another 38 million are at risk. Through this IOCC model, more than 300,000 children and adults have been assisted through awareness, prevention and treatment efforts.

Data and recommendations are being shared with Cameroon’s Ministry of Health planners to inform policy decisions regarding community-based management of morbidity due to podoconiosis with the goal of eliminating podoconiosis in the region and the country. A Northwest region podoconiosis advocacy committee has been formed to further these efforts.

This work is extremely important, considering two million people (10 percent of Cameroon’s population) are at risk of podoconiosis. Mapping in Northwest Cameroon has demonstrated that podoconiosis is endemic in this region. Several thousand people are affected with a mean prevalence of 1 percent. Further mapping is planned.

To learn more about Footwork and podoconiosis, visit: www.podo.org.

In addition to Cameroon, Footwork is active in Ethiopia and plans to work in Uganda and Rwanda, among other countries. It encourages integration of podoconiosis control into efforts to eliminate other NTDs, and works with those active in other related diseases of the foot and leg.

  • Our shared goal is to eliminate podoconiosis within our lifetimes.
  • Our vision is a world free of podoconiosis in our lifetimes.
  • Our mission is to bring together public and private partners to support prevention and treatment of, and advocacy for, podoconiosis.