I cant 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 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
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.
Last week, I was very excited to see that Paraguay’s Ministries of Health and Education, in collaboration with the Pan American Health Organization (PAHO) aimed to treat more than 1.4 million school children, as well as homeless and indigenous populations, for intestinal worms during a four-day deworming campaign. This year’s campaign marks a significant scale-up from last year’s effort which reached 700,000 school children in comparison.
In order to double the outreach from previous campaigns, they spread the word in a number of ways, including through social media. Thanks to visual informational materials, and even the creation of a friendly mascot, children across the country were motivated to take deworming medicine.
Intestinal worm infections disproportionately affect the poor in Paraguay. More than 50 percent of Paraguayan households lack access to clean water and sanitation, exacerbating the spread of neglected tropical diseases (NTDs) like intestinal worms.
These infections rob children of nutrients and energy and can lead to anemia and malnutrition, preventing them from going to school and undermining their potential to learn and succeed. But thanks to Paraguay’s expanded efforts to treat and control intestinal worms, more and more children will benefit from improved health. As girls grow up free of worms, well-nourished and better educated, they will also become better prepared for a healthy pregnancy and a successful delivery of healthy babies.
Last week’s campaign, launched in the City of San Lorenzo on August 4th, promoted the importance of proper hygiene and sanitation in addition to distributing deworming medicine. Regular hand washing, increased use of toilets and latrines and washing fruits and vegetables are essential to help prevent the spread and reinfection of intestinal worms.
The government of Paraguay, PAHO, municipal governments, school teachers, and parents all played a role during the campaign and helped promote hygiene practices by sharing materials and conducting trainings. To ensure that rural populations also received medicines and educational materials, national health teams worked closely with local health departments as well. We congratulate the leadership of the Ministries of Health and Education for this innovative and collaborative work.
Paraguay’s 2014 deworming campaign demonstrates the country’s commitment to controlling and eliminating NTDs. However, Paraguay can do more to lessen the unnecessary suffering caused by NTDs.
Efforts need to be made to map the prevalence of intestinal parasites, track and report existing deworming efforts, and focus on establishing programmatic collaborations with neighboring countries Bolivia and Argentina to implement NTD efforts in the cross-national Chaco Region where many communities of indigenous people are living in extremely poor conditions. With a strong commitment to maintain these activities, Paraguay’s children will benefit from a healthier and more prosperous country.
Last week, during the Pan American Health Organization’s (PAHO) 52nd Directing Council, NTD Special Envoy Álvaro Arzú, mayor of Guatemala City and former President of Guatemala, was asked to comment on the challenges of controlling and eliminating neglected tropical diseases (NTDs) in the region of the Americas. The interview (in Spanish) can be found below and you can read on to see what was discussed. To read more about the NTDs discussions held during the 52nd Directing Council, read our recap here.
PAHO: What are the challenges for mobilizing the agenda of neglected diseases in the region of the Americas?
NTD Special Envoy Álvaro Arzú: I think the biggest challenge is giving the issue the real importance it deserves. Indeed, when I was President, I was not informed of the relevance that neglected diseases have, that these diseases exist, and that they can be treated at a very low cost. But by not treating these diseases – their impact on the economy of a country is vast. If I had been told that story, I would have taken action.. So I think that the first and major challenge is to communicate to the heads of government and the people in decision-making positions, about the importance of coordinating a joint effort to distribute these drugs, which are very cheap and most are actually donated by pharmaceutical companies. And what is needed are the logistics to reach the communities that are in need of this medicine, which treats NTDs that are often overlooked because they are most prevalent in areas of extreme poverty. But today we know that a pill that costs 50 cents can treat and protect a person for one year. Now you can have a more or less definite solution.
PAHO: What is PAHO’s role in the fight against these diseases?
NTD Special Envoy Álvaro Arzú: Well, [it is] very important, because its role is precisely to coordinate all government agencies in the countries where we are still vulnerable to these diseases – to coordinate everyone in this effort. And you may be wondering what a mayor has to do with this matter? Well, I act as a spokesperson, really, of the organization – a Special Envoy, that is the term they have used – to give prominence or relevance to the topic. I think this is the main and first challenge we need to face, because people do not recognize the significance that this problem has within our countries.