Category Archives: poverty

“Worm Index” Reveals Association Between NTDs and Human Development

 

A new “worm index” developed by Sabin President Dr. Peter Hotez and Baylor College of Medicine’s Dr. Jennifer Herricks reveals a strong association between neglected tropical diseases (NTDs) and human development.

The index was based on the disease burden of major worm (or helminth) infections: intestinal helminths, lymphatic filariasis and schistosomiasis, which can lead to diarrhea, anemia, disability, disfigurement and even death. Increasing evidence over the last decade links the most common NTDs to significant adverse impacts on both human and economic development.

Hotez and Herricks created the worm index (see map below) using World Health Organization (WHO) data on disease burden for these worm infections in the world’s 25 most populous countries. Countries’ worm indices range from 0-1, with higher indices indicating a higher disease burden.

Heat map for worm index of the 25 most populous countries:
Worm Index Map

Hotez and Herricks then compared their worm index to the United Nations Development Programme (UNDP) human development index (HDI), which measures a country’s achievement in education, standard of living and years of life lived in good health.

This side-by-side comparison uncovered a strong negative correlation (see graph below).

Comparison of HDI to worm index in the 25 most populous countries:
worm_graph

It is tempting to conclude from these results that worm infections hold back human development, but it could just as easily be that situations of poverty (poor healthcare infrastructure and lack of access to clean water and sanitation, for example) result in worm infections. “It is possible or even likely that the causes and effects flow in both directions,” the researchers state.

That said, evidence illustrating this relationship abounds. Hotez and Herricks cite studies from Kenya showing that deworming led to improvements in school attendance and participation, and the effects of deworming could still be seen into adulthood—adults who received deworming treatments as children were more productive, both in hours worked and wages earned. Higher wages and more schooling are critical tools for achieving the Sustainable Development Goals (SDGs).

“Given the strong associations between helminthic and other NTDs and mental, physical, and economic human development, vulnerable and excluded populations, and HDI, in the coming months and years it may become essential to give due consideration to eliminating helminth infections as a means to achieve SDGs. Of course, poverty, “Water, Sanitation and Hygiene” (WASH), and nutrition play an important role in health outcomes. As we look to reduce poverty and increase WASH and nutrition, we must also focus on chronic diseases such as helminth infections that reinforce the cycle of poverty and malnutrition. Therefore, we suggest that the NTDs need to be an important consideration in any discussion about the SDGs, and helminth control and elimination as proposed by the 2012 London Declaration for NTDs must be embraced by the SDGs and the sustainable development community.”

No matter which came first—poverty or worms—the fact is that these infections impact millions of people every day, disabling communities’ workforces and further limiting economic growth where it’s needed most.

How to Ensure we “Leave No One Behind” on the International Day for the Eradication of Poverty

 

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Today marks the International Day for the Eradication of Poverty. This year’s theme, “Leave no one behind,” is especially important to me as an advocate for the world’s most vulnerable populations. As former director of the Pan American Health Organization (PAHO) and as a Special Envoy for neglected tropical diseases (NTDs), I have called attention to those who are too often left behind: the 1.4 billion people who suffer from NTDs.

NTDs have devastating consequences for the world’s poorest people. They cause anemia and malnutrition, and can lead to blindness, school absenteeism, disfiguration and the loss of livelihoods. Ultimately, NTDs undercut a family’s earning potential, productivity and ability to escape poverty. If we as a global community wish to end poverty, we must control and eliminated NTDs.

In less than a month, the Group of 20 (G20) will gather in Brisbane, Australia to discuss ways to stimulate economic growth among the world’s vulnerable populations. During G20 Summit, world leaders are expected to discuss financial sector reforms, infrastructure and employment opportunities. However, in order to make the largest possible impact on the world’s poor, the G20 should address global health and NTDs.

The G20 should embrace the fight against NTDs and include them among the most cost effective interventions to eradicate poverty and advance its goal to create a “sustainable path for current and future generations.” NTDs undermine the G20’s collective efforts to build human capital, increase employment opportunities, reduce inequality and expand access to agricultural and nutrition initiatives. NTDs can be eliminated by 2020 and the benefits of achieving this feasible goal will be long lasting.

Evidence has shown that debilitating and blinding NTDs such as lymphatic filariasis (LF) and trachoma can significantly affect a person’s income. For example, LF can lead to a 15 percent annual loss in personal income, and trachoma can cause a total potential productivity loss of $5.3 billion annually.

By addressing NTDs, we can ensure more children remain in school, and more women remain employed and empowered. Women with LF in particular, are vulnerable to stigma, social isolation, lost jobs and diminished wages, further embedding them in poverty. And when children are infected with one or more NTD, their cognitive and learning abilities are reduced making them unable to reach their full potential.

On the International Day for the Eradication of Poverty, I join the Global Network in urging the G20 to recognize NTDs as a key underlying constraint to poverty alleviation and economic growth. In addition, we are urging the G20 to support the inclusion of NTD control and elimination efforts in the final post-2015 development agenda.

In order to ensure that no one is left behind, world leaders must support global efforts to control and eliminate NTDs. Because NTDs already infect the world’s most marginalized populations, we must prioritize their health if we are to end poverty.

For more information on NTDs and the G20, read the Global Network’s report.

Why focus on NTDs, and Why Now?

 

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Of all the challenges our world faces, why do we focus on neglected tropical diseases (NTDs)?

For END7, the answer is simple. Because these are the most common diseases of the world’s poor, affecting more than a billion people around the world. And treatment and control of NTDs is critical to ending extreme poverty and malnutrition. These diseases stunt children’s growth and ability to learn. Parents grow too weak or disabled to provide for their children. As a result, they trap entire communities in a cycle of disease and poverty.

Not only is NTD treatment inexpensive (we can treat these debilitating diseases with a packet of donated pills), treating these diseases is necessary to ensure that global efforts to aid nutrition, education and development are successful.

Why do we need to act now?

As August comes to a close, we’re approaching a critical moment in the fight against NTDs. This year, for the first time, NTDs are included in the ‘global development to do list’ — an early draft of the Sustainable Development Goals that will guide the world’s efforts to end extreme poverty by 2030.

For the first time, world leaders would prioritize ending the suffering of the world’s poor from NTDs — if we make sure controlling and eliminating NTDs remains a development goal.

High level discussions will begin this fall and we need your help to ensure that NTDs remain in the SDGs during UN Member State negotiations throughout the coming over the next year.

Join us this month in spreading the word. We’re at a critical point in the fight against NTDs and are grateful to have so many END7 supporters speaking out.

Help us grow the movement by sharing this image. And tell us why you’re fighting NTDs by using the hashtag #NTDsnow.

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New Paper Highlights Key Progress, Challenges Ahead of Post-2015 Agenda Setting

 

boys collecting water in Citoboke, along the Congo Border

In an important new paper, “Neglected tropical diseases: now more than just ‘other disease’ — the post-2015 agenda,” published in International Health, David Molyneux, professor at the Liverpool School of Tropical Medicine, captures why defeating neglected tropical diseases (NTDs) is so critical. He writes, “The overall context of NTD control is the contribution it makes to the alleviation of poverty and improved social and economic prospects of individuals and communities.”

Given NTDs’ profound impact on poverty — and the potential for their control and elimination to make progress towards the Millennium Development Goals (MDGs) and targets set in the post-2015 development agenda — NTD partners must do everything possible to ensure World Health Organization (WHO) targets are met by 2020.

Before outlining the key challenges and actions needed to overcome them, Professor Molyneux recognizes advancements made in the global NTD fight.

For instance, in 2006, the U.S. committed resources to implement integrated NTD control programs through USAID, while in 2008, the UK pledged financial support through DFID, marking the beginning of their longstanding commitments to NTDs. In 2012, following the creation of the WHO Roadmap for NTDs and the formation of the London Declaration, the World Health Assembly (WHA) passed a historic resolution on all 17 NTDs in May 2013.

2013 was also a milestone year because the UN Secretary-General’s High-Level Panel report included NTDs alongside other pressing global health issues. Following this momentum, in spring 2014, a Lancet editorial reiterated the importance of addressing NTDs in the Sustainable Development Goals, and in summer 2014, the draft SDGs featured NTDs under proposed goal 3, “Attain healthy lives for all.”

Efforts in endemic countries have also led to successes. For instance, innovations in mapping disease burdens and diagnostics prove that “defining the areas of intervention can be undertaken rapidly and without the need for invasive or intrusive procedures [which have] been a contributing factor in the successful scale up of mass drug administration.” Community Directed Treatment (CDTI) and the reliance on existing infrastructure have helped “ensure that drugs are collected and distributed in ways that are best decided by the communities themselves.”

Yet remaining challenges could threaten the tremendous momentum attained to-date. The challenges — and their solutions— according to Professor Molyneux include:

Funding. “The funding provided is a fraction of that available for other diseases and a reflection of the gross inequity to implement programs that address the diseases of the poor.” Even with generous support from the U.S. and UK, funding from endemic countries and new commitments — such as resources pledged through the London Declaration to address soil-transmitted helminths — resource mobilization among diverse development partners is needed to ensure donated medicines reach the most vulnerable communities.

Implementation. Even though “over the past 3 years, in excess of 700 million treatments have been given annually” for the seven most common NTDs, efforts must be scaled up to reach all at-risk people, especially in conflict areas.

Human resources. Mass drug administrations all around the world are carried out through the work of thousands of health workers and volunteers — such as in Myanmar. But health systems must continue to be strengthened to adequately handle competing health priorities and deliver NTD and other treatments.

Application of research. While the NTD community has produced a rich body of research, “moving policy into practice needs to be accelerated.”

With the progress made thus far, there is clearly no choice but to continue the good work being carried out and expand efforts where current challenges lie.

To read the paper, click here