Category Archives: schistosomiasis

What Can the Experiences of Sierra Leone and Cambodia Tell Us about How to Fight NTDs?

 

By Romina Rodríguez Pose, independent consultant on international development and lead author for the Health Dimension case studies, Development Progress Project.

Image from Sierra Leone 15

Neglected tropical diseases (NTDs) affect the poorest billion people in the world. They cause number of chronic health conditions that largely limit people’s ability to study and work and consequently have a healthy and productive life. The stigma attached to them can also lead to isolation and fear for those who suffer.

Although they have been long ignored within international and national agendas, in the last decades, there has been an increasing awareness of how NTDs can impede endemic countries from achieving broader development goals. This led to the emergence of global public-private partnerships involving major drug donations from key pharmaceutical companies, the development of inexpensive control strategies and a growing number of donors earmarking funding for integrated NTD control.

These readily available solutions have enabled some endemic countries to fight the five NTDs that bear 90 percent of the global burden: onchocerciasis, also known as river blindness; schistosomiasis, also known as snail fever; lymphatic filariasis, also known as elephantiasis; soil transmitted helminths, also known as intestinal worms; and trachoma.

Image from Cambodia 8To better understand the drivers of progress, ODI’s Development Progress project has taken a closer look at two of the leading performers: Sierra Leone in Africa and Cambodia in Asia. In spite of their different contexts and epidemiological profiles, three drivers have emerged in both case studies:

1. Advances in the fight against NTDs have been driven by the availability of earmarked funds and donated drugs. These have been crucial for both resource-constrained countries, since most endemic countries are faced with several competing, and perhaps more urgent, health issues (such as high mortality rates for mothers and children in Sierra Leone and dengue outbreaks in Cambodia). As a counterpart, political will and local engagement to take advantage of global initiatives have been crucial in bringing NTDs within the national agenda. Both governments, through their Ministries of Health, have proactively looked for partners, secured funds and drugs donations and made important efforts to develop local capacity.

2. There is an important transitional role for development partners in providing access to strategies and guidelines on how to deal with NTDs until local capacity is fully developed. In both countries, this was achieved through bilateral, regional and global partnerships that helped build the local knowledge base for endemic countries to find their own solutions and to implement strategies according to the particular context. These dynamics between development partners and NTD programme managers have gradually led to a ‘transfer of ownership’ of the NTD programmes.

3. The integration of NTD activities within an existing government structure has been vital to set up cost-effective NTD programmes. Both countries have integrated the distribution of drugs within health and education systems. In Cambodia, given the main threat is from intestinal worms which particularly affect school-aged children, progress has been achieved by integrating the distribution of drugs into the school system and turning teachers into twice-yearly doctors/pharmacists. In Sierra Leone, given that the entire population is at risk from at least three NTDs, the main strategy involved the engagement and training of community members as drug distributors. Elected by their communities, their work is divided into catchment areas for which they are responsible, reaching the most remote corners of the country.

Image from Sierra Leone 14

Despite the increasing awareness of their importance, NTDs still loom large in the cycles of poverty, ill-health and under-development that afflict too many developing countries. Yes, as Sierra Leone and Cambodia show, progress can be achieved in the most difficult contexts and with minimal resources, stressing the importance of including NTD control and elimination targets within the post-2015 sustainable development goals.

All photos by Romina Rodríguez Pose. 

World Health Workers Week: Honoring the NTD Fighters

 

Susan Matthews educating her community in Boroma Village in Sierra Leone about schistosomiasis

Susan Matthews educating her community in Boroma Village in Sierra Leone about schistosomiasis

Sierra Leone’s Kono district is home to some of the highest rates of schistosomiasis in the country. Nearly 2 million people here are infected by this painful and sometimes-deadly neglected tropical disease (NTD).

Susan Matthews, a community health worker from Boroma village in Kono District, is on a mission to fight schistosomiasis in her community. We’re highlighting the important impact of her work, and the work of others like her, this World Health Workers Week. Health workers like Susan help sustain quality health care in rural communities by both treating and educating their communities about effective ways to prevent various diseases, including NTDs.

Susan’s work has an immense impact on people like Sahr Gando, a miner in Kono district. Sahr Gando became infected with schistosomiasis after spending hours a day mining for diamonds in infested waters. But through Mass Drug Administration (MDA), Susan is able to distribute medications to Sahr Gando and the rest of the community.  After receiving medication, those treated will be freed from NTDs for one year.

But Susan’s work doesn’t stop there.  Together with other health workers, Susan educates the community about the medication and how to prevent getting the disease.

“If you just come and drop the drugs, it will not be effective,” says Susan. “So we have to help educate them so that they know about the drug and the disease. We have to keep talking, talking, talking, talking, and then they will accept.”

Thanks to committed health workers like Susan, rural communities can have access to medication and also acquire knowledge about schistosomiasis prevention.

Luckily, people like Susan exist around the world.  This February, we were fortunate enough to meet several other dedicated health workers in India.

Health Workers at Church’s Auxiliary for Social Action (CASA) are helping those with lymphatic filariasis (LF) in Orissa, India. LF is a painful and disfiguring NTD that impacts more than 20 million people in the country. The devoted health workers at CASA help with disease management for individuals that have LF by cleansing and removing bacteria from their legs. END7’s celebrity ambassador, Abhishek Bachchan, has also worked with health workers in Orissa, India in an effort to help those that suffer from LF.

Health workers are uniquely positioned to have an incredible impact on health outcomes around the world because they understand the needs of their communities and they also have the trust of community members. Health workers also build individual and community capacity by increasing health knowledge among communities and promoting community empowerment.

We’d like to thank Susan Matthews, the health workers in Orissa, India, and all health workers across the globe that continue to fight NTDs in their communities.

Watch and learn more about the great and essential work that Susan Matthews is doing in Sierre Leone here.

Why You Shouldn’t Take Your Toilet for Granted on World Toilet Day

 

Photo by Flickr user SuSanA Secretariat

Photo by Flickr user SuSanA Secretariat

If you’re reading this blog post, chances are you’ve used a toilet recently. It’s also likely you’ve never really considered how fortunate you are to have access to that toilet. Could you imagine what it would be like to leave your house in the middle of the night to relieve yourself outside rather than inside the safety and privacy of a clean bathroom stall?

Today is World Toilet Day and we’re recognizing the 2.5 billion people around the world who do not have access to a toilet (that’s about 1/3 of the world’s population!). The magnitude of this problem is significant.  Without a toilet, people are forced to defecate outside – an act that compromises a person’s dignity, privacy and safety, and leaves billions susceptible to neglected tropical diseases (NTDs).

Schistosomiasis and intestinal worm infections such as roundworm, hookworm and whipworm are easily spread in communities that do not have access to toilets or sanitation facilities. Schistosomiasis spreads when infected people urinate or defecate close to a water source, contaminating it with the larvae of the parasite. Without proper infrastructure (toilets and city utilities) more than 80% of sewage in developing countries is discharged untreated — polluting rivers, lakes and coastal areas and promoting the spread of NTDs.

Simply walking barefoot around this polluted and contaminated water leaves people exposed to NTDs. As a result, people can be continually re-infected as they work, play, bathe or eat. Children especially have a high risk of contracting these diseases because they often play barefoot outside and put their hands in their mouths without washing them.

According to the World Health Organization, improving water, sanitation and hygiene can reduce trachoma by 27 percent, and improved sanitation could reduce schistosomiasis by as much as 77 percent.

By combining NTD treatment, hygiene education and creative solutions for the 2.5 billion people without access to toilets, we can tackle this problem. Important work is being done by several partner organizations to promote better water, sanitation and hygiene worldwide. The Global Network is also happy to work with former president of Ghana John A. Kufuor to promote long term NTD solutions by integrating mass drug administration with programs for water, sanitation and hygiene – a message the former president drove home at this year’s World Water Week in Stockholm, sweeden.

To learn more about the links between clean water, sanitation and NTDs, watch our quick video here

Africa’s lowest cost AIDS prevention strategy?

 

ANew commentary on the PLoS Speaking of Medicine Blog from Dr. Peter Hotez, president of the Sabin Vaccine Institute, highlights exciting findings that “give us compelling reasons to recast schistosomiasis MDA as a back door AIDS prevention strategy.”

The new study, led by a team of researchers at Yale University, found that treating young girls for female genital schistosomiasis (FGS) is a highly cost-effective approach to reducing the burden of HIV in sub-Saharan Africa. In fact, the drug praziquantel not only reduces the devastating burden of FGS on young women but also has the potential to save up to 100 million US dollars in AIDS healthcare costs over a 10-year period.

Dr.  Hotez, who has written extensively on FGS, asserts “a critically important piece of information is that schistsomiasis MDA is ridiculously inexpensive because of generous praziquantel donations from Merck KGaA or (when there is insufficient drug being donated) it can be provided as an extremely low-cost generic (often averaging around 8 cents per tablet) from Shin Poong, MedPharm and other companies through UNICEF, WHO, and the World Bank.”

Please read Peter’s full commentary at this link, and the new study, “Potential Cost-Effectiveness of Schistosomiasis Treatment for Reducing HIV Transmission in Africa – The Case of Zimbabwean Women,” here.