Category Archives: Water and Sanitation

END7 Funds NTD Projects Around the World

This spring, we awarded nearly $400,000 in new grants for neglected tropical disease (NTD) control and elimination activities in 2016.

This funding is made possible by generous donations to Sabin Foundation Europe, a partner of the U.S.-based Sabin Vaccine Institute and the Global Network also helped make these grants possible.

The grants will make a significant impact in supporting integrated NTD programs in six countries. All projects are coordinated with Ministries of Health and/or the World Health Organization in each country. Many of the projects include mass drug administration (MDA) for the most common NTDs and training of health care workers. These projects are expected to benefit nearly six million individuals at risk from NTDs and train tens of thousands of health workers and volunteers to lead the NTD control and elimination effort into the future.

Awarded to existing efforts that faced a funding gap, these projects will have a lasting impact on improving and expanding existing programs to reach ambitious NTD control and elimination goals in Africa, Asia and Latin America – the regions with the largest NTD burden:

Nigeria $50,000 to support integrated MDA for seven NTDs, administered by Sightsavers with the support of the Federal and Kebbi State Ministries of Health. Nearly 5.9 million people will receive donated medicine in Kebbi state, in northwest Nigeria, where all seven NTDs are widespread. Sightsavers will continue their successful MDA in the region and expand to new areas.

Somalia $66,200 to support the first integrated MDA in five regions of southwestern Somalia by the new NTD Program of the Ministry of Health and Human Services. The MDA will target schistosomiasis (snail fever), ascariasis (roundworm), hookworm and trichuriasis (whipworm) among school-age children and adults in areas of high prevalence. The NTD Programme was established in 2015; success this year will help scale up the delivery of donated medicine to the rest of the country.

Cote d’Ivoire $28,789 to support water, sanitation and hygiene education to prevent NTDs in Cote d’Ivoire, administered by Helen Keller International. More than 7,000 health workers, school teachers and community health volunteers will be trained to reach more than 2.5 million people.

Guyana $111,146 to support MDA to eliminate lymphatic filariasis in the most populous region of the country, administered by the Pan American Health Organization and the Ministry of Public Health. Guyana is on track to eliminate lymphatic filariasis (also known as elephantiasis) by 2020. These funds were raised for END7 by the Sabin City Group in London.

India $60,546 to assist a local NGO, Churches Auxiliary for Social Action (CASA), to expand their successful efforts to treat and prevent lymphatic filariasis to West Bengal. This grant will enable CASA to train community members to manage the swelling and disability that often results from later stages of lymphatic filariasis. Each infected patient will receive a hygiene kit with soap, a towel and antifungal ointment and be shown how to care for themselves to reduce swelling. CASA will also promote the government’s annual MDA targeting 500,000 people for lymphatic filariasis treatment in West Bengal.

Myanmar $75,645 to assist the Department of Public Health to determine where MDA for lymphatic filariasis has succeeded and can be concluded. Nine districts with a population of nearly 7 million have already conducted more than five rounds of MDA for lymphatic filariasis. Officials will determine whether transmission has been interrupted.

The Global Network team reviewed 37 proposals from a range of partners tackling NTDs around the world and selected projects with the potential to have the most lasting impact, leverage further investment and bolster country-led efforts to eliminate NTDs.

To date the Global Network has awarded more than US$1 million in grants to 19 partners. From individual donors contributing $5 a month to student groups raising $10,000 over the course of a school year, the END7 campaign has mobilized a diverse and growing community of supporters from countries around the world dedicated to supporting the fight against NTDs. Together, these contributions are moving the NTD elimination effort forward by helping communities set up treatment programs they can run themselves. END7 supporters fill funding gaps in successful NTD treatment programs, highlighting the tremendous impact of this inexpensive treatment and the power of partnership in the fight against NTDs.

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Untouched: How 284 Liberian Communities Remained Ebola-Free

By Piet deVries, Senior WASH Advisor, Global Communities

A community hand washing station in Liberia. Credit: Global Communities

Everything changed with Ebola.

For four years, Global Communities had been busy creating access to safe sanitation for communities in Liberia, helping to fight the spread of disease and improve health outcomes. Utilizing Community-Led Total Sanitation, we were making consistent progress, beginning work through the USAID-funded Improved Water, Sanitation and Hygiene (IWASH) program in 2010 in the three Liberian counties of Nimba, Lofa and Bong. Our program gained the support of the national government, and we worked with them to develop their sanitation strategy to improve the health of rural communities across the country. By early 2014, we had helped 284 communities become “open defecation-free” and were working with more communities.

Suddenly we and our partners in the Liberian County Health Teams and the Ministry of Health found ourselves at the center of a maelstrom. To combat Ebola, we scaled up our community engagement work, training community leaders who were already working to prevent open-defecation in how to provide information about Ebola prevention. As the epidemic swelled, our community engagement approach shifted again, focusing on acceptance of vital services like dead body management, and eventually, health screenings. In just a few months, our work scaled up from three to all 15 Liberian counties.

It was during this time that we received reports of an astonishing statistic. All 284 open defecation-free communities were reporting that they were also Ebola-free — despite being located in some of the regions hardest hit by the virus.

Was there a link between being open defecation-free and Ebola-free? Or between our program’s process and Ebola resistance?

Earlier this year, we employed two independent public health consultants to conduct research into the informal reports we had received. They came back with extraordinary findings. Focusing their research on 551 households in Lofa County, they established with a representative sample that the communities that had reached open defecation-free status were indeed Ebola-free.

They also found that communities that had only started the Community-Led Total Sanitation process — but not reached full open defecation-free status — were 17 times less likely to experience a single case of Ebola. This suggests a statistically significant correlation between our work to become open defecation-free and being Ebola-free.

Still, it would be wrong to assume that these findings mean that simply becoming open defecation-free stops Ebola. Rather, they suggest that people who had been exposed to the program’s education were far more likely to develop healthier behaviors and practices that lead to Ebola resistance — especially when led by a member of their own community.

Perhaps most encouraging, these behavior changes don’t just defend against Ebola. By utilizing CLTS, individuals can help prevent a variety of water, insect-borne and diarrheal diseases, including many neglected tropical diseases. In addition, such methods are inexpensive; in Liberia, incentives of only $130 per community can result in far better sanitation practices. Make household latrines, hand washing facilities, garbage pits and dish racks available, and you have a safe, hygienic and resilient community.

Disease spreads at the community level, and only by engaging with the community to create sustainable change can we hope to control and eliminate many of the diseases that are so prevalent in the developing world. CLTS does just that, and any focus on water and sanitation must recognize the importance of empowering communities to make wise decisions to help improve their health.

The Intersections of Poverty, Handwashing and Neglected Tropical Diseases

Sabha and her friends drink water and wash their hands from a village well in Ghorahuan Village, Bihar State, India

Today marks the global strategy to better integrate water, sanitation and hygiene (WASH) services — including handwashing education and access to handwashing facilities — with other public health interventions to eliminate and eradicate NTDs by 2020. The strategy aims to provide evidence-based guidance on effective ways for WASH and NTDs groups to collaborate to meet common goals.

Improved WASH is one of five interventions recommended by the WHO roadmap for the fight against NTDs. Access to clean water, handwashing facilities, proper waste management and good hygiene practices are critical to preventing NTDs from spreading. This is especially important for trachoma, the worlds leading cause of preventable blindness of infectious origin.

Approximately 232 million people are at risk of trachoma, and it is estimated to be responsible for the visual impairment of about 1.8 million people. A bacterial infection of the eyelid, trachoma is a highly contagious disease that can cause blindness if left untreated. It is spread by the eye, nose or throat secretions of an infected individual. These secretions are commonly spread by hands — as well as flies and shared facial cloths or tissues. Washing and other hygiene measures are critical to the success of trachoma interventions.

WASH and NTDs are both significant challenges to global development. WHO estimates that 1.9 billion people across 149 countries are at risk of at least one NTD, with many people at risk of suffering more than one. Likewise, 2.4 billion of the world’s population lacks access to adequate sanitation, while 1 billion people practice open defecation and 663 million do not have access to improved sources of drinking water. Both impacting the most impoverished communities, there is a significant overlap in the communities where NTDs are endemic and in which WASH resources are limited.

Notably, the strategy calls on endemic countries and partners to, “include, where possible, WASH indicators to contribute to success on NTD targets, and NTD indicators to contribute to success on WASH targets within the national frameworks for reporting progress against SDGs [Sustainable Development Goals].” NTD stakeholders have also recommended an NTD indicator to monitor progress on the SDGs. Because of the close links between poverty, the prevalence of parasitic diseases and access to WASH, measuring progress against NTDs provides insight into how effectively the global community is progressing towards ensuring equitable access to clean drinking water, improved sanitation and proper hygiene — and ultimately eradicating extreme poverty.

You can join the effort by asking your countrys representative to the United Nations to support and promote the inclusion of a global NTD indicator in the SDGs.

TAKE ACTION: Make NTDs count in the SDGs, send a message.

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