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
According to the World Health Organization (WHO), an estimated 873 million children are at risk of soil-transmitted helminths (STH), including roundworm, hookworm and whipworm. In children, STH infections can lead to malnutrition, anemia and stunting. In both adults and children, they can cause fatigue, intense abdominal pain and chronic diarrhea. In severe cases they can even cause bowel obstruction, rectal prolapse and appendicitis.
To improve health and development in infected communities and reduce the prevalence of neglected tropical diseases (NTDs), WHO aims to control STH and schistosomiasis by 2020. Meeting this goal requires regularly deworming at minimum 75 percent of the preschool-age and school-age children who are at risk of STH or schistosomiasis. To ensure such an ambitious global goal is met, it is paramount that ministries of health, WHO and non-governmental organizations (NGOs) coordinate and share data.
WHO operates the Preventive Chemotherapy and Transmission Control (PCT) Databank, which tracks the number of children given PCT for STH, schistosomiasis and three other NTDs. The databank is populated largely by information reported by ministries of health and helps policymakers and implementers understand where deworming programs are active and where more interventions are needed to meet the WHO target of controlling STH and schistosomiasis by 2020.
However, gaps in the PCT Databank have become apparent. The 2013 STH preschool treatment data was recently revised when supplementary data was submitted by UNICEF. This data caused a 104 percent increase in the recorded number of preschool-age children treated for STH. Clearly, better coordination is needed to ensure the global community meets 2020 goals.
To facilitate better coordination among WHO, ministries of health and NGOs, the Children Without Worms (CWW).
After the data are compiled, WHO will merge the CWW database with national program data provided by ministries of health to the PCT Databank. This effort will make deworming dollars go even further by strengthening program monitoring and leading to an efficient use of resources. Ultimately, it will be an important step in controlling STH and schistosomiasis.
More than 100 million people are affected by one or more neglected tropical diseases (NTDs) in the Latin America and Caribbean (LAC) region. As a former Director of the Pan American Health Organization, I’ve seen the suffering caused by these diseases first-hand. At the same time, I have also learnt what can be achieved when endemic countries and international partners put NTDs – and the people affected by them – front and center in their policies.
The World Health Organization’s Third Report on NTDs, released last month, rightly puts a strong emphasis on equity and shared prosperity – themes that are at the very core of tackling NTDs.
The report, “Investing to Overcome the Global Impact of Neglected Tropical Diseases,” charts a new course by outlining the investments needed to reach the WHO Roadmap goals– a critical guide for the global effort to control and eliminate NTDs by 2020. Importantly, it also examines what needs to be done to achieve universal coverage of all people in need by 2030.
The new WHO report calls attention to progress made, including in the LAC region, which is a source of pride and hope for all involved. The region’s milestones can serve as a model for other endemic countries and show the world what’s truly achievable:
- In 2013, Colombia became the first country in the world to reach WHO-verified elimination of onchocerciasis (river blindness), followed by Ecuador in 2014.
- Guatemala and Mexico are on track to eliminate transmission of onchocerciasis, leaving just one border area between Brazil and Venezuela with ongoing transmission of the disease.
- More than half of the regions countries with endemic Chagas disease have eliminated transmission by the diseases principal domestic insect vector, and 20 of 21 endemic countries have implemented universal blood screening for Chagas.
- Costa Rica, Suriname, and Trinidad and Tobago are no longer endemic for lymphatic filariasis as of 2011. More than 7 million people were treated for this disease in 2013, most of them in Haiti.
Landmark commitments like the 2012 London Declaration on NTDs and the 2013 World Health Assembly NTD resolution have helped sustain political will towards this effort. These commitments have influenced further action in the Americas, where commitments from the Organization of American States and the Council of Ministers of Health of Central America and the Dominican Republic accelerated the fight against NTDs.
Globally, over 800 million NTD treatments were delivered in 2012 alone– an outstanding result achieved through strong partnerships with pharmaceutical companies, endemic countries, affected communities, bilateral and multilateral organizations and implementing partners.
But, we still must finish what we’ve started and accelerate progress towards the 2020 goals. This will help set the stage for success as we look ahead to achieve universal coverage of everyone in need by 2030.
Many of the people affected by NTDs live in middle income countries, and the report calls for more domestic resources to be mobilized and more equitably distributed, including among the poorest and most marginalized people. Similarly, there is significant scope for development banks and donors, as well as emerging players like the BRICS, to finance NTD efforts by employing innovative models and leveraging public-private partnerships. Cross-sectoral collaboration with the WASH (water, sanitation and hygiene); nutrition; maternal and child health; and education communities is increasing access to NTD interventions, while also enhancing impact and ensuring sustainability.
The WHO report endorses the fact that controlling and eliminating NTDs paves the way for poverty alleviation and shared prosperity for all. As I’ve said before, targets to control and eliminate NTDs must be included in global efforts to address poverty and inequality, including the post-2015 development agenda and the corresponding Sustainable Development Goals.
I encourage you to read the full WHO report here.
This afternoon, global health leaders new report highlighting gains over the past two years.
Dr. Margaret Chan, Director-General of the World Health Organization; Bill Gates, Co-chair of the Bill & Melinda Gates Foundation; and several other expert panelists including Chris Viehbacher, CEO of Sanofi; Dr. Onésime Ndayishimiye, National Director of Burundi’s Neglected Tropical Disease & Blindness Control Program; and French Minister of Social Affairs and Health, Hon. Marisol Touraine, announced deepened commitments for efforts to control and eliminate the most common NTDs by 2020 including a $120 million pledge from the World Bank, a new collaboration to combat soil-transmitted helminthes (STH) and accelerated research and development efforts lead by pharmaceutical companies in conjunction with nonprofits.
The broad reach and attention of today’s event signals the fact that controlling and eliminating NTDs is embraced by a global community of national leaders, policy makers and donors. In addition, there is broad recognition that addressing NTDs is a crucial component of eliminating poverty and achieving development goals.
Echoing this fact, Dr. Tim Evans, World Bank Director of Health, Nutrition and Population stated during the event that NTDs are major constraints to development and addressing them will boost shared prosperity.
As detailed in the Uniting to Combat NTDs report and score card, progress on NTDs has accelerated quickly over the past two years. Pharmaceutical companies are now meeting 100 percent of requests for drugs, and endemic countries taking ownership of NTD programs. To date, 74 countries – roughly two-thirds of all NTD-endemic countries – have now developed national plans to help guide their control and elimination efforts.
Of particular note, Nigeria and Ethiopia, two countries with high NTD burdens, made national commitments to end NTDs. Nigeria launched its master NTD plan in February with the goal of providing treatment to more than 60 million people annually over the next five years. Ethiopia, the country with the highest trachoma burden, launched its national plan in June 2013. Success in Nigeria and Ethiopia would significantly decrease the global burden of NTDs worldwide.
click to view larger) shows a steady increase in drug donation and delivery, only 36 percent of people in need received all the drugs they needed in 2012. Mobilizing more financial resources to support program implementation, doing more to leverage the value of donated drugs and increasing collaboration across sectors are just a few ways the global community can further accelerate progress.
While donors, pharmaceuticals and NGOs are an integral part of the solution, endemic countries will drive progress forward by continuing to develop, own and implement their programs in a sustainable way.
“I always believe in country ownership, Dr. Margaret Chan said. “Were here to support your efforts.
We applaud the work done by endemic countries, NGOs, pharmaceutical companies, multilateral organizations and the Bill and Melinda Gates Foundation, and look forward to the path towards 2020.
Click to view the full report.