A New WHO Report Brings Fresh Data and Ideas on Ending NTDs

 

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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 region’s countries with endemic Chagas disease have eliminated transmission by the disease’s 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.

Water is Crucial to Ending Blinding Trachoma

 

Photo from International Trachoma Initiative

Photo from International Trachoma Initiative

By Elizabeth Kurylo
Communications manager, International Trachoma Initiative

Every morning and every night, I turn on the hot and cold water taps, adjusting them so the temperature is just warm enough to wash my face. I take for granted that the water will flow. I would be shocked if it didn’t. This easy access to water is a luxury not enjoyed by hundreds of millions of people around the world.

As we mark World Water Day, it is worth noting that 748 million people do not have access to an improved source of drinking water and 2.5 billion do not use an improved sanitation facility. For them, the lack of water can mean poor health, disability and even death.

Water and sanitation is especially important in the prevention and control of trachoma and other neglected tropical diseases (NTDs). Trachoma is an ancient eye disease caused by a bacterial infection. Left untreated, it can lead to blindness. But we can stop it with the World Health Organization-endorsed SAFE strategy – Surgery, Antibiotics, Facial cleanliness and Environmental improvement.

Water is crucial to facial cleanliness, and key to ending blinding trachoma.  But in many places where trachoma is endemic, water is scarce, and rationed for uses other than hygiene, such as cooking. Face washing is not a priority.

The global trachoma community has made much progress since 1998, when Pfizer began donating the antibiotic Zithromax®, which treats and prevents trachoma. More than 444 million doses of Zithromax® have been shipped to trachoma endemic countries to date. And seven countries have reported reaching their elimination goals.

Under the leadership of WHO and the Alliance for the Global Elimination of Blinding Trachoma by the year 2020 (GET 2020), national trachoma programs have steadily scaled up implementation. In 2014, WHO’s Weekly Epidemiological Report (WER) said trichiasis surgeries and antibiotic distribution were tenfold higher in 2013 compared to 2004.

The International Coalition for Trachoma Control (ICTC) has galvanized the global trachoma community’s commitment to reaching elimination by 2020.  Collaboration on game-changing initiatives with governments, health officials and trachoma endemic communities has led to the mobilization of more than 150 million dollars of new funding from DFID, USAID and the Queen Elizabeth Diamond Jubilee Trust.  That is in addition to the national government domestic budget allocations and support already provided by many non-governmental development organizations as well as other donors such as the Lions Clubs International Foundation, Conrad N Hilton Foundation and the Bill & Melinda Gates Foundation.  The WASH sector also is collaborating with the NTD sector to achieve shared goals of improving health and eliminating disease.

Still, there is much work to do. An estimated 232 million people in 51 countries live in trachoma endemic areas. Globally, 31 countries are implementing the SAFE strategy to eliminate trachoma, which signifies that 20 countries are still in need of help.

In 2015, ITI plans to ship 115 million doses of Zithromax®, donated by Pfizer. That is more than twice the amount approved for shipment in 2014.  ”We are doing everything we can to accelerate access to Zithromax® needed by people who are at risk of blindness from trachoma,” said Dr. Paul Emerson, Director of ITI. “We are empowering national programs so that those at risk of going blind from trachoma can be treated.”

Empowering people in trachoma endemic communities to prioritize water for hygiene also has lasting benefits. I saw this in Ethiopia, where I met Amarech Haluka, the mother of three young girls, one of whom had experienced the pain of trachoma. Health workers introduced the SAFE strategy to Amarech’s community, which received donated Zithromax® and education about the importance of using latrines and keeping their faces clean to avoid trachoma. Amarech and her husband got a loan to install a water pump in their back yard, and she now routinely washes her children’s faces twice a day. Even though she cannot adjust the temperature of the water that flows from her pump, her children’s faces are clean, and her family is free of trachoma.

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Speak out against Proposed Cuts to the USAID’s NTD Program

 

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The Global Network was disappointed to see the proposed decrease in neglected tropical disease (NTD) funding outlined in the President’s budget request for fiscal year (FY) 2016.  While the proposal includes $86.5 million for the U.S. Agency for International Development’s Neglected Tropical Disease (USAID’s NTD) Program, it is a drop of $13.5 million from the $100 million allocation approved by Congress for FY 2014 and FY 2015.

Bipartisan action in Congress has thankfully, over the past few years, led to increased funding for NTD programs beyond the Administration’s requests. This year, the Global Network is urging Congress to honor and continue these previous commitments by requesting that the USAID NTD Program receive $125 million in funding for FY2016.

USAID’s NTD Program, an extremely successful and cost-effective public-private partnership, has reached more than 465 million individuals in 25 countries, focusing on the scale-up of mass drug administration (MDA) with the aim of controlling and eliminating the seven most common NTDs. The program leverages more than $6.7 billion worth of drugs donated by pharmaceutical companies in order to scale-up MDAs in endemic countries, such as Ethiopia, Indonesia, and Nigeria.

The USAID NTD Program is crucial for cutting poverty and increasing broader health outcomes worldwide, considering that NTD treatment contributes to the success of other development efforts. Maternal and child health, nutrition, water, sanitation and hygiene, education, and health systems strengthening ALL benefit from NTD treatment.

The Global Network’s END7 campaign is taking action against the proposed budget cuts with its recently-launched “Call to Action” petition. To get involved and speak out, add your name here.

For other ways to get involved and join the fight, use END7’s new Twitter tool to tweet directly at your member of Congress, urging them to defend the USAID NTD budget.  And lastly, feel free to share our infographic with your family, friends, neighbors and colleagues, which outlines just how crucial the USAID NTD Program is to the global effort to end NTDs.