Will the Agenda of the November 2014 G20 Leaders Summit Help End NTDs?

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By Haley Brightman and Amber Cashwell

With the G20 Leaders Summit quickly approaching, the Global Network has released its G20 Call to Action. This policy brief outlines the exceptional opportunity for G20 leaders to take concrete action to address global health priorities, including NTDs, during this year’s discussions, to be held on November 15-16 in Brisbane, Australia. The Global Network’s G20 Call to Action examines how and why the G20 is well-equipped to tackle NTDs and advance its overarching goal to catalyze sustainable, inclusive growth.

Why should the G20 address global health?

While the Summit will focus on strengthening the global economy and building resilience, G20 leaders must also address the root causes that undermine these efforts. NTDs contribute to the suffering of more than 1.4 billion people, and are linked to reduced worker productivity and wage earning potential.

Trachoma, for example, which can lead to permanent blindness, has caused an estimated global productivity loss of US$5.3 billion. Recognizing the impact of this disease, Australia has added trachoma control and elimination to its development policy. As host of this year’s summit, Australia has a unique opportunity to galvanize support among the G20 for trachoma and other NTDs.

NTDs also contribute to social stigma and increase susceptibility to other diseases like HIV. Equally important, NTDs are associated with anemia, poor nutritional status and lower socioeconomic status.

How can investments in health and NTDs help build strong economies and support equitable growth?

Australia’s Prime Minister Tony Abbott, as President of the G20 this year, recognized that “…you can’t have strong communities without strong economies to sustain them…” In order to develop strong communities, Australia and other G20 leaders must invest in the health of people – the real drivers of growth – and free them from the burden of NTDs.

The Global Program to Eliminate Lymphatic Filariasis (GAELF) has already demonstrated that investing in NTD treatment leads to stronger economies. For example, GAELF has treated nearly 600 million people for lymphatic filariasis since 2000, resulting in an economic rate of return estimated at between US $20-30 for every dollar spent on treatment.

But why specifically the G20?

The G20 accounts for 90 percent of global gross domestic product and 94 percent of global official development assistance, putting it in a uniquely opportune position to leverage resources and support for the fight against NTDs. Specifically, the G20 could help maximize the use of public-private partnerships and encourage investments that will close the US$220 million funding gap for NTD treatment. Through public-private partnerships, such as the London Declaration on NTDs, pharmaceutical companies are currently donating nearly all the medicines necessary to treat the most common NTDs –  but more is needed to help these drugs reach the communities that need them. The G20 nations can help close the funding gap for NTD treatment.

Here are 5 ways that the G20 can help end NTDs and build healthy communities and strong economies:

  1. Recognize NTDs as a key underlying constraint to global economic growth.
  2. Highlight the importance of NTD control and elimination programs in the G20 Development Working Group agenda and broader G20 policy statements.
  3. Call on historic and emerging donors to prioritize the issue of NTD control and elimination in their foreign policy, development and poverty reduction agendas.
  4. Call on NTD endemic countries to prioritize NTDs in their national poverty and health plans.
  5. Support inclusion of NTD control and elimination efforts in the final post-2015 development agenda.

 

Stay tuned for more updates on End the Neglect on how Australia can improve health and development across the region in advance of this year’s G20 Leaders Summit and beyond.

Calling All Campus Campaigners!: END7’s New Resources to Support Student NTD Advocacy

 

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Over the past year, the END7 campaign has dramatically increased its base of student supporters at universities around the world. Students at dozens of universities have organized advocacy, education, and fundraising events, raising over $21,000 for END7 during the 2013-2014 academic year alone. The representatives of the END7 Student Advisory Board are hard at work planning a new year of on-campus activities to support the NTD control and elimination effort.

This year, the END7 campaign is involving students in promoting all of our online advocacy actions and providing them with resources to plan their own events on campus. September’s focus centers on the opening of the 69th United Nations General Assembly in New York – the starting point for the final round of deliberations that will finalize the post-2015 development agenda and adjoining Sustainable Development Goals (SDGs). The SDGs, which will succeed the Millennium Development Goals set in 2000, will play a key role in guiding international development and global health efforts over the next fifteen years. It is critical that a health target to control and eliminate NTDs is included in the final SDGs, not only to ensure that they are prioritized on national and global development agendas over the next fifteen years, but also because treating these diseases is necessary to ensure that our goals to improve nutrition, education, health and economic productivity are successful.

To that end, END7 has launched a petition targeting Ambassador Elizabeth M. Cousens, United States representative to the UN Social and Economic Council, asking her to continue to support the inclusion of NTDs in the SDGs as the goals are being finalized over the next year. To help us spread the word and collect more signatures on this important petition, we created a Student Action Kit to give students all the tools they need to be informed and effective NTD advocates: key facts about the United Nations and the SDGs, suggested tweets to promote the petition, ideas for events to help drum up support on campus, links to factsheets and a downloadable poster to spread the word, and even a Prezi presentation students can give to classes and club meetings.

Students have already made tremendous progress in their advocacy – in just one week, they’ve collected over 500 signatures on the petition, and our END7 Student Advisory Board representatives are poised to collect 500 more on post cards we printed with space for personal messages asking Ambassador Cousens for her support of the inclusion of NTDs in the SDGs. We know this outpouring of public support will send a strong message to the United Nations as we chart a course for the next fifteen years of international development efforts – a message that our generation is committed to seeing the end of NTDs.

We are so proud of our student supporters’ efforts to speak out on behalf of the poor and vulnerable communities most impacted by NTDs. If you (or a student you know!) want to get your campus involved, email me at emily.conron@sabin.org to get started, check out our Ideas for Students, and join our END7 Students Facebook group.

Tearing Down the Roadblocks: Another Look at Building the Resilience of Smallholder Farmers

 

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As I drove home from the Baltimore-Washington International Airport earlier this month, I could not help but notice the electronic bulletins on the I-95 and Capitol Beltway that flashed “D.C. Event Aug 4-6, expect delays.” The event, of course, referred to the first ever U.S.-Africa Leaders Summit, while the delays referred to the inevitable abundance of motorcades.

During the span of those three days, nearly 50 African heads of state gathered in Washington, D.C. for discussions with President Obama, administration officials and business leaders on a range of topics under the theme of “Investing in the Next Generation.” While we expected many roadblocks to be put up around D.C. that week, we were hoping that one major development roadblock would be pulled down during the Summit: neglected tropical diseases (NTDs).

These parasitic and bacterial infections affect 1.4 billion people living in poor and marginalized communities around the world, particularly in agricultural populations. Once infected, poor communities remain impoverished due to resulting physical and mental disabilities, including blindness, anemia, immobility, delayed cognitive development and social stigma. NTDs leave children too sick to attend school and keep adults from working. And because NTDs destroy vital social and economic capital, controlling and eliminating these diseases must be an essential element of the emerging new Africa that is increasingly seeking growth through business opportunities.

Regretfully, NTDs and the roadblock they raise against productivity and prosperity were not prioritized at the Summit (outside of a mention in USAID’s press release about its major initiatives). While we were happy to see impressive new private-sector commitments to electricity and food security, particularly to the New Alliance for Food Security and Nutrition, the omission of NTDs from those conversations and commitments signaled a missed opportunity for US-Africa relations.

For example, over the past two years, private companies, philanthropists and governments have committed an astounding $10 billion for agriculture investments in Africa through the New Alliance for Food Security and Nutrition. This initiative was launched in 2012 to build on the commitments made by G7/8 leaders to achieve sustained and inclusive agricultural growth, food security and good nutrition in the region over the next ten years.

While the New Alliance (and many other initiatives) is undeniably doing great work at strengthening the resilience of agricultural communities in Africa, fighting NTDs is an immediate and cost-effective opportunity that is available now to expand and strengthen these efforts. By working to reduce the incidence of NTDs in Africa, partners could positively impact the New Alliance’s same target areas, and more importantly, the poorest populations most affected by poor nutrition and food security.

Because Africa’s core agricultural workforce — smallholder subsistence farmers — are disproportionately affected by NTDs, the billions of dollars in agricultural investments made by governments and the private sector could be undermined if NTD control and elimination is not prioritized. In fact, smallholder farmers will be less productive and derive fewer benefits from New Alliance funding if NTDs are not addressed.

NTD infections also prevent people from enjoying the benefits of having access to a diverse, nutrient-rich diet. Roundworms, for example, compete with children for key nutrients and vitamins in order to grow. As a result, roundworm infections and other NTDs have serious consequences on a child’s growth and development, leading to micronutrient deficiencies, stunting and overall poor nutritional status.

Simply put, the New Alliance’s goals of achieving food security and good nutrition in Africa cannot be fully and sustainably achieved without addressing NTDs.

Many incredible (and highly cost-effective) victories have been won in the fight against NTDs, but greater investments are still needed to help smallholder farmers overcome the first basic roadblock to doing good business. Tackling NTDs truly helps communities invest in the next generation by offering them the opportunity to participate in their own sustainable solutions to poverty.

Watch for more information from the Global Network on the important linkages between NTDs and nutrition in the coming months!

Going Beyond Cooperation: Why it’s Critical for NTD Control and Elimination in Nigeria

 

Trachoma prevalence mapping in Katsina State by State Team of Examiner and Recorder on hand-held mobile device. Photo from RTI International.

Trachoma prevalence mapping in Katsina State by State Team of Examiner and Recorder on hand-held mobile device. Credit: RTI International.

The following guest blog post from Benjamin Nwobi, resident program advisor for RTI International and the ENVISION project in Nigeria, and Sunday Isiyaku, country director for Sightsavers in Nigeria and lead for the UNITED Project, details a new alliance aimed at strengthening Nigeria’s Neglected Tropical Disease (NTD) program and maximizing the impact of resources directed at NTD control and elimination.

If we are to succeed in reaching the World Health Organization (WHO) NTD control and elimination targets for 2020, we must focus on Nigeria – a country with one of the highest NTD burdens in the world. We therefore commend the government of Nigeria for making NTDs a priority and working with partners to implement the national integrated NTD control and elimination plans. Such efforts have contributed to the eradication of guinea worm and will surely contribute to efforts such as the Saving One Million Lives Initiative.


 

It has been one hundred years since Nigeria’s independence and while much has changed through substantial development and investments, Nigeria’s rating against the World Health Organization’s (WHO) Health-Indicators still lags; maternal and child morbidity and mortality remain high and quality and affordable health services are either lacking or not readily accessible, especially for the 70 percent of Nigerians living on less than $2 a day.

It is not surprising then that Nigeria carries one of the highest burdens of neglected tropical diseases (NTDs). These communicable diseases are inextricably linked with poverty and are prevalent in areas with poor sanitation, inadequate safe water supply and substandard housing conditions. In late March 2014, Nigeria and its partners celebrated the country receiving the WHO certification for officially eradicating Guinea worm disease. Nigeria had been the most endemic country in the world for guinea worm with over 800,000 cases documented. Scale-up efforts are now underway to achieve control and elimination of other high prevalence NTDs such as onchocerciasis, soil transmitted helminths (STH), schistosomiasis, trachoma and lymphatic filariasis (LF) by the year 2020.

An enormous task

An undertaking so ambitious requires unprecedented partnership and coordination. Nigeria is a federated country consisting of 36 states and 774 local government areas and each level of government plays a specific role in fighting NTDs. Implementing a national NTD programme that can effectively wipe out these diseases is an enormous task.

An estimated 31 million people are currently at risk for onchocerciasis across 32 states of the country. Though prevalence mapping is still underway, Nigeria is ranked third highest in the world for LF, with 63 million persons at risk, and is estimated to have one of the highest STH burdens in Africa. Trachoma is the second major cause of avoidable blindness in the northern part of Nigeria. Ongoing mapping efforts will provide more information on exactly which areas require treatment.

As Dr. Bridget Okoeguale, Director of Public Health at Nigeria’s Federal Ministry of Health so aptly expressed, “We must work as a team or we cannot go anywhere.”

Promoting standardization

This is why USAID’s ENVISION Project implemented by RTI International and the Carter Center, and DfID’s UNITED project, led by Sightsavers, are establishing a new working order to donor-driven support for the national NTD programme in Nigeria – an alliance, aimed at exploiting synergies, eliminating duplication of efforts and maximizing impact of resources directed at NTD control and elimination.

With ENVISION working primarily in central and southern Nigeria and UNITED in northern Nigeria, the alliance helps the national program to maintain consistency and promote standardization of approaches across the various states, supporting not only the integrity of programming but also management functions such as drug logistics and data reporting, playing off the respective strengths of the partner organisations.

Children in Nasarawa State, Nigeria gather to learn how samples will be collected in their school. Photo by RTI International.

Children in Nasarawa State, Nigeria gather to learn how samples will be collected in their school. Credit: RTI International

Maximizing reach and impact

Teams from ENVISION and UNITED support many of the same core programme areas in the states where they work; activities like mass drug administration and community education and sensitization. But each project also brings additional areas of support, not necessarily provided by the other project. Forming this alliance has allowed more geographic reach for this expertise than could be achieved otherwise.

RTI International has introduced a new planning tool, the NTD Tool for Integrated Planning and Costing (TIPAC) across the country, and this is now being used nationwide to improve planning and costing. RTI has also worked with the WHO to develop an integrated NTD database platform that will allow the country to store, manage, analyze and report NTD data more effectively across all states.

Sightsavers has been focusing on improving supply chain management for commodities such as drugs in its project states. The national-level component of this project supports clearing of all NTD drugs to the national Drug Storage. Again, in this case, all other states benefit from strengthened supply chain capacity and are therefore able to maximize output. They have also developed behaviour change tools and strategies that will be applied across Nigeria.

The synergies that have resulted from this close alliance bring unique benefits to Nigeria’s national NTD programme and its ability to advance towards its elimination timeline, especially when coupled with the comparative advantages for implementation achieved through the coalition of organisations working across the nation.

As we enter another century in Nigeria’s history as a country, we are hopeful that this alliance will continue to be one of the critical pillars in supporting the Nigerian Government in reducing the NTD burden. Together we will see how, when a country is committed and aid organisations and international governments synchronize and combine their efforts, ambitious goals can be achieved and the lives of Nigerians improved forever.