Together with international partners and NGOs, the government of Nigeria has the potential to drastically expand and strengthen their neglected tropical disease (NTD) program to treat and protect its population from the devastating impact of NTDs. Nigeria bears the largest NTD burden within sub-Saharan Africa, but the country’s national plan to tackle NTDs has already laid the groundwork for controlling and eliminating these diseases by 2020. However, additional training, especially at the state level, will help Nigeria scale up and maintain a sustainable NTD program that could lead to the control and elimination of NTDs by 2020.
Nigeria’s geography poses a unique challenge in the fight against NTDs. For example, each Nigerian state possesses its own quasi-autonomous state ministry of health each with its own integrated NTD program. With this challenge in mind, The World Health Organization (WHO) and partners developed a training program for the first week in February for the 36 Nigerian states and the Federal Capital Territory (FCT) to provide representatives with the tools and technical skills needed to establish, scale up and sustain integrated NTD programs within their respective states. The training was supported by The Envision project, The United project, and was attended by state representatives, including federal ministers of health, members of federal NTD teams and zonal coordinators and NGO partners.
Highlights from the 5-day training were shared through Twitter, thanks to @NTDNigeria and RTIinterntional:
Dr Pamela Mbabazi of pic.twitter.com/zKsaTr4Z8O
— NTDnigeria (@NTDnigeria) February 5, 2014
Throughout the training, facilitators from Nigeria and the U.S. led sessions on scaling up integrated MDA programs, monitoring and evaluation, data management and advocacy. The facilitators also went over some basic but essential tasks – including filling out the appropriate forms to apply for NTD medications.
During her session, Global Network senior program officer Wangechi Thuo stressed the importance of effective advocacy in creating sustainable NTD programs. She led participants through exercises, demonstrating how to effectively raise awareness about NTDs among key policy influencers with the goal of garnering sustained ownership, leadership, and commitment from governments and their partners for NTD programs
Wangechi Thuo of the pic.twitter.com/Qyuk68WU2B
— NTDnigeria (@NTDnigeria) February 4, 2014
The training also brought together key government partners including Nigeria’s National Agency for Food and Drug Administration and Control (NAFDAC) and the National Primary Health Care Development Agency. Together, partners discussed ways to better and more effectively distribute NTD medicine to populations in need. While Nigeria has the medicine necessary to treat its population, delivering the medicine to more than a hundred million Nigerians is a difficult task.
As the globe moves towards NTD elimination by 2020, Nigeria must remain a top priority given its large NTD burden. Thanks to this month’s NTD workshop, Nigeria’s government expects to see more and more people treated for NTDs, and more precise monitoring and evaluation of drug delivery in the coming year. Through continued government and partner support, Nigeria can see the end of NTDs. In the words of Dr. Bridget Okuaguale, Director of Public Health (DPH) at the Federal Ministry of Health, “We must work as a team, or we cannot go anywhere.”
In late January, the African Union’s (AU) 22nd Heads of State Summit launched 2014 as the Year of Agriculture and Food Security. Through increased dialogue, innovations, and advocacy, the AU is seeking to make lasting advances in improving nutrition, ending hunger, increasing gender equality and creating jobs.
But those aren’t all the positive steps the AU is taking to accelerate poverty reduction.
In her speech to the Heads of State and Government, HE Dr. Nkosazana Dlamini Zuma, Chairperson of the African Union Commission envisioned the African continent in 2063. She said, “If I have to single out one issue that made peace happen, it was our commitment to invest in our people. … Coupled with our concerted campaigns to eradicate the major diseases, to provide access to health services, good nutrition, water and sanitation … our people indeed became and are our most important resource.”
We couldn’t agree more. The fight against neglected tropical diseases and other diseases is about much more than just ensuring good health. It’s about empowering individuals to live productively and engage in society – having the potential for a radical transformation that leads to growth of all kinds ahead.
It is remarkable, therefore, that at the Summit, the AU adopted the Continental Framework on the Control and Elimination of Neglected Tropical Diseases (NTDs) in Africa by 2020 called “Neglected Tropical Diseases in Africa, the End is Possible.”
This is a tremendous momentum builder for efforts to combat neglected tropical diseases (NTDs) – which exacerbate the lack of food security and malnutrition – and reaffirms African leaders’ commitment to making NTDs a priority for Africa’s health and development agenda.
This key Framework was first discussed during the Sixth Conference of African Union Ministers of Health (CAMH6) held last year. This document echoes the World Health Organization’s goal to end NTDs as public health treats by 2020 and calls attention to the milestone London Declaration for NTDs.
Simply put, the Global Network is thrilled to see the AU’s leadership on NTDs. Controlling and eliminating NTDs by 2020 will not be possible without African country government ownership in expanding commitments to prioritize NTDs, mobilize resources, strengthen advocacy and coordination, collaborate with partners, and enhance monitoring and evaluation.
Eliminating the most prevalent neglected tropical diseases (NTDs) from our planet is an ambitious goal. It requires commitment, patience, know-how and dedication: qualities that are also required to summit Mount Kilimanjaro. This summer, the Summit to See the END.
According to Sarah Marchal Murray, Senior Vice President of the END Fund, Summit to See the END came into fruition after a new board member and avid hiker joined the END Fund team this past summer. His combined passion for hiking and ending NTDs in children fueled the idea. In November, the END Fund turned this idea into a reality as they “soft launched” the project and started to spread the word amongst the END Fund community.
The ultimate goal of the journey is three-fold:
- to demonstrate the exhilaration that comes from tackling the 19,341 ft summit and draw the parallel in tackling NTDs,
- to raise awareness about NTDs and how they affect the most impoverished populations, and
- to mobilize crucial donations for the END Fund’s work in 2014 and beyond.
Hikers also pledge to reach out to their networks to help achieve these goals, in addition to making an initial individual commitment. After summiting Kilimanjaro, they will also participate in an NTD learning day where they’ll be able to see NTD control programs in action, interact with those closest to the cause, and meet members of a community affected by these debilitating and disfiguring diseases.
But the journey to the top of Mount Kilimanjaro is far more meaningful than a set of goals typed on a website. Sarah sees this trek as a life-changing and transformative journey that requires those involved to deliberately reflect on their own commitment to ending NTDs, as well as the lives of those suffering from these debilitating diseases.
Besides getting the body and mind in shape for the hike, the training process also provides the hikers with another way to connect with their families and communities and increase NTD awareness.
The END Fund hopes that the experience will leave a lasting impression, fueling the hiker’s engagement with the NTD cause and motivating each hiker to share their experiences with those close to them – further expanding the network and increasing awareness for NTDs.
“Providing our community with a link to the people we serve was important to us. We think the summit is symbolically significant: if each individual hiker comes home and shares with their networks and circles how it personally touches them, there’s a ripple effect,” Sarah explained. “While financial resources are imperative if the NTD community is going to reach our aims of control and eradication by 2020, there is great power in the amplification of our voices amongst each hiker’s personal circles.”
For hikers like Sarah, this experience is a very personal one. In a letter addressed to her friends and family, she explained why she is making the trek.
“Partially because of where my husband and I are lucky enough to live, we wont have to worry about our daughter contracting one of the five disabling, debilitating and deadly diseases known as NTDs. A group of parasitic and bacterial infections, they affect nearly 800 million children and are the cause of death for over 500,000 people per year.”
“So [I am hiking] to prove to myself and my daughter that anything is possible.” In addition, she writes, “[I am hiking] so that the only worms I need to educate my daughter about live in the ground and not inside children her own age.”
Ultimately, like the fight to end NTDs, the preparation and hike up Mount Kilimanjaro is a marathon – not just a sprint.
“NTDs won’t be wiped off the planet this year,” Sarah said. But if we concentrate our efforts, join together with the growing international movement committed to seeing their END, and continue to push forward, “we can summit to see the END in our lifetimes.”
Learn more about Summit to See the END.
By Wangechi Thuo and Andrew Carlson
The Community Eye Health Journal announced in November that the National Blindness Prevention Programme (PNLC) in Mali, established in 1998, is on track to eliminate trachoma as a cause of blindness by 2015.
Trachoma is a bacterial disease that is transmitted through flies that come into contact with infected people or person to person contact. In areas where people live in close proximity, the disease spreads at an alarming rate, and can quickly infect entire communities. Repeated infection causes eyelids to turn inward and scratch the cornea, leaving an infected individual one unbelievably painful step closer to blindness with every blink they take, a process called trachomatous trichiasis
Just before PNLC’s inception, Mali bore a generous portion of the global burden: during a national survey conducted in February 1996-May 1997, an estimated 85,700 people needed trichiasis surgery.
Since then, The END Fund, and the International Trachoma Initiative (ITI). The PNLC has set a high standard in trachoma elimination that similar national initiatives throughout sub-Saharan Africa strive to emulate.
Three important benchmarks help explain how Mali has achieved this success:
- Distribution of antibiotics: Through district-level mass drug administration, the PNLC has reduced active disease well below the recommended threshold in 84% of the districts in which the disease is present
- Surgical Efficiency:
trichiasis surgeries were conducted by only a handful of surgeons
- Preventive sanitation: Since 2009, 53,090 latrines have been constructed allowing safer disposal of waste
To foster community awareness, the PNLC has developed a primary school curriculum on trachoma, trained community leaders in trachoma prevention and ensured the dissemination of health messages through radio broadcasts with help from HKI.
PNLC’s successes are even more laudable as they were achieved in spite of the military coup d’état in March 2012, which elicited a considerable decrease in financial support to the Malian government.
With support from partners, Mali is less than one year away from achieving the goal of trachoma elimination and is positioned to celebrate this achievement, five years ahead of the global elimination date. Mali’s success story and lessons learned can provide can also be example for more countries throughout the world.