By Romina Rodríguez Pose, independent consultant on international development and lead author for the Health Dimension case studies, Development Progress Project.
Neglected tropical diseases (NTDs) affect the poorest billion people in the world. They cause number of chronic health conditions that largely limit people’s ability to study and work and consequently have a healthy and productive life. The stigma attached to them can also lead to isolation and fear for those who suffer.
Although they have been long ignored within international and national agendas, in the last decades, there has been an increasing awareness of how NTDs can impede endemic countries from achieving public-private partnerships involving major drug donations from key pharmaceutical companies, the development of inexpensive control strategies and a growing number of donors earmarking funding for integrated NTD control.
Cambodia in Asia. In spite of their different contexts and epidemiological profiles, three drivers have emerged in both case studies:
1. Advances in the fight against NTDs have been driven by the availability of earmarked funds and donated drugs. These have been crucial for both resource-constrained countries, since most endemic countries are faced with several competing, and perhaps more urgent, health issues (such as high mortality rates for mothers and children in Sierra Leone and dengue outbreaks in Cambodia). As a counterpart, political will and local engagement to take advantage of global initiatives have been crucial in bringing NTDs within the national agenda. Both governments, through their Ministries of Health, have proactively looked for partners, secured funds and drugs donations and made important efforts to develop local capacity.
2. There is an important transitional role for development partners in providing access to strategies and guidelines on how to deal with NTDs until local capacity is fully developed. In both countries, this was achieved through bilateral, regional and global partnerships that helped build the local knowledge base for endemic countries to find their own solutions and to implement strategies according to the particular context. These dynamics between development partners and NTD programme managers have gradually led to a ‘transfer of ownership’ of the NTD programmes.
3. The integration of NTD activities within an existing government structure has been vital to set up cost-effective NTD programmes. Both countries have integrated the distribution of drugs within health and education systems. In Cambodia, given the main threat is from intestinal worms which particularly affect school-aged children, progress has been achieved by integrating the distribution of drugs into the school system and turning teachers into twice-yearly doctors/pharmacists. In Sierra Leone, given that the entire population is at risk from at least three NTDs, the main strategy involved the engagement and training of community members as drug distributors. Elected by their communities, their work is divided into catchment areas for which they are responsible, reaching the most remote corners of the country.
Despite the increasing awareness of their importance, NTDs still loom large in the cycles of poverty, ill-health and under-development that afflict too many developing countries. Yes, as Sierra Leone and Cambodia show, progress can be achieved in the most difficult contexts and with minimal resources, stressing the importance of including NTD control and elimination targets within the post-2015 sustainable development goals.
All photos by Romina Rodríguez Pose.
By Kim Koporc, Director
More than 800 million children are at risk of infection with intestinal worms, and at greatest risk are school-age children (age 6 to 15) – 600 million of them. Worms sap children of the nutrients they need to grow and learn, but there is a solution. I recently traveled to Cambodia with the Global Health TV to tell the story of a deworming day – a day when children receive deworming medication and learn about handwashing and sanitation. Check out the video below to learn more about a deworming day.
Reposted with permission from the ONE Campaigns blog
Kim Koporc from Children Without Worms (CWW) writes about an illness that affects children all over the world, including Africa: intestinal worms.
When I visited Cambodia with Johnson Johnson for a deworming day at Poek Ho (waterfall) school in Kandal Province, I was struck by the sheer number of students who lined up to receive mebendazole. These children showed up to receive treatment for intestinal parasites with mebendazole donated by Johnson Johnson. They also received a meal, which for some was likely the only meal they received that day.
These children were at particular risk of infection with intestinal worms because worms thrive in the warm climate. The lack of access to sanitation facilities in Cambodia doesn’t help much, either. In America, it is hard for us to imagine that more than 1.2 billion people living in developing countries are infected with intestinal worms. Worms are most prevalent in children between the ages of 6 to 14 and can lead to malnutrition, robbing them of the energy they need to learn and grow.
Schools provide CWW and our partners with a means to distribute the mebendazole to the children who need it, and schools also provide a platform to teach STH prevention by promoting healthy behavior within the classroom. Helen Keller International, our partners in Cambodia, works to integrate deworming prevention and hygiene into school programs and curriculum.
Even though schools provide a platform for reaching children in Cambodia, many of the poorest children do not have the resources and ability to attend school, and therefore, are left out of these deworming days. Strategies need to be developed to target this vulnerable population, such as inviting non-enrolled children to attend on “deworming day” and working with community leaders to identify and treat these children.
Treatment, hygiene education and access to sanitation and clean water are all components needed to bring STH infection under control, and together, governments, NGOs and other groups can come up with better solutions to reach this vulnerable population and find ways to prevent and treat intestinal worms.
There are many health challenges that children face throughout the world. But for intestinal worms, there is a solution that greatly improves a child’s capacity to learn and grow. A dose of medication, along with hygiene education and access to sanitation, are vital steps forward in improving a child’s life.
Johnson Johnson to school age children as part of the Cambodia’s national deworming program.