By Helen Hamilton, Policy Advisor on NTDs at Sightsavers
This week the Neglected Tropical Diseases (NTD) community will come together at the NNN – a welcome acronym for the Non-government Development Organisations Neglected Tropical Disease network. Together, we’ll be reflecting on achievements such as the global trachoma mapping project and the challenges ahead if we are to achieve our elimination goals.
At the same time, across the Atlantic, world leaders in New York will turn their attention to questions of poverty eradication and sustainable development in the post-2015 development agenda.
Today many millions benefit from the huge advances and scale up in the NTD response but many others won’t unless more is done to reach the most vulnerable across the globe – those already marginalised and underserved by national and global development. For the NTD community, the post-2015 dialogues are a huge opportunity both to ensure the specific inclusion of NTDs within the framework and provide an enabling environment, such as improved hygiene alongside water and sanitation, which supports the elimination and control of these diseases.
We know that nothing has more impact on health than poverty and marginalisation and this holds true for NTDs. That’s why we’re calling for a post-2015 development framework that includes NTDs and also addresses their major risk factors, such as inadequate access to health and water, sanitation and hygiene services.
Why is this important to the NTD response? Because one billion people globally who are affected by NTDs precisely because they are marginalised, vulnerable and living in poverty. Their health needs and rights are not met and upheld.
A new focus
The focus of post-2015 has been addressing broad systematic inequalities that keep people in poverty and allow diseases to flourish. The focus on delivering lasting change and the recognition that equity and wellbeing must be central in this new agenda aligns squarely with the NTD response.
One of the major ideas to gain traction in post-2015 discussions is ‘leave no one behind’. This shift would mean that no post-2015 goal could be reached unless it meets the need of everyone – in particular poor and marginalised groups such as people with disabilities, children and older people.
To do this, we need a framework that puts people at the centre that addresses the structural barriers to accessing health services, such as making health services accessible and inclusive to people with disabilities.
A new health narrative
Under the MDGs, there were three health-focused goals but this is unlikely to be the case for the post-2015 framework. The health sector has united behind the call for one goal that supports healthy lives for all. Building strong and resilient health systems are critical to achieving and sustaining NTD goals. Health systems are the only way to ensure that everyone everywhere can access the healthcare they need, including targeted NTD services, when they need it and in a way that is affordable.
A dedicated NTD target
Within any health goal we need a specific NTD target that delivers on preventive, curative and rehabilitative care for people at risk or affected by NTDs. To do this effectively and support the NTD response, it will need to draw on existing targets and objectives that the NTD community is working towards, such as the WHO NTD roadmap and the London Declaration on NTDs.
Neglected no more
The post-2015 discussions are primarily a question of people’s opportunity to influence their future. Good health plays a critical role in empowering people to achieve other development goals. Neglected populations who have been subject to centuries of ill health caused by neglected tropical diseases must be prioritised within any new framework if we are truly committed to leave no one behind.
Improving health is not just a case of tackling disease but influencing the wider determinants of health such as poverty, employment, housing and education that allow NTDs to exist and flourish. We need a framework that takes a dual approach to NTDs – addressing them directly through specific targets and indicators while also recognising that universal health coverage within stronger health systems and eliminating extreme poverty are critical to ending NTDs.
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 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 firstname.lastname@example.org
In an important new paper, Liverpool School of Tropical Medicine, captures why defeating neglected tropical diseases (NTDs) is so critical. He writes, “The overall context of NTD control is the contribution it makes to the alleviation of poverty and improved social and economic prospects of individuals and communities.”
Given NTDs’ profound impact on poverty — and the potential for their control and elimination to make progress towards the Millennium Development Goals (MDGs) and targets set in the post-2015 development agenda — NTD partners must do everything possible to ensure World Health Organization (WHO) targets are met by 2020.
Before outlining the key challenges and actions needed to overcome them, Professor Molyneux recognizes advancements made in the global NTD fight.
For instance, in 2006, the U.S. committed resources to implement integrated NTD control programs through historic resolution on all 17 NTDs in May 2013.
2013 was also a milestone year because the UN Secretary-General’s High-Level Panel Lancet editorial reiterated the importance of addressing NTDs in the Sustainable Development Goals, and in summer 2014, the draft SDGs featured NTDs under proposed goal 3, “Attain healthy lives for all.”
Efforts in endemic countries have also led to successes. For instance, innovations in mapping disease burdens and diagnostics prove that “defining the areas of intervention can be undertaken rapidly and without the need for invasive or intrusive procedures [which have] been a contributing factor in the successful scale up of mass drug administration.” Community Directed Treatment (CDTI) and the reliance on existing infrastructure have helped “ensure that drugs are collected and distributed in ways that are best decided by the communities themselves.”
Yet remaining challenges could threaten the tremendous momentum attained to-date. The challenges — and their solutions— according to Professor Molyneux include:
Implementation. Even though “over the past 3 years, in excess of 700 million treatments have been given annually” for the seven most common NTDs, efforts must be scaled up to reach all at-risk people, especially in conflict areas.
Application of research. While the NTD community has produced a rich body of research, “moving policy into practice needs to be accelerated.”
With the progress made thus far, there is clearly no choice but to continue the good work being carried out and expand efforts where current challenges lie.
To read the paper,
In a recently-released policy brief, partners from the global health community continue to urge all United Nations (UN) Member States to ensure that the forthcoming post-2015 framework include specific targets for the control and elimination of neglected tropical diseases (NTDs); Doing so would reduce human suffering, increase economic prosperity and help achieve greater global equality for more than one billion people affected by NTDs in the developing world.
Because NTDs have far reaching effects on several other poverty and development interventions – such as efforts to increase maternal and child health, combat HIV/AIDS and increase school attendance and nutrition – the inclusion of NTDs in the post-2015 framework would be a win for not just the NTD community, but for all those seeking to end poverty, increase health and boost prosperity.
Even more, when integrated with water and sanitation, nutrition, child and maternal health, and education initiatives, NTD control and elimination efforts are proven more effective and sustainable. The overlapping nature of NTDs should be clearly stated in the final post-2015 development agenda, state the co-signers of the policy brief.
Investing in the control and elimination is a “best buy” and one of the most cost-effective health interventions in global health. For approximately US $0.50 per person per year, we can treat and prevent these diseases and in turn improve nutrition, education, maternal and child health, and HIV outcomes, and set the stage for sustainable and inclusive economic growth.
UN Secretary General has already echoed the importance of NTD control and elimination efforts in the fight against poverty. “I share your view that poverty reduction and the elimination of NTDs go hand-in-hand,” he said in October, 2013.
NTDs have already been included in the UN High Level Panel’s final 2013 report on the post-2015 agenda; in the World Health Assembly’s May 2014 resolution on health and the post-2015 development agenda; and, just last week in the UN’s Open Working Group on Sustainable Development Goals’ final draft of the Proposed Sustainable Development Goals and Targets for the post-2015 agenda.
While the inclusion of NTDs in the preceding reports and resolutions is a very promising sign, government leaders must continue to support the inclusion of health goals and targets for NTDs during the Member State negotiations throughout the coming year. This continued support will help build momentum leading up to the final post-2015 development agenda and its ultimate approval in the fall of 2015.
To read the full brief, click here.