Monthly Archives: May 2013

Travel log: Getting there is half the battle

NTDs


By Richard Hatzfeld

Richard recently traveled with filmmaker Mo Scarpelli to explore what life is like in , an area that supplied most of the country’s “conflict diamonds” during its bloody civil war, and which has some of Sierra Leone’s highest rates of neglected tropical diseases.

Seiyo

Driving east from Freetown, Sierra Leone, to the remote district of Kono, the challenge of getting medicine to the communities that need it becomes pretty clear.  The country’s infrastructure is slowly being rebuilt after a devastating civil war, but many of the roads can’t withstand the rainy season that lasts from May until October.

Following a downpour, roads are often transformed into rivers of mud, with pot holes large enough to swallow trucks.  Once one vehicle becomes stuck, it creates a bottleneck that prevents other cars and trucks from passing.  It’s not unusual for some drivers to be stuck for days during especially torrential downpours, forcing them to sleep on the road and find food wherever they can.

Helen Keller International, our partner in a recent treatment program for neglected tropical diseases (NTDs) in Sierra Leone, overcame these types of challenges as they transported hundreds of boxes of pills upcountry to Kono district.  Drivers like Seiyo – pictured here – are unsung heroes in the effort to control and eliminate NTDs in Sierra Leone and around the world.

Often pushing vehicles to their mechanical limits, finding invisible pathways through the mud, and helping to clear stuck trucks, Seiyo and others like him ensure that the key transit routes for Sierra Leone’s commerce stay open and essential medicines get to the people.

You can see more stories about unsung heroes and others filmed during my trip to Kono District in “In the Rough,” a new short film by the END7 Campaign.

 

Papua New Guinea successfully integrates five essential maternal and child health services

Asia

PNG map

By Anupama Tantri

Papua New Guinea is one of the most culturally diverse places on earth, with over 800 languages spoken across the country.  Despite its rich heritage and natural resources, many people live in extreme poverty with more than one-third of its 7 million people living below the national poverty line. More than 80 percent of the population lives in rural areas, and only 33 percent of this rural population have access to a safe water source. Much of the country is only accessible by air and less than 5 percent of roads are usable year round.

In addition to the lack of infrastructure and access, another factor impeding development and growth in Papua New Guinea is the high burden of communicable diseases, particularly neglected tropical diseases (NTDs). NTDs affect the poorest, most neglected populations, particularly those living in remote rural areas. In Papua New Guinea, more than 80 percent of the population is at risk for at least one NTD.

Soil-transmitted helminthes (STH), or intestinal worms, are among the most common NTDs in Papua New Guinea. STH infections cause malnutrition and anemia, can result in adverse pregnancy outcomes such as low birth weight and contribute to poor physical and cognitive development in children. Approximately 2.5 million children in Papua New Guinea require deworming to protect them against STH infections. Continue reading →

17 diseases, 1 resolution and a better future for more than 1.5 billion people

NTDs, , , World Health Assembly

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Taking on 17 diseases with names like schistosomiasis, lymphatic filariasis and dracunculiasis may seem daunting. Yet earlier this year the World Health Organization (WHO) set targets for intensified control, elimination or eradication of all of these neglected tropical diseases (NTDs) by 2020.

In the past, NTDs were tackled vertically, or one by one, even in parts of the world where people were at risk for multiple infections. For decades the World Health Assembly (WHA), the decision-making body of the WHO, has chipped away at this huge global health challenge by passing resolutions that address individual NTDs.

But yesterday the WHA passed a landmark resolution that for the first time takes on all 17 NTDs at once. The resolution reinforces the approach that the global health community has taken recently to combat NTDs, which focuses on combining treatment programs for the most common NTDs to achieve cost reductions and increase coverage.

This is significant not only because it more effectively addresses these pervasive diseases of poverty; it also elevates the status of diseases that individually would not attract such attention, despite their tremendous impact on the world’s most vulnerable populations. Now is the time for action. As Dr. Neeraj Mistry, managing director of the Global Network, notes in the video below:

“Collectively, these 17 diseases affect a billion and a half people around the world and these are the billion and a half people that live on less than a $1.25 a day. This resolution means that governments around the world will actually institute policies and put money towards tropical diseases programs to change the predicament of the poorest communities.”

For full coverage of the WHA resolution, visit the WHO’s Neglected tropical diseases page.

Linking HIV with Neglected Tropical Diseases (NTDs)

HIV/AIDS

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Dr. Neeraj Mistry, managing director of the Global Network, wrote this blog post on the close relationship between neglected tropical diseases and HIV/AIDS for the Elizabeth Glaser Pediatric AIDS Foundation. We’re reposting it here with their permission.

By Dr. Neeraj Mistry

Recently, there has been a lot of discussion about global health funding and how we can do more with less. As we reflect on 10 years of the President’s Emergency Plan for AIDS Release (PEPFAR), move forward with new funding streams for the Global Fund and transition bilateral and multilateral support to country-ownership platforms, we must examine the best ways to link HIV/AIDS services with other global health interventions. HIV/AIDS programs are often linked with other major global health challenges like tuberculosis, malaria, cervical cancer, and male circumcision.

But one integration approach that is not widely recognized but can have a far-reaching impact on HIV/AIDS treatment and prevention methods is for a little-known but widely pervasive group of parasitic and bacterial infections known as neglected tropical diseases (NTDs).

NTDs infect more than 1.4 billion people living in poverty around the world and disproportionately impact women and children. Geographically, areas of high NTD infection overlap with areas that have high prevalence rates of HIV/AIDS. from the past twenty years have shown different ways that HIV/AIDS can be exacerbated by various NTD co-infections. NTDs weaken the immune system, making it more likely for an individual to contract other diseases and less likely that they will be able to fight them. Recent studies have shown that treatment for some NTDs is associated with decreased HIV viral loads and/or elevations in CD4 counts. Maternal soil-transmitted helminth infections, such as hookworm, roundworm, and whipworm, increase the risk of maternal-to-child HIV/AIDS transmission.

A parasitic infection known as schistosomiasis or snail fever is another major co-infection challenge that infects more than 200 million people, mostly in sub-Saharan Africa. It is transmitted by contact with contaminated fresh water, so swimming, bathing, fishing, and even domestic chores such as laundry and herding livestock can put people at risk of contracting the disease. But one form of the disease has particular repercussions for women and their health and reproductive systems. Known as female genital schistosomiasis (FGS), it causes pain and bleeding in the uterus, cervix and lower genital tract. These lesions provide conduits for the HIV virus to enter and infect women. Women with FGS have a 3-4 fold increase in the risk of acquiring HIV/AIDS. Not surprisingly, maps of the distribution of schistosomiasis and HIV/AIDS in Africa reveal extensive overlap in southern Africa, especially in Mozambique, South Africa, Tanzania, and Zimbabwe.

Integrated treatment campaigns for NTDs and HIV/AIDs need to begin now. It took almost 10 years for the AIDS community to accept the link between circumcision and HIV transmission and we don’t have that kind of time or resources to waste. By working together, the NTD and HIV/AIDS communities can enhance the impact of their programs, work more efficiently, and build better lives for at-risk communities around the world.

Dr. Neeraj Mistry is the managing director of the Global Network for Neglected Tropical Diseases, an initiative of the Sabin Vaccine Institute. Dr. Mistry was a founding member and former vice president of the Global Business Coalition on HIV/AIDS, Tuberculosis and Malaria (GBC) where he led the work on co-investment and public-private partnerships with the President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund.