Monthly Archives: June 2013

Spotlighting NTDs Will Further Pres. Obama’s Goals for Africa Trip

Obama Administration

After stopping in Gorée Island, Senegal, President Obama remarked, “I’m a firm believer that humanity is fundamentally good, but it’s only good when good people stand up for what’s right.”

While President Obama was referencing the need to strengthen and uphold human rights protections, his comment certainly applies to the urgent obligation to control and eliminate NTDs in Africa. With over 90% of the NTD burden occurring in this continent, Africans are deeply suffering from the debilitating health, social, and economic impact of these diseases – and remain stuck in extreme poverty as a result.

As the President continues his tour encouraging African nations to foster economic growth and empower youth, we urge him to acknowledge the essential link between treating NTDs and advancing prosperity. Here’s our “wish list” of points we’d like President Obama to address:

  • The U.S. is committed to reducing the impact of NTDs in Africa by supporting integrated treatment programs and offering technical assistance. USAID has already delivered hundreds of millions of treatments and will continue to invest in reducing the impact of the seven most common NTDs.
  • Adding deworming programs to all childhood nutrition efforts will strengthen food security and nutrition interventions. Removing worms will ensure that kids retain the nutrients required for proper physical and cognitive development.
  • As a leader on the continent, South Africa can play a major role in elevating NTDs as a priority health issue for the African region. Treating NTDs supports peaceful, healthy, and equal outcomes for society.

Tackling NTDs offers a concrete way to alleviate poverty, enhance food security and improve the lives of millions of Africans. Here’s to hoping that President Obama takes advantage of this monumental trip by giving these horrific diseases the attention they deserve.

An Unbearable Anguish for Children with NTDs

NTDs

 

Have you ever really thought about what the commonly used “ation” words – stigmatization, ostracization, disfiguration, inflammation, impoverization – actually mean when describing the burden of NTDs on preschool and school-aged children?

Here’s just a glimpse of what life can be like for kids suffering from one or more NTDs:

  • Missing out on precious playtime and classroom learning because of fatigue, malaise, and excruciating chronic pain in the intestines, genitals and limbs.
  • Feeling ashamed because scarring on the skin, and especially on the face, is impossible to ignore – a devastating reality for kids who just want to fit in.
  • Dealing with infection after infection, not necessarily understanding what’s going on with their bodies but knowing that something is horribly wrong.

As a new Archives of Disease in Childhood article, “Global trends in neglected tropical disease control and elimination: impact on child health,” by Global Network’s Drs. Gregory Simon and Neeraj Mistry, Sabin Vaccine Institute’s Dr. Peter Hotez and Baylor College of Medicine’s Meagan Barry, reveals, millions of children living in extreme poverty are suffering from the grave impact described above because NTD control programs, including mass drug administration (MDA), have not yet treated even close to the targeted percentage of at risk people.

Consider some of the staggering facts they point out for the NTDs most common in children:

  • Soil transmitted helminth infections (STH) – ascariasis, trichuriasis, hookworm infection: “In 2011, 875 million children lived in high-risk areas worldwide, of whom about 30% are preschool age children and 70% school age children.” In fact, “in sub-Saharan Africa alone an estimated 50 million school-aged children are infected with hookworm.”
  • Schistosomiasis (snail fever): “In 2011, 243 million people lived in high-risk areas, including 112 million school aged children, predominantly in sub-Saharan Africa.” Unfortunately, “infection in the infant and preschool age groups is also increasingly being recognized and documented.” Yet, “of the 112 million school children in need of preventive chemotherapy for schistosomiasis in 2011, only 16 million received treatment.”
  • Trachoma: “WHO estimates that in 2010, 325 million people lived in areas endemic for C trachomatis, and more than 21 million people were actively infected. In hyperendemic areas, 90% of preschool age children may be infected.”

Although lymphatic filariasis (LF) and onchocerciasis are more often found in adults, they still infect children:

  • LF: “LF is now recognized to be an infection often contracted in childhood … Children under 10 years of age have prevalence rates around 30% of the adult prevalence rates, while those 10-19 years-old have approximately 69% of the adult prevalence rate.”
  • Onchocerciasis (river blindness): “The rate of infection among adolescents is often high and community directed treatments typically include children.”

Suba Fodey, 6Despite this relatively bleak analysis of the problems posed by NTDs in children, the authors are optimistic that we “may be able to reduce or eliminate the tremendous NTD disease burden in children globally.” Public-private partnerships (PPPs), expanded MDA and preventive chemotherapy programs, greater pill donations from pharmaceutical companies, the development of new drugs and the creation of new vaccines (Sabin is working on developing hookworm and schistomiasis vaccines) all offer real solutions.

Given that it takes just 50 cents to treat one person against these seven NTDs for an entire year, there’s no reason that children should have to suffer any longer.

Please click here to read the full article.

Making Progress against NTDs in Honduras

de-worming, END7, Latin America and the Caribbean, NTDs, Public Health, , , , , , , ,

Three to four hours. That’s how long one mother was willing to walk to make sure her child attended the annual vaccination and deworming campaign in the village of Coyalito in San Esteban, Honduras.

This past April was my third trip to Honduras in the last 14 months. On my first two trips, I spent the majority of my time running between government offices and meetings – including attending the launch of the Honduras national integrated plan on neglected tropical diseases (NTDs).  Honduras was the first country* in Latin America and the Caribbean region to launch such a plan – which ensures that the country is tackling all diseases at once – versus one at a time.

This time on my return to Honduras, I saw firsthand how that plan was being put into motion.

And I was amazed.

For a country facing severe challenges in security and violence, Honduras is a leader and innovator when it comes to tackling NTDs.

Three government divisions – the Ministries of Health, Education and Social Development are working together to reach people in even the most remote parts of the country.  They’ve taken charge by developing working groups to tackle issues and problems they notice when bringing the programs to the community.

They’re enthusiastic. They’re driven. And I’m quite positive that they’re going to succeed.

I know this because I traveled over six hours with the Ministry of Health over unpaved and rocky roadways on their visits to various districts.  Distribution was carefully arranged: a health worker used a loud megaphone to call out to members of the community to invite them to visit the vaccine and deworming campaign.  From there, mothers would bring their young children to receive essential vaccines and deworming medicine.

A nurse practitioner told me that bundling healthcare delivery– such as vaccination and deworming – often encourages more families to come. Most parents know about these diseases, especially the intestinal worms.  In Honduras, and many other countries in Latin America and the Caribbean,  there’s a common belief that if children grind their teeth at night, they have parasites. There is a demand for deworming, and mothers came armed with their child’s immunization card and found a space to account for their child’s annual deworming treatment.

The Honduran ministries are also thinking beyond treatment for NTDs to a more comprehensive approach.  These diseases are often spread due to lack of access to clean water and proper sanitation, which is a reality for some of the families in villages like Coyalito.  As a result, the ministries are pushing to incorporate water filters in schools, and other sanitation initiatives which will propel these treatment programs toward long-term success.

At the end of the day, I joined the health team in brief survey to determine attendance of the campaign. We walked around each “manzana” – or block – to knock on people’s homes and ask them if children were dewormed and vaccinated. Health workers talked to them about why it’s important to attend these campaigns and have their children treated.

Among advocacy organizations, it seems that we often divvy up health issues, as if family planning, treatment for NTDs and vaccination are all independent projects.  But, the reality is that often, at the point-of-care level, everything is bundled together. It’s very effective.

Our partners in Honduras want to expand this successful initiative to help many more families. END7 is asking supporters to help fill a funding gap to make sure this medicine reaches Honduran children in 20,061 schools. With your help we can reach 1.4 million school children and protect them harmful parasitic worms, including roundworm, hookworm, and whipworm.

Help us see the end of NTDs in Honduras by making a contribution. Read more about END7’s effort to raise money and support for NTD treatment in Honduras here.

*In March 2013, Brazil launched their integrated national plan, and currently several other countries have draft plans in development.

A Minute with an NTD Expert: David Molyneux, Director of the Lymphatic Filariasis Support Centre and Emeritus Professor of Tropical Health Sciences at the Liverpool School of Tropical Medicine

NTDs

 

At last November’s “Uniting to Combat NTDs: Translating the London Declaration into Action,” we had a chance to catch up with David Molyneux, Director of the Lymphatic Filariasis Support Centre and Emeritus Professor of Tropical Health Sciences at the Liverpool School of Tropical Medicine.  Molyneux works extensively with the Centre to improve the lives of the bottom billion by contributing to the development of tools and control strategies for NTDs, specifically lymphatic filariasis (LF).

 

Global Network: What’s changed since you became involved in NTDs?

David Molyneux: I think the global recognition that these are serious diseases that impact poverty and development, and that they are bigger than just health conditions. I think one has to go back into the history of this, to the time I started to work with Peter Hotez and Alan Fenwick […] There was no momentum for delivery or implementation, at the time, because there were no drug donations. I think that like all movements, in science and particularly in health, these are evolving processes, and they evolve on the basis of science, they evolve on the basis of advocacy, and in the end they evolve on the basis of rational thinking in terms of cost effectiveness.  It seems that we created some kind of momentum to address something which is imminently doable.

When I was running the Onchocerciasis Control Program Expert Committee, it was very interesting at the time. Many of the experts around the table didn’t want the non-governmental organizations to be involved. They said that this has got to be done through the health services, it’s got to be done by mobile distribution. But gradually, they recognized that that was just not feasible.

It’s been an evolving process, it’s been based on science, on massive pharmaceutical donations, and on a rational approach to health […] we have to recognize that we’re dealing with the poorest people, and if you’re actually going to make an impact on poverty, you need to address the problems of the poorest. […] If we don’t address their problems, we’re never going to achieve any of the millennium development goals. It’s very satisfying to see how many people are now involved and engaged from different quarters and different sectors, nationally and internationally.

GN: What is the value of integration in NTD disease programs?

DM: I think the concept of integration is about making the best use of the facilities available at the national level and maximizing the impact of the resources at one’s disposal. We started to talk about integrated control when we looked at these diseases separately.  We were wasting resources doing two deliveries a year, three deliveries a year for diseases which could be treated with the same drug […] It’s trying to make the best use of available resources, which are naturally scarce, recognizing that the drugs hit more than one infection, and looking to opportunities in other health programs.

GN: What is one wish you have for the NTD community?

DM: I have two wishes. One is the passing of the World Health Assembly Resolution in May next year, so all member states commit to neglected tropical disease control and elimination […] The second one relates to the identification of these diseases in the post-2015 millennium development goals. If we achieve that, we’ve come a very long way in highlighting the problems of the poor because this is an equity issue.

[editor’s note: the World Health Assembly did pass the resolution, see a related blog on that topic here; meanwhile, the UN high-level panel identified NTD control and elimination as a priority, though talks continue, see related blog post here.]

GN: Why should we care about NTDs?

DM: I think there are several answers to that question. Why they should care? Because it’s common humanity […] It is also a human rights issue, it has resonances of equity, it has resonances of areas beyond the physical impediments – blindness, deformity, stigma. There are other, broader issues in relation to health burden […] such as the mental health burden associated with conditions such as we see in NTDs.

So, there is a whole plethora of reasons for doing this and for trying to convince the public out there that they have an obligation, first of all, to see taxpayers’ money appropriately spent in buying more health for less money. [We have an obligation to recognize] issues around common humanity, and issues around equity and human rights.  I don’t think it would be ever accepted that we allow conditions such as elephantiasis, particularly male genital elephantiasis or scrotal elephantiasis, to exist when all you need is to do surgery at a cost of $50 per person to treat it. […] So for me it’s as you say a no brainer, I don’t have any doubt about that, and for me also, our job and our mission, and your job in terms of advocacy, is to make sure that more people know about this and more people feel guilt that they’re not doing something about it.