Monthly Archives: July 2013

Honoring Ida

Africa, schistosomiasis, ,

 

Photo courtesy of BBC

Photo courtesy of BBC

 

We use a lot of numbers to tell the big picture about neglected tropical diseases (NTDs) and it’s easy to forget that often there are real people, with profound stories, behind those numbers.  We can talk about how NTDs infect more children than the total populations of the U.S. and Brazil combined.  We can tell you that schistosomiasis (snail fever) kills nearly 300,000 people a year – half the global toll of malaria.  But until those figures are linked with real people, NTDs remain abstract, even impersonal.

A few months ago, a film crew from BBC captured a story that presented NTDs in starkly human terms. As part of Comic Relief’s Red Nose Day in the United Kingdom, , a 29 year-old woman from Malawi suffering from late-stage schistosomiasis. Ida contracted schistosomiasis by drinking contaminated water from a local pond – her only water supply.  She lived in constant pain as parasites multiplied inside her body and slowly destroyed her organs.

What makes NTDs like schistosomiasis even worse is the collateral damage they have on families.  Parents become so weak that they cannot work or care for their children, while kids with NTDs often miss out on educational opportunities that could help them break free of poverty.  In the video, Ida revealed that she had a two year old son named Samuel. “I worry a lot because my son is still very young and I worry about how he will be helped if I’m dead,” Ida said.

Ida could not produce milk to feed her son because she was too sick. Instead of milk, she was forced to fill her hungry son’s stomach with the only available resource she had – the dirty, contaminated pond water that bred the parasites slowly killing her.

The BBC film crew took Ida to the hospital, but it was too late to help her. We learned that she had died a few weeks later and that Samuel died shortly after.

Ida’s story alone is enough to convey the severity and reality of the suffering caused by schistosomiasis.  But the horrific reality is that thousands of people just like Ida die every year from the same disease. Children are orphaned, communities are devastated and the cycle of poverty continues.

The BBC video inspired Comic Relief to dedicate £100,000 to one of our partners, the Schistosomiasis Control Initiative (SCI), for NTD control in Malawi. That donation will prevent unnecessary deaths by offering treatment to entire communities before it is too late.  

Any preventable death, particularly of a child, is difficult to share. This story is one of the hardest we’ve told, but it also strengthens our commitment to protect families from the unnecessary suffering caused by NTDs.

¡Felicidades, Colombia! Colombia Eliminates Onchocerciasis

Latin America and the Caribbean, NTDs, parasites, ,

 

Credit: Flickr user Char R/ CC

Credit: Flickr user Char R/ CC

The Global Network for Neglected Tropical Diseases would like to congratulate Colombia on becoming the first country in the Americas to eliminate onchocerciasis. This Monday, July 29, Colombia received verification of the elimination of onchocerciasis from the World Health Organization (WHO). This is a great achievement in the field of neglected tropical diseases (NTDs) and global health!

Onchocerciasis, also known as river blindness, is an NTD caused by a parasitic worm and is transmitted by the bite of Simulium black flies. This NTD causes disfiguring and painful skin infections and eye lesions, and is the second leading infectious cause of blindness globally. Control and elimination efforts began in the region of the Americas in the early 1990s, primarily with the formation of the Onchocerciasis Elimination Program for the Americas (OEPA). OEPA, which is sponsored by the Carter Center, was launched in 1993 in response to the Pan American Health Organization’s (PAHO) resolution CD35.R14, which calls for the elimination of onchocerciasis from the Americas. At the time of the resolution, 500,000 people were at risk for onchocerciasis in the region and the NTD was endemic in 13 foci found in 6 countries: Brazil, Colombia, Ecuador, Guatemala, Mexico and Venezuela.

The recent success in Colombia is a result of close collaboration between Colombia’s Ministry of Health and Social Protection, Colombia’s National Institute of Health and its partners, which include The Carter Center and OEPA, PAHO, Merck and many others. In countries endemic for onchocerciasis, people were treated with ivermectin (Mectizan) through mass drug administration campaigns two to four times a year. The hard work and dedication demonstrated by the local health workers and community leaders in distributing the treatment and educational information was essential for achieving the goal to eliminate transmission of the disease. Ivermectin is donated by Merck & Co through the Mectizan Donation Program.

Ecuador may be the next country in the region to apply for verification of elimination, following the 3-year post-treatment surveillance phase established by the World Health Organization (WHO). Guatemala and Mexico will complete the 3-year post-treatment surveillance phase in 2014 and could then request verification from the WHO. The remaining two foci in the region are in southern Venezuela and northern Brazil, among the Yanomami indigenous community. A key to the elimination of onchocerciasis in the Yanomami area is an integration of activities to address other determinants of health and NTDs, such as strengthening primary care services, access to clean water and improved sanitation.

On the same day, energized by the announcement that Colombia received certification for the elimination of this NTD, the Colombian President Juan Manuel Santos and Minister of Health and Social Protection Alejandro Gaviria demonstrated once more their government’s commitment to the people of Colombia by launching its 5-year integrated national plan of action to address trachoma and soil-transmitted helminthes.

Colombia’s experience can help guide the efforts of other Latin American and African countries working towards elimination of this and other NTDs. Thanks to these great achievements, we are closer to seeing the end of the seven most common NTDs by 2020!

Haiti Sees Success with NTD Program

NTDs,

SLE12 0713 SABIN0063

“Working together, we can do more”.  – Dr. Abdel Direny of IMA World Health

On Thursday, June 25, InterAction hosted On the Road to Elimination: The Haiti Neglected Tropical Disease Program, bringing together esteemed panelists, each uniquely impactful in the journey to make NTDs history in Haiti.  The event was attended by government officials from Haiti  and partners from the U.S. Centers for Disease Control and Prevention, CBM, IMA World Health, the University of Notre Dame, and RTI International t. USAID support for the Haiti NTD Control Program comes from the ENVISION Project, managed by RTI International and implemented by IMA World Health. We gathered to learn about and discuss the country’s success in controlling and eliminating neglected tropical diseases – especially lymphatic filariasis (LF) and soil-transmitted helminths.

The panel featured Dr. Oscar, head of LF and Malaria programs at the Haitian Ministry of Public Health and Population, Dr. Desormeaux, Deworming Program Coordinator of the Haitian Ministry of Public Health and Population, Dr. St. Eloi of the Haitian Ministry of Education, Dr. Desir of the University of Notre Dame, Sikhumbuzo Vundla of Christian Blind Mission and Dr. Direny of IMA World Health.

Dr. Oscar kicked off the discussion, highlighting the history of Haiti’s LF program and treatment integration with soil-transmitted helminthes.  He shared an impressive statistic:  In 2012, more than 8.3 million people were treated for LF in Haiti.  The nation’s incredible progress and Dr. Oscar’s presentation confirmed that the program has a very bright future.

The Global Network applauds the nation’s MDA success: Haiti has reached the recommended 5 rounds of MDA needed to control NTDs in over half the country.  The program is building a solid foundation to continue towards reaching their goal to cover the entire country in the next five years.

The Ministry of Health has deliberate plans to continue coordinating the LF and soil-transmitted program through mass-drug administration to both deworm individuals and treat LF.  Moreover, there are strategies planned to reach a wider audience through sanitation education. Dr. Desormeaux spoke to the benefits of integration in reaching more of Haiti’s population, also confirming NTD treatment as one of the “best buys in public health”.

How has the program been so successful?

Haiti’s efforts to control and eliminate NTDs are not limited to rural areas.  Dr. Desir spoke of the effort to provide MDA to the urban Haiti population, noting that controlling NTDs in urban areas poses unique and difficult challenges.  The NTD program leveraged radio, TV, and community meetings to spread the word about NTD treatment, and mobilized resources to successfully treat 70% of LF cases.  According to Abdel Direny, NTD Program Manager at IMA World Health, the NTD program has also been a platform for other public health benefits, providing shoes, hygiene kits, bed nets, and even water filters during the cholera outbreak.

But the program is not just mobilizing resources, it’s mobilizing people: 30,000 volunteers administered MDA to provide treatment against parasites and LF.   Additionally, the program is utilizing its efforts to spread other important public health messages.  Dr. St. Eloi described the success of the many school-based interventions Haiti has employed including training teachers in schools to recognize symptoms of parasites and utilizing school curriculums as a means to educate children about the importance of Water, Sanitation, and Hygiene (WASH) initiatives.  Moreover, Self-help Groups were instituted by CBM International, to provide a supportive community for individuals in Leogane infected by LF and to reduce the stigma surrounding LF and parasitic diseases.

Though the success of the program was recognized, the panelists consistently reiterated the need for sufficient funds to bring the NTD program to scale.  With an aggressive plan to control and eliminate LF by 2020, the program will mobilize existing resources but will also depend on additional support.

At the conclusion of the event, the atmosphere was positive and encouraging.  “Strong Haitian leadership, steadfast partners, generous support from USAID and the donation of albendazole from GlaxoSmithKline have been critical to the success of this program. We remain committed to elimination and look forward to supporting the Haitian Ministries of Health and Education in the years to come,” says RTI’s Lisa Rotondo. Haiti’s NTD program has made incredible strides in recent years and there is a strong commitment from the community’s leaders to scale-up current efforts.  The program’s in-country dedicated leadership will ensure the sustainability of and a bright future for these programs.  But Haiti’s continued success is also dependent on us. As Dr. Lammie said, “appropriate support can help countries facing NTDs provide health care and treatment on a very large scale.”

Thanks to Laura Cane and RTI International for their comments.