All posts by Deborah Elson

The Role of Worms in Malnutrition

nutrition,

 

Photo by Olivier Asselin

Photo by Olivier Asselin

In impoverished communities worldwide, children and pregnant women are especially vulnerable to malnutrition, anemia, impaired cognitive and physical development, and pregnancy complications. As a result, they remain trapped in poverty, facing the socioeconomic consequences of decreased productivity and an inability to work or go to school because of their poor health.

But the reason behind their suffering may surprise you.

A new article in PLOS NTDs reveals how soil-transmitted helminths — a group of three parasitic worm infections — can be the culprit in many areas with heavy neglected tropical disease (NTD) burdens and bleak living conditions.

The authors, Sabin Vaccine Institute President Dr. Peter Hotez, former World Bank Lead Health Specialist for Africa Dr. Donald Bundy and Baylor College of Medicine (BCM) Medical Resident Dr. Selvi Rajagopal, focus on vitamin A and iron deficiencies and their relationship to the three soil-transmitted helminths: ascariasis, hookworm and trichuriasis.

On vitamin A, the authors write, “As well as having direct effects, severe vitamin A deficiency can have significant indirect consequences, for example, increasing susceptibility to potentially fatal illnesses such as measles and lower respiratory infections. As a result, the link between vitamin A deficiency and ascariasis has potentially important consequences for global health, especially since ascariasis may be the most common chronic childhood infection worldwide.”

Hookworm and trichuriasis, meanwhile, can lead to iron deficiency anemia. “Among adults, even light [hookworm] infections can produce anemia, especially in pregnant women. … Moderate-to-heavy hookworm infections and trichuriasis specifically have in some circumstances been shown to lead to failure to achieve intellectual potential and cognitive impairment. … Anemia and a moderate-to-heavy parasite burden of either helminth species were identified as independent risk factors for stunting,” the authors explain.

Given the clear linkages between soil-transmitted helminths and malnutrition, the authors suggest that more research be conducted to help identify how programs delivering interventions for each can be integrated in a cost-effective, sustainable way.

To read the full article, “Micronutrient Supplementation and Deworming in Children with Geohelminth Infections,” click here.

New Paper Highlights Key Progress, Challenges Ahead of Post-2015 Agenda Setting

policy, post 2015, poverty, ,

 

boys collecting water in Citoboke, along the Congo Border

In an important new paper, “Neglected tropical diseases: now more than just ‘other disease’ — the post-2015 agenda,” published in International Health, David Molyneux, professor at the 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 USAID, while in 2008, the UK pledged financial support through DFID, marking the beginning of their longstanding commitments to NTDs. In 2012, following the creation of the WHO Roadmap for NTDs and the formation of the London Declaration, the World Health Assembly (WHA) passed a historic resolution on all 17 NTDs in May 2013.

2013 was also a milestone year because the UN Secretary-General’s High-Level Panel report included NTDs alongside other pressing global health issues. Following this momentum, in spring 2014, a 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:

Funding. “The funding provided is a fraction of that available for other diseases and a reflection of the gross inequity to implement programs that address the diseases of the poor.” Even with generous support from the U.S. and UK, funding from endemic countries and new commitments — such as resources pledged through the London Declaration to address soil-transmitted helminths — resource mobilization among diverse development partners is needed to ensure donated medicines reach the most vulnerable communities.

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.

Human resources. Mass drug administrations all around the world are carried out through the work of thousands of health workers and volunteers — such as in Myanmar. But health systems must continue to be strengthened to adequately handle competing health priorities and deliver NTD and other treatments.

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, click here. 

New World Bank Video Shows an Amazing River Blindness Success Story

Africa, Onchocerciasis,

 

APOC

To celebrate the remarkable progress made against river blindness (onchocerciasis) in Africa since the formation of a tremendous public-private partnership to combat the disease forty years ago, global partners recently gathered at World Bank headquarters in Washington, DC. Leaders poignantly spoke about how this country-owned, community driven effort — the World Bank’s first health project — carried out through the Onchocerciasis Control Programme (OCP) between 1974-2005, and the African Programme for Onchocerciasis Control (APOC) between 2005-present, is now reaching 100 million people in 31 countries annually thanks to bold visions, clear strategies and the collaboration of partners.

To coincide with OCP/APOC’s 40th anniversary, narrates the unlikely story of how insecticide and Mectizan (ivermectin) — a pill donated by Merck for free for as long as needed — have transformed the lives of millions of people. Generating blindness, impaired vision and severe itching, among other effects, river blindness once devastated entire communities. The disease left people unable to farm for sustenance and a living, inhabit land in river valleys and take care of their families.

But, with insecticide sprayed by helicopters, and eventually the distribution of ivermectin in all affected countries, some areas are free of the disease. 25 million hectares of arable land — enough to feed 17 million people — are now freed up for use.

By 2025, we can eliminate river blindness in Africa and end the cycle of poverty caused by this horrific disease. But, we must continue to mobilize and pool resources, increase country leadership and integrate efforts to accomplish this goal.

Congratulations to all of the APOC partners fighting for a brighter, healthier future!

Make sure to watch the full video:

Abuja Media Roundtable Highlights Necessity for Collaboration on Health

Africa, NTDs,

 

As African Ministers of Economy and Finance gathered at the Seventh Annual Joint African Union (AU)-United Nations Economic Commission for Africa (UNECA) Conference in Abuja, Nigeria, the Global Network joined a lively conversation with GAVI, Roll Back Malaria (RBM) Partnership, and about 40 Nigerian reporters on how health, human capital and social development partnerships will catalyze widespread economic growth.

The AU-UNECA meetings, themed, “Industrialization for inclusive and transformative development in Africa,” could not have provided a more perfect backdrop to discuss health issues. Countries’ investments for building and sustaining strong, competitive economies need to include health services. Vibrant labor markets require a productive workforce, which is contingent on people’s health status.

Recognizing the role of health in economic growth and poverty alleviation, African leaders pledged to allocate 15 percent of their budgets to health through the Abuja Declaration. Yet 13 years post-Declaration, and the majority of African nations have not yet followed through.

With these issues at the forefront, Rotimi Sankore, coordinator of the Nigerian-based organization Afri-Dev, opened the media roundtable. He asked the journalists, “What are the success stories? What are the challenges we are facing?” He asked the development partners, “What are you contributing human capital development, health and socio-economic development? What are the gaps?”

Dr. Thomas Teuscher, deputy executive director, Roll Back Malaria (RBM) Partnership

Dr. Thomas Teuscher, deputy executive director, Roll Back Malaria (RBM) Partnership

Dr. Mercy Ahun, GAVI’s special-representative to GAVI-eligible countries, explained her organization’s role in saving lives through vaccines. GAVI spends about 64 percent of its commitments in Africa, which so far has amounted to more than five billion dollars. “Everyone in Africa knows the impact of measles on children and families. … We know that prevention is better.”

Journalists can spark a “dialogue to get a better vision for how the limited amount of development investment is channeled,” said Dr. Thomas Teuscher, deputy executive director of RBM. He also stressed why health is a priority. “You need to be in good shape, be healthy and survive to go to work every day. This is clearly a national investment. [We] need investments of governments to serve their people. This cannot just be aid finance,” he said.

Wangechi Thuo, senior program officer for Africa, Global Network

Wangechi Thuo, senior program officer for Africa, Global Network

Global Network’s Senior Program Officer for Africa, Wangechi Thuo, captivated the audience about neglected tropical diseases (NTDs). After explaining how NTDs are underlying drivers of poverty, Wangechi delivered a call to action: “African governments need to increase their domestic investments in health, and be innovative in how we use resources and see where we can have cost-savings. NTDs serve as a vehicle for how you can multi-sectoral investments, and how you can pull forth greater investments in human capital and for other sectors.”

Then, journalists from Nigeria and abroad shared their insights on the state of health reporting, how they can do their part in advancing the health MDGs and post-2015 development agenda discussions, and what’s needed for fruitful partnerships between the media and development organizations.

Ms. Moji Makanjuola, head of Health Desk at Nigerian Television Authority.

Ms. Moji Makanjuola, head of Health Desk at Nigerian Television Authority

Making an impassioned plea for increased health reporting to hold leaders accountable, Moji Makanjuola, head of the health desk at Nigerian Television Authority, said, “We have refused to see health as an investment … that can propel the development initiatives of the continent forward…We cannot do that. Until we move the agenda to make it a political agenda, we must ask questions.”

From AllAfrica.com, CEO and Cofounder Reed Kramer explained that they’re “trying to find new ways to work with media colleagues across the continent to make reporting possible and more effective.” Another media representative present, Habiba Bello-Giwa from Nigeria’s Premium Times, later shared her collaboration with AllAfrica.com to expand her paper’s investigative journalism section.

Mr. Martins Oloja, editor, Nigeria's Guardian Newspape

Mr. Martins Oloja, editor, Nigeria’s Guardian Newspaper

Echoing Ms. Makanjuola’s earlier sentiments, Martins Oloja, editor of Nigeria’s The Guardian stated, “Poverty in reporting what African leaders all over the place are not doing. We need to hold them to account. Why are they not funding health matter adequately? Where is the medium? The medium is the message.”

Ultimately, it is through a comprehensive approach to health that African nations can reduce the burden of disease and other pervasive public health threats – and lift millions of people out of poverty. Through a unified push, we can provide comprehensive health access and create more equitable, inclusive growth for all Africans. It is our hope that we will continue to explore ways to work together.

Thanks to all the partners at the media roundtable for a great discussion!