Category Archives: Brazil

New Report: The Neglected Tropical Disease Initiative in Latin America on the Effectiveness of Integrated NTD Programs

Brazil, Guyana, IDB, integration, Latin America and the Caribbean, IDB, ,

 

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While major gains have been made in the fight against neglected tropical diseases (NTDs), the Latin American and Caribbean region’s most poor and marginalized populations still suffer from the pain, disability and social exclusion associated with NTDs — diseases which have been successfully controlled in higher income countries.

However, the Latin America and the Caribbean Neglected Tropical Disease Initiative (LAC NTD Initiative), a partnership between the Inter-American Development Bank (IDB), Pan American health Organization (PAHO) and Sabin Vaccine Institute’s Global Network for Neglected Tropical Diseases, is proving that the control and elimination of NTDs within the region is possible and within reach.

In a recently-published report, titled It Can be Done: An Integrated Approach for Controlling and Eliminating Neglected Tropical Diseases, the IDB draws upon four NTD demonstration projects to provide lessons learned in integrated NTD control projects. The projects, taking place in Brazil, Guyana, Haiti and Mexico, took an integrated approach to addressing NTDs by combining interventions from the water and sanitation and education sectors, and taking advantage of synergies within governments, NGOs and private sectors within the region. This integrated approach stands in contrast to the more traditional approach to addressing NTDs — one which historically involved concentrating on one disease at a time and offering medications and treatments to entire at-risk populations to stop the spread of disease.

The work undertaken by the LAC NTD Initiative is critical; the Latin America and Caribbean region has been plagued by underfunding for NTD control even though more than 100 million individuals in the region are infected by at one or more of these diseases. Yet NTDs can be treated at a very low cost in comparison to other public health interventions. For example, it is estimated that lymphatic filariasis, onchocerciasis and trachoma could be eliminated, and soil-transmitted helminth and schistosomiasis controlled in the Latin America and Caribbean region by 2020 for as little as US$0.51 per person in most countries.

As the world quickly approaches the deadline of the United Nation’s Millennium Development Goals (MDGs), and the Post-2015 Sustainable Development Goals go into effect, we must focus on the world’s poorest and most marginalized communities who suffer from NTDs in an effort to ensure that no one is left behind.

It Can be Done: An Integrated Approach for Controlling and Eliminating Neglected Tropical Diseases seeks to inform policymakers and program managers’ efforts to design, manage, implement and evaluate integrated NTD programs. The report, which presents the first comparative analysis that uses a single methodology to investigate the feasibility of implementing integrated programs, will certainly move the world one step closer to ending the suffering caused by NTDs.

To read the full report, click here.

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South-South Cooperation Moves Forward to Free the Indigenous Yanomami People from Neglected Tropical Diseases

Brazil, Latin America and the Caribbean, Onchocerciasis,

 

Photo by Shaan Hurley

Today marks the United Nations (UN) Day for South-South Cooperation — an opportunity for the global development community to examine how developing and emerging countries can share knowledge, exchange best practices and pursue joint projects to generate tangible solutions to development challenges.

As a young officer in the Ministry of Health of Argentina, I attended the first UN Conference on Technical Cooperation among Developing Countries (TCDC) where I had the opportunity to witness the launching of the Buenos Aires Plan of Action, a blueprint adopted in 1978 that offered guidance and new energy to the concept of south-south cooperation. At the same time, the International Conference on Primary Health Care concluded with the Alma Ata Declaration — a public health milestone that recognized health as a fundamental human right.

It was an exciting time to be a part of these landmarks in public health and see how these principles are being carried out today. A closer look at Brazil and Venezuela’s joint commitment to controlling and eliminating neglected tropical diseases (NTDs) within the Yanomami community —a nomadic indigenous tribe made up of approximately 35,000 people — spotlights the key role of south-south cooperation in reaching all populations in need of key health interventions. Equally important, this successful model can be replicated within the Latin American and Caribbean (LAC) region and across the globe.

The Yanomami territory is a remote stretch of tropical rainforests and mountains on the northern border of Brazil and southern part of Venezuela (approximately 19,000[1] people live on the Brazilian side and 16,000 on the Venezuelan side). The combined border area is over 9.6 million hectares — about twice the size of Switzerland — and represents the largest forested indigenous territory in the world. The entire community is affected or at risk for onchocerciasis, also known as river blindness.

The high prevalence of onchocerciasis  within the Yanomami community represents the last stronghold of this disease in the LAC region, which has made significant strides towards its elimination, in addition to controlling many other NTDs. Several countries across the region have either launched or implemented national plans to control and eliminate NTDs within their borders. In 2014, Colombia became the first country in the world to eliminate onchocerciasis. These successes underscore the strong political commitments made by regional leaders including the Organization of American States (OAS), the Pan American Health Organization (PAHO) and the Council of Ministers of Health of Central America and the Dominican Republic (COMISCA).

While these are impressive milestones, more work needs to be done to address NTDs within the Yanomami community —  as the area occupied by the Yanomami is regarded as the greatest challenge for interrupting the transmission and making LAC an oncho- free region. Because of their nomadic habits plus their isolated and forested environment, health workers must travel by helicopter or boat to reach them. Many logistical and financial challenges need to be overcome to deliver the required series of treatments.

Here is how south-south cooperation can help address these challenges:

Brazil and Venezuela formalized and agreed to join efforts to tackle this problem in May 2014 during the 67th World Health Assembly. Through this commitment, these two countries will coordinate efficiently the provision of continuous integrated healthcare for affected communities in both Brazil and Venezuela. They will work together to train local community health workers and form bi-national humanitarian teams that will also include local residents to treat the last focus of onchocerciasis in the Americas through the development of integral  healthcare to affected communities on both sides of the border.

Furthermore, these teams will support the creation of a bi-national health model to provide work assistance for Brazil and Venezuela. A technical team of the Brazilian Ministry of Health is working with the Venezuelan Ministry of Health team in order to strengthen and integrate public policy to eliminate onchocerciasis in the Yanomami area.

By harnessing their collective experiences and expertise, I am confident that these countries can successfully work together to end the unnecessary suffering of the Yanomami population — and ultimately help the LAC region see the end of onchocerciasis.

Looking ahead, the post-2015 development agenda dialogue, the BRICS Ministers of Health meeting and the UN South-South Cooperation EXPO offer exceptional opportunities for government officials and development partners to showcase south-south cooperation as a critical, sustainable and successful model to address NTDs and other pressing global health and development challenges.

[1] According to Health Ministry of Brazil, in 2012, the Yanomami territory had 293 small villages that contain 4,550 families from five different ethnic groups, most of them Yanomami. There were 21 thousand of indigenous people living in this region, which 11,600 were located in endemic area.

BRICS in the Response to Neglected Tropical Diseases

Brazil, BRICS, India, policy,

 

Children march through the streets of Ghorahuan Village

Photo by Esther Havens

The BRICS nations (Brazil, Russia, India, China and South Africa) have a unique opportunity to lead the world in eliminating the threat of neglected tropical diseases (NTDs). Released just ahead of the BRICS annual meetings, a paper published in the Bulletin of the World Health Organization, explains how the BRICS could draw upon their own experiences tackling domestic global health challenges to further advance global efforts to control and eliminate NTDs by 2020.

In their paper, titled  BRICS in the response to neglected tropical diseases, authors Amber Cashwell, Anupama Tantri, Ashley Schmidt, Neeraj Mistry and Greg Simon call on the BRICS to lead the rest of the world by example. The BRICS countries – in particular, India and Brazil– shoulder a large NTD burden. By scaling up their own domestic NTD programs, the BRICS can help close the global NTD treatment gap and lead by example.

In addition, the authors call on the BRICS to pursue opportunities for joint cooperation. The annual BRICS Heads of State and Health Ministers meetings offer platforms where BRICS countries can exchange experiences and increase collaboration on NTDs. The BRICS countries can help apply best practices, innovative models, and lessons learned about NTD control and elimination to other NTD endemic countries.

And lastly, as powerful and emerging economies, the BRICS can use their collective voices to build political commitment, mobilize resources and implement policies that will help meet global NTD goals.

As the BRICS countries gear up to launch their own development bank this July, it’s important to keep in mind that addressing NTDs will also help the BRICS countries – and the rest of the world – develop economically. Global health challenges like NTDs perpetuate poverty and inequality, thus thwarting opportunities for social progress and economic growth.  NTDs can result in long-term health problems such as blindness and other physical disabilities, delayed cognitive development and malnutrition, leaving people unable to go to work, learn and live productive lives.

Controlling and eliminating NTDs by 2020 will surely be a global effort – and one that will progress more quickly and sustainably with BRICS at the lead.

To read the full paper, click here. 

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Celebrating 10 Years of Bolsa Família, the Widely Successful Brazilian Poverty Alleviation Plan

Brazil, Latin America and the Caribbean, poverty, ,

 

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Brazil’s Bolsa Familia program contributed to a dramatic drop in poverty and inequality within the country, said Tereza Campello, Minister of Social Development and Fight Against Hunger at a January 29th event at the Woodrow Wilson Center.

The event, titled “A Conversation with Tereza Campello, Brazil’s Minister of Social Development and Fight Against Hunger,” was co-sponsored by the Woodrow Wilson Center’s Brazil Institute and the World Bank’s Latin America and the Caribbean Region and shed light on some of the progress made in poverty alleviation in the first 10 years of the Bolsa Família program.

Minister Campello began her discussion by saying that poverty and inequality in Brazil has dropped dramatically thanks to three main public policies: a raise in the minimum wage, the expansion of the formal job sector, and the Bolsa Família program. The program was launched in 2003 during former President Luiz Inácio Lula da Silva’s term. It is the largest conditional cash transfer program in the world, and is responsible for lifting 22 million people out of poverty. The three main goals of the program are to alleviate poverty and hunger; increase education attendance and reduce school drop-out rates; and improve access to health services for children, pregnant women, and women who are breastfeeding.

Since the beginning of the program, Bolsa Família has assisted over 50 million people — over a quarter of Brazil’s population. In return for direct cash transfers, beneficiaries must ensure their children attend school and receive their vaccinations, and pregnant women must receive prenatal and postpartum care.

Minister Campello highlighted the following achievements from the Bolsa Família program in the focus area of health:

  • 19.4% reduction in infant mortality rate,
  • 52% decrease of chronic infant malnutrition in children up to 6 years of age,
  • 58% reduction in death due to malnutrition,
  • Drop from 16.8% to 14.5% in the rate of stunting in children up to 5 years of age,
  • 50% increase in prenatal care,
  • 46% reduction in deaths from diarrhea, and
  • 99.1% vaccination rate in children.

Its impact has been greatest in the northeast and Amazon regions of the country, where poverty is more prevalent. Additionally, out of the total current beneficiaries of the program, 73% of them are afro-Brazilian women.

The success of Bolsa Família is inspiring many countries around the world. The Ministry of Social Development and Fight Against Hunger has received delegations from 63 countries interested in learning more about how the program works. Deborah Wetzel, Country Director for Brazil for the World Bank, said the World Bank is working with the Brazilian government on ways to share the lessons learned with other countries.

Although Bolsa Família has been widely successful, challenges do remain. Brazil is the fifth largest country in the world with a population of more than 200 million people living in more than 5 thousand municipalities. To address this issue, the Brasil Sem Miséria plan (Brazil Without Poverty plan) was launched during President Dilma Rousseff’s term in 2011 in order to expand the reach of the Bolsa Família program. Through this complementary plan, the Ministry of Social Development and Fight Against Hunger is currently reaching out to an additional 9 million people who are not part of the Bolsa Família program but are in dire need of support.

Minister Campello closed the conversation by saying that the “end of poverty” is only the beginning. We join the Brazilian government in celebrating the first 10 years of Bolsa Família and we look forward to sharing many more success stories!