Tag Archives: Integration

Intervention with Impact: Integrating Safe Drinking Water, Sanitation, and Hygiene to prevent Undernutrition and NTDs

nutrition, WASH, Water and Sanitation,

 

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By: Jordan Teague, Program Associate at WASH Advocates

My niece turned two years old on Sunday. It was a joyful occasion, celebrating that she can now speak in full sentences, gives full-blown hugs and started pre-school in the fall. The entire family gathered this weekend with presents, cake and a birthday outing to a fire truck parade. During the festivities, it occurred to me that my niece is now past the first 1,000 days of her life, the most critical time with regard to her nutrition. We are fortunate that because we live in the United States, we have not had to worry about undernutrition or the illnesses related to that condition, but what if she had been born somewhere else?

In many places around the world, undernutrition is not the only worry that families have for their small children and themselves. Over 1.4 billion people in Africa, Asia, and Latin America and the Caribbean are affected by at least one of the neglected tropical diseases (NTDs). These diseases largely overlap in areas where undernutrition is prevalent and magnify its impact on childhood growth and micronutrient deficiencies. In fact, all of the 34 countries with the highest levels of malnutrition are endemic for NTDs. Several NTDs like schistosomiasis and soil-transmitted helminthiasis (STH) are underlying contributors to stunting and undernutrition. Not only do they affect child health and survival, but they also have detrimental impacts on cognitive development, educational outcomes and economic growth.

A lack of safe drinking water, adequate sanitation and proper water, sanitation and hygiene (WASH) contributes to both NTDs and undernutrition. Safe WASH is key to five NTDs: Soil transmitted helminthes (also known as intestinal worms), schistosomiasis, trachoma, lymphatic filariasis and Guinea worm. Similarly, poor sanitation and unsafe drinking water cause diarrheal disease and environmental enteropathy, which inhibit nutrient absorption and lead to stunting and undernutrition. Improved WASH allows for the absorption and use of vital nutrients and calories, leading to improved nutrition and health.

Given the myriad of linkages between WASH, NTDs and nutrition, joint policies and programming have significant potential to scale up the impact of the individual efforts. For example, in 2013 Dubai Cares launched an that includes elements of all three sectors. This program includes in-school meals prepared from local foods and commodities in addition to deworming treatment and provision of WASH interventions in the schools. This program shows how different stakeholders can collectively use their diverse expertise to make a larger impact on the health of a community.

WASH interventions support the sustainability of progress made through NTD and nutrition programs on reducing disease and improving health. Real and sustainable impacts can be achieved when investments in NTDs and nutrition go hand-in-hand with efforts to provide WASH.

Jordan Teague is the Program Associate at WASH Advocates, where she focuses on sustainability within the WASH sector and the integration of WASH with other development efforts such as nutrition, NTDs and education.

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

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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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Experts Weigh In On Successes, Challenges with Tackling NTDs

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Photo by Esther Havens

 

Sabin Vaccine Institute president Dr. Peter Hotez and many of our neglected tropical disease (NTD) partners contributed to a comprehensive report in Infectious Disease News on efforts to control and eliminate NTDs by 2020.

“NTDs require more recognition, resources to be controlled,” by Emily Shafer, details the activities currently underway and provides a frank assessment of the challenges we must overcome. Experts remarked on a number of priorities, including: carrying out advocacy, conducting mass drug administration, encouraging greater investments from current and potential donor governments, integrating NTDs in existing development interventions and building up endemic countries’ infrastructure to deliver treatments.

Here are some of the highlights:

On donor government funding:

“According to [Dr. Peter] Hotez, with the exception of the U.S. and British governments, there has not been widespread funding provided by other G-20 countries for NTD control or elimination. However, this may change in the coming years, and now some G-20 countries are supporting research and development efforts for NTDs.”

On the importance of strengthening capacity:

“We need to take advantage of the large donations to distribute free and safe medications to distribute to the poorest of the poor. … We need to develop the infrastructure to deliver the medicine, along with health education and community engagement, so that everyone is on board with the process.” – Dr. Frank O. Richards, director of the River Blindness, Lymphatic Filariasis, Schistosomiasis and Malaria Programs at the Carter Center

On NTD integration:

“Bed nets don’t only prevent malaria, they will also help eliminate lymphatic filariasis. We’re trying to get people to take a more holistic view of the way health care interventions are delivered to local communities.” – Dr. James Kazura, director of the Center for Global Health and Diseases and professor of international health, medicine and pathology at Case Western Reserve University

On our end goal:

“If the drug donations continue and we continue reaching out to people and delivering treatments, then the net results will be that the diseases disappear.” – Dr. Alan Fenwick, professor of tropical parasitology at Imperial College London

For the full article, click here.

Tropical Disease Experts Urge Integration of NTD and HIV/AIDS Interventions

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At this year’s American Society of Tropical Medicine and Hygiene (ASTMH) conference, experts emphasized the need to integrate neglected tropical disease (NTD) and HIV/AIDS interventions. Many of those who suffer from NTDs are also infected with HIV, and addressing both diseases with one intervention would actually be cost-effective and more clinically beneficial. Below is an article published by ASTMH that describes in depth the benefits of integration:

Global HIV/AIDS prevention and treatment efforts are missing a major opportunity to significantly improve health conditions in poor countries by simply adding low-cost care for the many other chronic and disabling diseases routinely afflicting and often killing these same patients, according to a panel of disease experts who spoke at the annual meeting of the American Society of Tropical Medicine and Hygiene (ASTMH).

“People want better health; they do not understand why we silo diseases,” said Judd Walson, a global health and infectious disease expert at the University of Washington. “If you die from malaria, you don’t care that your HIV was treated. Communities want us to leverage the resources we have to treat and prevent disease as effectively as possible.”

Walson and his colleagues on the panel noted that many victims of HIV/AIDS also typically suffer from one or more of about 17 neglected, but burdensome, tropical diseases often called “diseases of poverty” because they prey on the “bottom billion”—the world’s poorest people. They include ailments such as trachoma, schistosomiasis, lymphatic filariasis, leishmaniasis, Chagas disease and onchocerciasis, all of which are either insect-borne disease, bacterial infections, or caused by parasitic worms. Click here to continue reading.