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FY 2016 Budget Maintains Critical Funding to Fight NTDs

The U.S. Congress just passed a federal budget that maintains critical funding to fight neglected tropical diseases (NTDs) in financial year (FY) 2016.

Thousands of END7 supporters wrote to the president and members of Congress this year to oppose cuts to the United States Agency for International Development’s (USAID) Neglected Tropical Disease Program. With its funding maintained for another year, the program will continue to deliver donated medicine to millions of people in more than 25 countries to control and eliminate the most common diseases of poverty.

For the fourth year in a row, President Obama had recommended significant cuts to the USAID NTD Program that would have threatened the progress to control and eliminate these diseases by 2020. This is the third consecutive year that Congress has increased funding over the president’s proposal, a testament to the bipartisan support for the highly successful NTD Program.

USAID’s NTD Program is a unique public-private partnership. Over the last 10 years, the United States has demonstrated exemplary leadership in increasing access to medicines to treat the seven most common NTDs, including ascariasis, trichuriasis, hookworm, schistosomiasis, lymphatic filariasis, trachoma and onchocerciasis. Robust funding and support from the U.S. government has been critical to leveraging more than $8.8 billion in NTD treatments donated by pharmaceutical companies. Moreover, the U.S. government’s strong commitment is critical to bringing other donors to the table, including governments of other G7 countries, and closing the global annual funding gap currently estimated at $220 million.

NTD control is one of the simplest and most cost-effective investments in global health and development. Investments in NTD programs have significant cross-cutting impact on other development efforts, including maternal and child health; nutrition; education; and water, sanitation and hygiene.

Strong commitment from the U.S. government and the generosity and compassion of the American people has enabled us to build on significant progress in eliminating these diseases as public health threats. With continued support in this fiscal year, we have the opportunity to control and eliminate many of the most common NTDs in a timetable measured by years, not decades.

Treating NTDs has huge impacts on the lives of those living in extreme poverty. Fewer people will go blind, fewer people will be disabled and disfigured and progress to control and eliminate the most common NTDs by 2020 will continue.

From Houston and Washington to the German Capital; the Fight to End NTDs Returns to Berlin

Global Network and Sabin Vaccine Institute representatives meet German parliamentarian, Mr. Martin Rabanus, a Member of the Committee on Education, Research, and Technology Assessment

Global Network and Sabin representatives meet German MP Martin Rabanus

In September, the Global Network for Neglected Tropical Diseases (Global Network) and the Sabin Vaccine Institute traveled to Berlin to meet with Members of Parliament, German NGO partners and the media to inspire action on the promises to combat neglected tropical diseases (NTDs), made during the G7 Summit held in Germany this summer.

The Global Network, which is committed to seeing the end of NTDs — a group of 17 diverse diseases with distinct characteristics that thrive mainly among the poorest and most marginalized populations — works with partners around the world toward achieving this mission. The momentum to combat these debilitating and disfiguring diseases continues to grow and, during the G7 Summit at Schloss Elmau in June, Germany elevated the profile of NTDs by making “neglected and poverty-related diseases” a key topic for discussion.

The city of Berlin has a unique historical connection to NTDs; it was in Berlin 10 years ago that scientists, the German government and implementing partners first came together and coined the term “NTDs,” an important milestone in defining a collective response against these diseases. Germany is also home to the Institute for Tropical Medicine at the University of Tübingen where two 19th century German scientists who were instrumental in discovering the causes of schistosomiasis and elephantiasis, Theodor Bilharz and Otto Henry Wucherer, often lectured. Representatives from the university are also members of the newly formed German Network against NTDs.

During this most recent visit to Berlin, the Global Network’s Dr. Neeraj Mistry and Ms. Michelle Brooks, accompanied by Sabin’s President, Dr. Peter Hotez, as well as Dr. Maria Elena Bottazzi, participated in one-on-one meetings with Members of the German Bundestag, discussing short- and long-term goals surrounding disease elimination. Globally, nearly 1.4 billion people, including more than 500 million children, are at risk from NTDs and require treatment. Medicines are generously donated by pharmaceutical industry partners, however, the value of the donated drugs is not enough to combat NTDs if the funding falls short to ensure their delivery to communities who need them most.

It is fitting that a decade after pivotal meetings in Berlin created the term “NTDs,” the focus is once again on Germany. The G7 Leaders’ Declaration, published at the culmination of the summit, offers hopeful news for communities across Africa, Southeast Asia and in Latin America and the Caribbean, most marginalized by NTDs by promising to “invest in the prevention and control of NTDs in order to achieve 2020 elimination goals.”

An immediate increase in financing for NTD treatment and prevention programs is essential to build on the progress achieved so far. Opportunities to eliminate elephantiasis, river blindness and trachoma are nearly within our grasp. Countries worldwide, including the G7 nations, can play an important leadership role by helping to close this annual funding gap of US $220 million. If we fail to act now, not only will we reverse many milestones achieved, but one in six people across the world will continue to suffer unnecessarily from NTDs, held hostage in a cycle of perpetual poverty and inequality. Moreover, failure to act now will undermine the efforts of the G7 to demonstrate their accountability and effectiveness as a group.

We certainly applaud the German government for her bold steps taken on behalf of NTDs this year, and we will be watching this week on October 8th and 9th as the G7 ministers for health and research meet once again in Berlin to discuss next steps.

Dr. Neeraj Mistry speaks at the UN ECOSOC High-Level Political Forum on July 9, 2015.

What Gets Measured Gets Counted

A man is disfigured and shunned by his community. A child is too tired and sick to go to school. A woman is blinded by an infection. These are just some of the effects of neglected tropical diseases (NTDs). There are 1.4 billion of these stories — one for each person whose life is impacted by an NTD.

We can’t tell every one of these stories, so we rely on numbers. 1.4 billion people. More than half a billion children. These numbers are our rallying cry. Statistics tell us where we are improving and where we are failing, and provide a sense of scale for problems too big to comprehend.

Fifteen years ago, the United Nations (UN) established the Millennium Development Goals (MDGs), eight international development goals that brought together the global health and development community to tackle some of mankind’s greatest challenges. The eight narrow targets “helped channel everyone’s energies — and money,” according to NPR’s Nurith Aizenman. Unfortunately, that meant issues without clear targets were left behind. NTDs were listed in the MDGs as “other diseases,” and had no specific indicator. As a result, these diseases, true to their name, have remained neglected.

When the MDGs expire at the end of 2015, they will make way for the Sustainable Development Goals (SDGs), a new set of targets that present a second chance to ensure NTDs receive the attention they deserve. Back in 2000, the process of developing the MDGs was “brilliantly simple,” Mark Malloch-Brown, a member of the original UN team that developed the MDGs, told NPR. But things are very different this time around. With the MDGs far surpassing initial expectations, all eyes are on the SDGs, and the process is far from simple.

Following years of politicking and debate, the UN Summit is expected to adopt the finalized SDGs in September, and the UN Statistical Commission plans to set official indicators in March 2016. At last count, the proposal contained 17 goals and 169 proposed targets. Though critics say the proposal’s broad scope will dilute its effectiveness, these myriad goals will level the playing field, elevating important issues that were ignored by the MDGs.

NTDs are included in Goal 3 of the proposed SDGs, which reads, “by 2030 end the epidemics of AIDS, tuberculosis, malaria, and neglected tropical diseases and combat hepatitis, water-borne diseases, and other communicable diseases.” This explicit mention of NTDs is already an improvement over the MDGs, but what does it mean to “end the epidemic”? A clear indicator will be key to rallying support for NTD elimination.

But an initial draft of indicators presented during the March meeting of the UN Statistical Commission failed to include indicators for NTDs. As we have learned from the MDGs, “what gets measured gets counted,” said Global Network Managing Director Dr. Neeraj Mistry in remarks at the UN Economic and Social Council’s High-Level Political Forum earlier this month.

To effectively control and eliminate NTDs will require a coordinated global effort, and finding the right set of indicators will be extremely important. The NTD community strongly recommends:

90 percent reduction in the number of people requiring interventions against NTDs by 2030

Treating NTDs is extremely cost-effective and contributes greatly to the success of broader development goals. With medications already available, NTD elimination is not only possible, it’s within our grasp. And with a clear indicator, we can meet this target within the next 15 years.

Update: You can join the effort by asking your country’s representative to the UN to support and promote the inclusion of a global NTD indicator in the SDGs.

Photo: Dr. Neeraj Mistry speaks at the UN ECOSOC High-Level Political Forum on July 9, 2015.

UK Parliamentarians Call Attention to Neglected Tropical Diseases During Recent Debates

uk-parliament

This blog post was originally published on the Sabin Vaccine Institute website.  

Earlier this month the United Kingdom’s Houses of Parliament met on two separate occasions to discuss global health priorities  with debates on global health research and development and health systems strengthening. These debates occurred at a crucial time in the Parliament’s calendar as the UK draws closer to the end of this parliamentary session (2010 – 2015) and moves forward towards the General Election in May 2015. It is one of the last few opportunities for parliamentarians to raise awareness of key global health issues before a new Government and parliament is voted in during the spring of 2015.

Baroness Helene Hayman, Board Trustee at the Sabin Vaccine Institute and Vice-chair of the UK’s All- Party Parliamentary Group on Malaria and Neglected Tropical Diseases (NTDs); and Jeremy Lefroy, Member of Parliament (MP) and Board Trustee for Sabin Foundation Europe, raised important points on the role of NTD control and elimination in alleviating poverty and needless suffering in these parliamentary discussions, highlighting successes to date and the challenges that lie ahead.

On Monday December 8th, following the release of the All-Party Parliamentary Group on Global Tuberculosis report on Global Health Research and Development, the UK parliament’s House of Lords hosted a debate on research and development for tuberculosis, and the UK’s broader global health research agenda.

Baroness Hayman began by congratulating the All-Party Parliamentary Group on Global TB on their recent report titled, Dying for a Cure: Research and Development in Global Health. She applauded the report’s recognition of the 1.4 billion people who suffer from NTDs and called for increased research for new tools to combat these diseases, highlighting the significant impact of vaccines in combating these diseases.

“[The report] has recognized that NTDs are diseases not only born of poverty but which create poverty,” she said. “They undermine education, employment, health—all the opportunities that would allow people to claw their way out of poverty. Therefore, combating the diseases of the poor, including the big three (HIV/AIDS, tuberculosis and malaria), is an essential element of the fight against poverty and for social and economic development.”

“For some of those diseases, we already have treatments for which we need more resources — for example, for mass drug administration for soil-borne helminth diseases,” argued Baroness Hayman. “But we still desperately need to develop better medicines, smarter diagnostics and, above all, vaccines if we are to make progress.”

Given the success of investments (including from the UK Government) in to product development partnerships (PDPs) such as Drugs for Neglected Diseases initiative and PATH, in producing a number of new tools to combat diseases as well as filling a robust pipeline of candidates for clinical trials in recent years, Baroness Hayman called on the Department for International Development (DFID) to not only increase its budget to further support global health research and development (R&D) but also that continued support and greater investment be directed to  PDPs. PDPs, an innovative model of research that combines private, public and philanthropic partnerships to help develop and progress research candidates in the most efficient way possible, have proven themselves to be an excellent R&D model that is channeling results from investments.

Baroness Hayman also recognized that new tools for NTDs will play a vital role alongside the scale up of delivery of existing NTD treatments to help us achieve global goals in control and elimination of these diseases.

Baroness Hayman ended her comments with two final pleas to the UK Government. The first, to increase their commitment, and the resources they devote, to the “vital work of PDPs.” The second, “to not neglect the importance of the research that can take place in the countries and the communities where diseases are themselves endemic,” commenting on the importance of investing in capacity strengthening of scientists in countries with a high burden of these diseases.

On December 11th, two days after the House of Lords debate, the House of Commons convened for an additional debate following the final reports of the International Development Select Committee (IDC) inquiries on Health Systems Strengthening and Disability. Jeremy Lefroy MP, urged Parliament and the UK Government to continue to prioritize NTD efforts in the areas of health systems strengthening and disability.

In his comments, Jeremy Lefroy references the importance of integrated disease programs in Tanzania which have helped maximize the efficiency of health systems.

“This programme tackles neglected tropical diseases,” he explained. “Instead of looking at only one—lymphatic filariasis, for instance, or worms—it is tackling four of those debilitating diseases alongside each other.

In other parts of the world we find the use of pooled funds—for example, pooled health funds in South Sudan and Mozambique, the development partners for health in Kenya and the health transition fund in Zimbabwe. All are excellent examples of people coming together to strengthen health systems locally, showing that it is not simply about one person making their one vertical intervention, but everyone working to bring the money together and make the best use of it.”

Jeremy Lefroy also emphasized the importance of prevention for controlling and eliminating NTDs and malaria.

“[NTDs] affect the poorest people on this planet—something like 1.4 billion people in the course of a year.” He said. “In fact, NTDs not only affect the poorest people and cause morbidity and sometimes mortality, but they often cause disability. And they are eminently curable, or at least eminently preventable, often by very cheap interventions.

That is why I was thrilled that the last Government decided to make NTDs a priority, and this Government, through the London declaration on NTDs in January 2012, has continued that work, providing, I think, £240 million in total, including the money committed by the last Government, over a four-year period. I ask the Minister to ensure that that commitment to the prevention and treatment of NTDs is continued, because it has a huge impact on disability and the prevention of disability.”

As we draw closer to the end of the current set of Millennium Development Goal and global discussions on what happens next through the Post 2015 development agenda, these parliamentary discussions on global health issues in many countries, including those like the UK who are key champions for NTDs, will play a critical role in building the essential political will to increase efforts to reach global NTD goals. We hope that these discussions will also continue in other countries to stimulate further global discussion on recognizing the milestone achievements we have reached so far as well as what more must be done to end these diseases for once and for all.

To read the full transcript of the House of Lords debate, click here. To read the full transcript of the House of Commons debate, click here.

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