This article was originally published in Politics Home
In recent years we have seen incredible progress in the fight against neglected tropical diseases (NTD), but with the elimination of 10 NTDs on the agenda, we need stronger international commitment to achieve targets.
January 30th 2017 marked the fifth anniversary of the London Declaration on NTDs, when donors, governments, pharmaceutical companies and NGOs committed to eliminating 10 of the 17 WHO-recognised NTDs by 2020. With just three years to go until this deadline, the fifth anniversary of the London Declaration represents an opportune moment to review our progress.
NTDs are diseases of poverty that affect the most vulnerable populations, trapping them in a cycle of illness, suffering and stigmatisation. These diseases are preventable and treatable, yet for decades have remained prevalent in the world’s most underdeveloped regions. This is largely due to weak health systems in endemic countries, a lack of access to adequate healthcare for many around the world, low donor prioritisation and poor international cooperation.
The economic consequence of contracting an NTD can be huge, for both individuals and governments alike. The costs of treatment and impact of disabilities caused by many NTDs serve to reinforce poverty and, at the national level, high disease burdens can limit economic prosperity and hold back growth. In total three billion people are at risk from NTDs, which are responsible for around 500,000 deaths every year.
In the years since the London Declaration, with the increase in global funding that it unlocked, some significant progress has been made in efforts to control and eliminate. Four previously endemic countries, Côte d’Ivoire, Niger, Nigeria and Ghana, are now free from guinea worm infection. In 2015 alone, 980 million people received preventive chemotherapy treatment, with 2.4 billion tablets donated by pharmaceutical companies to prevent and treat NTDs. We have also seen a promising growth in investment for research and development of vital new drugs and diagnostics.
Significantly, the elimination of NTDs is included in the Global Goals for Sustainable Development. With this global focus, it is now, more than ever, possible to expand international awareness of NTDs and mobilise efforts towards their elimination.
Malaria Consortium has played an important role in the fight against NTDs. In 2016, we provided over 800,000 treatments for schistosomiasis and soil transmitted helminth infections, supporting the South Sudanese Ministry of Health in conducting mass distributions of deworming drugs to school-aged children across Central Equatoria. With funding from UK Aid, we recently demonstrated the effectiveness of using three innovative vector control strategies to reduce the threat of dengue fever in Cambodia, such as the use of guppy fish. The fish, which are placed in large household water containers where the mosquitoes breed, were discovered to be popular with local communities and highly effective. Results showed that the use of guppy fish and other larvicides were decreasing the number of dengue-carrying mosquitoes in households in areas where the trio of interventions was implemented.
However, despite these examples of progress, there is much yet to be done. NTDs still remain underfunded relative to their burden and impact and new challenges continue to arise and threaten progress. These include political crises (giving rise to mass migration and areas where it is impossible to operate), international epidemics and climate change. To ensure that the achievements made so far are sustained, stronger commitment from policy makers and donors to NTDs is needed, as well as improved methods to manage and monitor them.
Disease surveillance is a particularly neglected aspect of NTD programming, but one that is vital for control, elimination and outbreak preparedness and response. An effective surveillance system is important for understanding a country’s true burden of disease, and then planning and implementing targeted interventions. As elimination is approached, surveillance is needed for detecting the last cases that need treating, and in post-elimination settings it is vital for early detection of disease resurgence. Surveillance systems should be integrated into all NTD programmes and local communities must be engaged effectively at all stages to ensure sustainability. A high level of international financing and cooperation in the implementation and scale-up of surveillance systems is required for this to be achievable.
The UK is at the forefront of the fight against NTDs; the Department for International Development is one of the leading funders, its universities and pharmaceutical industry are pioneering new diagnostics and drugs, and UK NGOs are delivering on the ground. Malaria Consortium calls upon the UK Government to continue its commitment to the fight against NTDs, but also to use its position of leadership to encourage other donor countries to join the fight against these debilitating diseases of poverty.
Keywords: Surveillance, monitoring and evaluation