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Neglected Tropical Diseases (NTDs)

The problem
| The solution | Our approach

Neglected Tropical Diseases

Copyright Malaria Consortium/Jenn Warren

The World Health Organization currently classifies 17 bacterial and parasitic infections as ‘neglected tropical diseases’ (NTDs). NTD infection causes immense human suffering, chronic disability and/or death with 149 endemic countries, over one billion people infected worldwide and 500,000 deaths a year. Primarily occurring in rural and poor urban areas of low-income and middle-income countries, NTDs are defined as poverty-promoting through their stigmatising features and their impact on child health and education, pregnancy and worker productivity. Like malaria, NTDs perpetuate a cycle of disease and poverty in which the worsening of socioeconomic conditions contributes to poor living conditions which cause the spread of infections. Traditionally NTDs have carried a low priority on donor agendas. Less funding is allocated to them in comparison to more well-known diseases such as HIV/AIDS, malaria and tuberculosis even though their effects are ranked closely when measuring the number of cases.

Some of the more well-known NTDs include trachoma, lymphatic filariasis, leprosy, schistosomiasis and dengue. These diseases, apart from dengue, are primarily concentrated in sub-Saharan Africa, where such infections carry huge social and economic costs in addition to the long-term health effects. Despite the low cost of cures for some NTDs, the diseases are consistently underfunded and do not attract the same attention as other prominent diseases. However, ignoring them obstructs efforts to achieve the Sustainable Development Goals as well as overall economic development.


The Solution

NTDs are medically diverse and therefore vary in terms of treatability. However, many of the diseases are safe and cheap to treat. For example, the cost of treating a child for soil-transmitted helminths only comes to about $0.50 for a year. On the other hand, some NTDs are more difficult to treat – dengue, for example, has no specific drug to clear the viral infection, and clinicians provide supportive treatment only and current methods of transmission control are costly. Other diseases such as visceral leishmaniasis, Human African trypanosomiasis and Chagas disease as well as such conditions as Noma and Buruli ulcer are difficult to diagnose and treat and can cause death and severe disability. Tackling NTDs therefore involves a mix of distributing current treatments, improving healthcare access for the most hard-to-reach populations, and investing in research for new cures. Much progress has been made in reducing the incidence of NTDs and the associated stigma and morbidity, yet much work remains to be done.

Read more about NTDs here

Copyright Malaria Consortium/Jenn Warren

Our Approach

Copyright Malaria Consortium/Jenn Warren

Malaria Consortium’s focus is on ensuring access to effective prevention and treatment for NTDs, especially for those who are most vulnerable. Our strategy supports, where possible, the integration of malaria and NTDs at all levels and where these diseases are co-endemic. We focus on the need to develop new responses to the current NTD challenges while adhering to the World Health Organization’s guiding principles. We also promote a holistic approach that emphasises the engagement of the education sector, the community and the primary healthcare structure.

We design our programmes to incorporate internationally-accepted procedures on NTD prevention and management, and to fit into existing health and community structures to avoid any parallel, unsustainable system. We also acknowledge that one size does not fit all so we support the integration of our NTD interventions into those already being used for malaria or other diseases and that reflect local endemicity and country priorities.

Vector control: Malaria Consortium supports integrated vector control activities for insect vector-borne diseases in our core areas of work, depending on needs and disease burden. For example, Malaria Consortium studied the association between nets usage and the disease burden of leishmaniasis, and we are looking into assessing the impact of the most effective intervention to prevent malaria, such as long lasting insecticidal nets, on lymphatic filariasis. We are also addressing vector control by engaging communities in malaria and dengue vector control via social research studies aimed at understanding community perceptions and acceptance of specific vector control strategies

Preventive treatment: Malaria Consortium is using its experience in the mass distribution of long lasting insecticidal nets and seasonal malaria chemoprevention to improve mass drug administration for NTDs. In countries where a national plan for blanket treatment is already in place, we are using primary schools, primary healthcare centres and major community gathering points as distribution sites for mass drug administration to reach both school enrolled and non-enrolled children, as well as adults. Where the disease burden is very low and yet treatment is needed, we are seeking to integrate preventive chemotherapy and/or NTD treatment within the primary healthcare system.

Case management: Malaria Consortium has many years of experience building capacity and supporting community-level health workers to recognise, diagnose, treat and refer children under five suffering from malaria, pneumonia and diarrhoea. For NTDs, we are using our expertise in community-based delivery systems and integrated community case management to align NTD interventions and create cost-effective platforms. Both primary health care systems and community structures are engaged in case management. The first is the primary platform to deliver essential treatment for diseases that cannot be managed through preventive chemotherapy, while the community is an essential component to support the primary health care system in case detection at early stages and home care management for disability related to untreated NTDs.

Health system effectiveness and efficiency: We support governments by providing evidence-based guidance and implementation support for disease prevention, control and management strategies. We do this by assessing their current health system, and designing and implementing sustainable solutions, tailored both to endemicity and current capacity. Practical activities that Malaria Consortium supports are disease mapping, especially NTDs that are not treatable through preventive chemotherapy; gap analysis of the health structure resources; and health information management systems in reporting NTDs. We also assist in the development of tools for recording patient attendance, triage, diagnosis, disease confirmation, treatment, follow up and cure for priority NTDs and malaria. The final goal is to facilitate the primary health care system in understanding disease trends and using data for disease control and surveillance.

See our NTD brochure for more details of Malaria Consortium’s approach here