What will it take to eliminate neglected tropical diseases once and for all?
What do you think of when you hear of “neglected tropical diseases” or NTDs?
Malaria, dengue and yellow fever probably come to mind – but there are actually 20 infections and conditions under the umbrella of neglected tropical diseases. NTDs, which primarily affect people living in poverty, affect more than one billion people worldwide and are still prevalent in various developing countries.
Over the past 50 years, the work of the international community has made significant progress in making these debilitating conditions a thing of the past. For example, Guinea worm disease – which former US President Jimmy Carter and the Carter Center have worked to eradicate since 1986 – has fallen to only 14 cases in 2021. But there is still a lot of work to do.
Ending NTDs is not a utopian fantasy; it is a concrete vision of the future towards which we can work every day. The World Health Organization (WHO) has set out an ambitious roadmap to fight these diseases by 2030, but implementing it requires strong leadership from countries, partners and citizens around the world. political will.
Here’s why – and how – NTDs can be a thing of the past.
What are NTDs?
According to WHO, NTDs are a “diverse group of 20 conditions that are mostly prevalent in tropical areas”. Caused by bacterial, parasitic or viral infections, they often lead to disability, cognitive damage, disfigurement or death. Although the epidemiology of these diseases is “complex“, they tend to thrive in remote parts of the world where access to sanitation, nutrition and health care is lacking.
NTDs are considered neglected for many reasons, including lack of awareness and their global rejection as important public health problems. “Neglected” is also a word that aptly describes how low-income populations affected by these diseases have been left to fend for themselves.
What are the 3 key facts people should know about NTDs?
Nearly one billion people worldwide are affected by NTDs.
These debilitating conditions often affect the poorest and most vulnerable communities, with 80% of cases in developing countries.
The Kigali Declaration is a global commitment to eliminate NTDs by 2030. But with the COVID-19 pandemic and other seemingly competing health priorities, they have taken precedence over international attention and action.
What is the link between NTDs and poverty eradication and global goals?
NTDs are, in essence, diseases of poverty. Not only do they affect the world’s poorest and most marginalized communities, but they also fuel a vicious cycle of poor health and poverty. The resulting loss of income affects not only households but also communities, the health systems on which they depend and, ultimately, national economies.
When an individual contracts an NTD, it stunts their growth and development. A child with an intestinal worm infection, for example, may not be able to attend school because of the disease. Their caregiver may not be able to leave the house to work, and the household, in turn, may not be able to feed themselves. Without proper nutrition, they will be more susceptible to infection and disease. In this way, NTDs perpetuate the cycle of poverty: they cause a range of ripple effects in different areas, from the way people eat and drink to the way they play and work.
Because of this worrying cycle, it’s not hard to see why NTDs are such an important part of achieving the UN Global Goals, the framework for ending poverty, tackling climate change and reducing inequality by 2030.
By eliminating these diseases, we can contribute to achieving Goal 3: Good health and well-being, as well as Goal 2: Zero hunger, Goal 4: Education for all and Goal 5: Gender equality.
How do we achieve this?
The WHO roadmap towards elimination and eradication of NTDs serves as a guiding document for world leaders, non-profit organizations, disease experts and other stakeholders to work together through through intersectoral actions. Some of the goals set out in this roadmap include a 90% reduction in the number of people requiring treatment for NTDs, the elimination of NTDs in at least 100 countries, and the complete eradication of two diseases.
The plan also identifies “cross-cutting” targets, such as better access to water, hygiene and nutrition. Since the onset of NTDs can be spread through contaminated soil or insects that thrive in unsanitary environments, improved sanitation could reduce up to 78% of cases worldwide, according to the Centers for Disease Control and Prevention.
Each goal is measurable and quantifiable, with additional intermediate milestones in 2023 and 2025 to ensure all parties are held accountable.
The Kigali Declaration, should be fully embraced during World NTD Week, goes even further in this aspect. It specifically calls on the public and private sectors to work together to complement these efforts, stressing the need for concerted efforts by all stakeholders involved and renewed funding. In other words, governments and donors must make the commitment to eliminate NTDs a high priority.
However, because COVID-19 has severely disrupted access to health care services and programs, it has been difficult to strengthen fragile health systems equipped to deal with seemingly competing health threats. Tackling this issue and building resilience will be crucial to ensure the pandemic does not lead to a resurgence of disease, putting more people at risk.
Who are the main actors involved?
Many organizations and initiatives have been working for years to eliminate NTDs.
Among them is Unite to fight NTDs, a partnership between the World Health Organization and the Bill & Melinda Gates Foundation. Their collaboration, initially intended to support the London Declaration on NTDs, now focuses on achieving the 2030 global roadmap towards the elimination of NTDs.
Sightsaversan organization working in communities in 30 countries, has also been at the forefront of eliminating diseases such as trachoma and river blindness.
Finally, governments have made significant commitments to address NTDs over the years. At the Global Citizen Festival: Mandela 100 in 2018, for example, Mozambique, Botswana and Belgium pledged to do their part. Mozambique pledged $6 million to map the scope of river blindness and increase coverage of elephantiasis and intestinal worms, and called on other African countries to help improve health for all. working to improve health for all. Botswana has committed to prioritizing the elimination of NTDs by mapping their prevalence and working with Southern African countries to eliminate NTDs by 2023. And Belgium has allocated over $6 million to the Special Expanded Project for the Elimination of Neglected Tropical Diseases (ESPEN) and a WHO initiative in Africa.
The UK has been a leader in the effort against NTDs, contributing millions to public health initiatives to eliminate NTDs globally. Recently, however, the UK announced major cuts to its aid budget, jeopardizing these promising efforts.
What action can we all take to help?
As we mark World NTD Day on January 30, you can do your part by supporting and amplifying the work of those leading the global eradication effort, as well as continuing to call on world leaders to step up their efforts.
You can start by adding your voice to the Sightsavers social wall and using the hashtags #PlayYourPart or #BeatNTDs.
For more news and coverage on NTDs, check out ‘The Last Milers’, a series of global citizen profiles that highlights people battling neglected tropical diseases (NTDs) around the world.
Disclosure: The Bill & Melinda Gates Foundation is a financial partner of Global Citizen.