Neglected tropical diseases affect the poorest and most marginalized communities in the world, authors say
Donors and affected countries must remain firmly committed to achieving a world without NTDs, they argue
Editor’s Note: Ambassador (ret.) Mary Ann Peters is CEO of The Carter Center. Sue Desmond-Hellmann is the CEO of the Bill & Melinda Gates Foundation. The views expressed are their own.
The first thing you notice about Jude is his playful spirit and insatiable curiosity. An inquisitive and talented 13-year-old boy in Nigeria, Jude loves going to school, practicing drums and playing soccer with his friends. He dreams of growing up to serve his community and nation.
Last week, Ambassador Peters was with Jude as he received a handful of small pills: the 500 millionth treatment the Carter Center has given across Africa and Latin America to stop diseases that blind, stunt development and rob people of nutrients. The story behind treatments to stop tropical diseases like these, and how they come to improve the lives of so many, is a remarkable public health success that few people know anything about.
Neglected tropical diseases, or NTDs, are a group of debilitating illnesses that affect the poorest and most marginalized communities in the world. They can kill – NTDs cause about 150,000 deaths every year – but their main impact is to sicken and disable. Approximately 1.6 billion people are affected by one or more NTD.
Yet many people haven’t heard of these illnesses, with complicated names like onchocerciasis, lymphatic filariasis and soil-transmitted helminths. Together, they have been coined “neglected” for the lack of attention they receive.
The flip side is that eliminating NTDs unlocks enormous economic potential. According to one study, doing that would restore around $600 billion in lost economic productivity by 2030: more than the GDP of 46 African countries in 2015. Compared with the investment needed to accomplish it, that’s one of the best buys in global development.
So it’s encouraging that NTDs are the focus of a sophisticated and far-reaching public health campaign, which goes back decades but reached its apex with the London Declaration on NTDs in 2012. By signing this declaration, leaders from pharmaceutical companies, philanthropic organizations, the World Health Organization, civil society, and donor- and developing-country governments pledged to work together against NTDs, focusing resources and attention on fighting these diseases. The handful of pills Jude took last week were among $17 billion worth of tablets donated by pharmaceutical companies since the declaration.
Thanks to the commitments of these players, NTD programs have achieved astonishing results over the past several years. Community health workers distributed NTD treatments to nearly 1 billion people last year, 200 million more than just two years ago. And an increasing number of countries are getting rid of diseases altogether. Recently, seven countries eliminated trachoma, the world’s leading infectious cause of blindness. Guinea worm disease, a painful and disabling disease that 30 years ago afflicted more than 3 million people, is on the brink of eradication.
In fact, a few years ago, Jude would have received two additional treatments – but the diseases those pills would have prevented, lymphatic filariasis and trachoma, are no longer present in Nasarawa state, where Jude lives, thanks to the country’s commitment to elimination and the work of NGOs like the Carter Center.*
As successful as these efforts have been, our goal is to see the end of these diseases. To achieve that, the world needs to focus on where it can do better.
While companies donate medicines to treat many in need, the local health systems expected to deliver them to poor and remote villages often lack resources and health workers to do just that. National governments must prioritize building basic health facilities and providing clean water, roads, electrification, and education – the infrastructure that makes permanent progress against diseases possible.
A 2015 report from the World Health Organization makes clear that these improvements will not only help control and eliminate NTDs in the short-to-medium term but will bring far greater benefits to the poorest among us.
Public and private funders, including country governments, also need to invest more in discovering and refining the tools needed to fight NTDs. This means not just drugs, but better diagnostics and new tools to protect people against flies and snails that transmit disease. To fight sleeping sickness, countries like the Democratic Republic of the Congo (DRC) have introduced a simple finger-prick diagnostic and “tiny targets” that attract and kill disease-carrying flies. These efforts are helping drive cases in the DRC and globally to the lowest levels in recorded history.
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Donors and affected countries must remain firmly committed to achieving a world without NTDs. The United States Agency for International Development (USAID) and United Kingdom Department for International Development (DFID) are exemplars in this area. Their hefty contributions don’t just help deliver hundreds of millions of treatments and save lives, they keep NTDs on the global development agenda and bring to the table new private and public donors. Unwavering leadership from the US and UK will be vital to reducing the burden of NTDs.
In health, issues that receive the most attention get fixed, while issues that are ignored tend to stay that way. For too long, these diseases of the very poor lived on the periphery of our attention, even as other health issues like HIV became global priorities. That is beginning to change, and millions of children like Jude now have the chance to lead healthy, productive lives. Let’s not stop until we’ve finished the job.
*This piece has been updated to make clear that lymphatic filariasis and trachoma, are no longer present in Nasarawa state, not no longer present in the entire country of Nigeria as originally stated.