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Josh Ruxin Headshot

Mass Drug Administration; Not a Cure, But a Necessary Treatment

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Right now, American public school children are getting their H1N1 vaccines in nurse's offices all across the United States. And while swine flu is a concern here in Rwanda where I live, the impact of Neglected Tropical Diseases (NTDs) on the population's well-being and productivity is much greater and cannot be compared to anything in the States.

Last month, the Rwanda Ministry of Health, in conjunction with the Access Project, USAID, The Global Fund, the Red Cross and World Food Program, undertook a public health effort that's as extensive as the swine flu intervention taking place in America. Those agencies administered a Mass Drug Administration campaign against worms and schistosmiasis - two of Rwanda's most prevalent Neglected Tropical Diseases (NTDs). It reached and effectively treated more than four million people living in all six districts of Rwanda, or 92% of those who are most susceptible.

Especially prevalent in the young and poor, NTDs leave children anemic, urinating blood, too weak to walk. They can't attend school and their growth is stunted. In adults, the effects are no less devastating and paralyzing. Disabling pain leaves subsistence farmers too weak to work, robbing their families of food. Developing nations are left with a diminished ability to achieve their economic goals as these diseases exert an outsized influence rarely considered by the industrialized world.

According to a 2008 survey conducted by the Access Project on the prevalence of schistosmiasis and soil-transmitted helminthes (commonly known as worms), a staggering 65.8 percent of school-age children in Rwanda are infected with one or more of these parasites. In some areas of the country infection rates reach as high as 100 percent. The overall incidence of schistosmiasis was 2.7 percent, but it reached as high as 69.5 percent in certain sectors.

NTDs are terrifying diseases to watch. We've all seen pictures of African children with big bellies, and it makes us wince because we know that these fat stomachs are filled with worms, not food. It's scary to think that these very treatable diseases can be defeated with a very modest investment, far less than it takes to fight pandemics like AIDS and tuberculosis. Yet they continue to be neglected by aid providers in favor of more familiar, higher-profile scourges. Millions continue to suffer needlessly.

However, in the world of global health, the kind of program just undertaken by the Government of Rwanda is extremely important. It's effective and relatively inexpensive in treating the effects of these diseases.

This kind of program not only shines a spotlight on diseases often left in the shadows, it shows that with the right medical management systems these infestations can be conquered quickly, effectively and cheaply. It's a sensible use of global heath dollars, and the return on these kinds of investments can often be priceless.