Global leaders and forward-thinking philanthropists and donors committed to eradicating Neglected Tropical Diseases (NTDs) by signing onto The London Declaration. This is a big and bold move, as NTDs are brutally efficient at undermining the health and nutritional status of hundreds of millions of people worldwide. NTDs infections are considered one of the main reasons why the "bottom billion" struggle to escape poverty. Successfully eradicating NTDs will transform the world.
The London Declaration builds on the momentum already established through the success of the global polio eradication campaign which inches closer to its goal, and similarly courageous efforts to eradicate malaria, TB and HIV/Aids. It understands that the key to success is setting a clear, somewhat audacious goal and then driving funding, programming and research relentlessly towards the achievement of that goal. It should be applauded.
Yet I am saddened by the emphasis on vaccines and medicines as the seemingly only vehicles to eradicate NTDs by London Declaration signatories. And I wonder where water, sanitation and hygiene are in this mix, as by all accounts it is not anywhere to be seen in the NTD eradication initiative. Why is that?
It certainly is not because the signatories do not understand the importance of water, sanitation and hygiene in NTD control. The Bill & Melinda Gates Foundation, USAID, UKAid, The Lions Club, the World Bank and others are at the forefront of water and sanitation sector work worldwide. The science on the link between sanitation and helminth control and prevention is beyond clear, as this study demonstrates.
I fear that the reason signatories are pushing forward without the water, sanitation and hygiene sector may have to do with our timidity and fearfulness.
We speak different languages!
The London Declaration proclaims a big goal -- complete eradication of NTDs -- and puts their energy, resources and reputations on the line towards that clearly definable goal. Either girls -- worldwide -- go to school worm-free or they don't. "Judge us on this outcome," the signatories collectively shout, with one loud voice. "Just like polio. Just like malaria... "
And into that refreshing roar you simply can't hear the whimper of the water and sanitation sector. Our voices, which should be central to any debate on worm eradication, are simply not heard at all. We are too busy arguing about "our models," making the case that we need more "projects," more money for loans to women in India and Bolivia, promoting the next great technology that rarely works and crying for more funding and support instead of roaring for transformative change globally.
But I fear there is a second, more powerful critique at play here as well. Quite simply, many of the girls that the NTD eradication initiative will target will likely be treated next to the broken hand pump or disused toilet that litter the landscape of Africa, Asia and Latin America. An effective eradication campaign would combine flowing water, latrines and proper handwashing plus medication to truly eradicate NTDs. Everyone knows that, especially the signatories of The London Declaration. Yet they also know that the massive investments in water and sanitation have not created the environments for worm transmission to cease. And so The London Declaration offers a medical solution to a water and sanitation problem.
Sadly, the water and sanitation sector will continue to be left behind in the bold initiatives that will shape our world -- including those that are directly related to water and sanitation -- unless we collectively commit to eradicating water poverty worldwide; until we commit to a program that is rigorously monitored and where results are measured in water flowing over time instead of the number of projects completed or loans repaid. We will be left behind until we can demonstrate we are problem solvers and that our investments lead to transformative change for communities worldwide, rather than a community that continues to sell poverty and peddle for more money on emotions rather than measurable results. We need to talk of success, not problems, and frame challenges in a bold way that mirrors the reach of The London Declaration mixed with an optimism and willingness to stretch for that result.
Polio is a water-related disease and we were left behind. Malaria has water- and sanitation-related aspects and we are being left behind. And our most obvious sweet spot -- NTDs -- have just left us behind again.
It's not their fault. It's ours.
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