Newly Released Scorecard Marks Progress in the Fight against Neglected Tropical Diseases
Today, on the heels of Universal Health Coverage Day, we celebrate the remarkable progress in the effort to control, eliminate, and even eradicate neglected tropical diseases (NTDs). NTDs – such as elephantiasis, leprosy, and trachoma (the leading cause of infectious blindness) – can be debilitating and disfiguring for the more than one billion people they affect. Data collected by the World Health Organization (WHO) in 2006 demonstrated that, among infectious and parasitic diseases, 25 percent of productive years lost to disability and 10 percent of deaths were the result of NTDs. These scourges are more accurately defined not as neglected tropical diseases, but as diseases of neglected populations. As such, NTDs are both a target and potential marker of successful Universal Health Coverage.
In 2012, partners worldwide made a large-scale commitment to address these infections through the London Declaration on NTDs. Endorsed by nearly 100 pharmaceutical, research, governmental, and non-governmental organizations, the London Declaration has been a catalyst for the fight against 10 of these diseases through increased drug donations, coordinated research, and enhanced support to the countries where the diseases are endemic. Today, with the release of the Fifth progress report on the London Declaration in conjunction with the Universal Health Coverage Forum in Tokyo, we can see that this commitment is paying off.
Immediately following the London Declaration, drug donors – notably Merck, Pfizer, GlaxoSmithKline, Johnson & Johnson, and Eisai – committed crucial medicines to treat and prevent NTDs. Thanks to those donations, NTD programs have made remarkable strides towards achieving the WHO goals for the control, elimination and eradication of 10 NTDs by 2020. In fact, as the Scorecard Report points out, more than one billion people received treatment for NTDs in 2016 alone! Furthermore, in response to the success of these efforts and new research findings on the potential value of combining donated medicines, Merck has recently recommitted to its donation of ivermectin, expanding its reach by 100 million people each year.
Research is crucial to this effort, and the London Declaration also has catalyzed commitments to fund this work – including the NTD Support Center’s own grant from the Bill & Melinda Gates Foundation, which was followed by crucial support from USAID and DFID as well. Successes in research since the London Declaration have helped countries overcome key barriers they face first in defining just who needs to receive medicine for treating the NTDs and then getting those medicines to them appropriately. For example, newly developed research strategies for determining the prevalence of lymphatic filariasis (LF, the infection that leads to elephantiasis) helped the ministries of health in Ethiopia and Tanzania determine that of 55 districts initially suspected of needing treatment, fully 52 were found not to require mass drug administration to stop the disease’s transmission. In total, that discovery alone saved the countries more than $9 million and allowed them to focus these savings on other important health issues.
Operational Research, as we recognize, is most successful when conducted with and owned by national ministries of health, the implementers of health programs. These ministries are the gateway to Universal Health Coverage and increases in support to them by USAID, DFID, and others since the London Declaration has allowed them to train health workers, provide surveillance mechanisms and undertake other crucial activities to fight NTDs. In addition, this support has enhanced the local health facilities, thereby strengthening the responsiveness of the overall health systems. The current scorecard report describes a very challenging case study from Niger which has been able to treat populations at risk for NTDs by using support from USAID and calling on its strengthened health system to provide nearly 9 million NTD treatments in 2016, despite widely dispersed populations, high temperatures, dangerous weather and heightened security risks. This and other stories exemplify the power of focus, commitment and collaboration, the principal elements embodied in the spirit of the London Declaration.
That new spirit has already helped 10 countries to eliminate lymphatic filaraisis as a public health problem and has brought Guinea worm disease to the brink of eradication. Moreover, the success of this effort has created an important ripple effect. In fact, since the burden of NTDs was assessed in 2006, recent data shows a remarkable 30-40 percent decrease in health impact of the most prevalent of these NTDs. Indeed, by preventing these diseases, NTD programs and their supporting partners not only ensure healthier lives for today’s affected populations, but they also strengthen those delivery systems that make health accessible to all.
The fight, however, is far from over. As we progress towards the NTD targets of 2020, we must strive to do so in step with all the essential partners needed in the fight. Moving forward together, we can leave the NTDs behind.