Affecting the lives of more than a billion people across the world, it can be hard to comprehend that neglected tropical diseases (NTDs) are overlooked. On paper, the number of people living with these diseases – many of which are preventable and curable – is difficult to ignore, but in reality that’s exactly what has happened for far too long. Today, a wide range of organisations are coming together and taking action to change that.
As the second anniversary of the sustainable development goals, which include a commitment to tackling NTDs, is recognised, we look at some of the ways that the fight against NTDs is progressing.
Tracking NTDs in numbers
One in seven people across the world are affected by NTDs, more than the entire population of Europe. At present, 856 million people in 52 countries remain threatened by lymphatic filariasis (or elephantiasis). The Bill and Melinda Gates Foundation – one of several organisations along with Gilead that presented the London Declaration on NTDs, committing their organisations to backing up the World Health Organization’s (WHO) work – are investing in surveillance and precision mapping. These initiatives enable them to more accurately identify where people are affected by lymphatic filariasis, so that resources can be effectively targeted to treat them and eventually eliminate it.
The importance of Wash facilities
Many people who have an NTD have contracted it because they have no access to safe water, sanitation or hygiene (Wash) facilities. Lymphatic filariasis is a worm disease contracted in childhood. The worms block the lymph glands, leading to disfiguring swelling of the limbs. The recently released guidelines on deworming children is just one example of an early intervention practice that can prevent NTDs from taking hold in communities.
The WHO is focusing on tackling trachoma – the world’s major infectious cause of blindness, a painful eye condition affecting 40 million people in 57 countries – through its surgery for trichiasis, antibiotics, facial cleanliness and environmental improvements (SAFE) initiative. Wateraid is one of the organisations implementing the SAFE strategy and working to improve the quality and availability of safe Wash facilities that serve communities in Uganda, where an estimated 10 million people are at risk of trachoma.
The physical and financial impacts
NTDs can cause considerable physical and psychological suffering, chronic disability or disfigurement, and even premature death. As with leprosy and many other NTDs, people with these conditions are often stigmatised and subjected to discrimination.
The International Federation of Anti-Leprosy Associations (ILEP) works to have anti-leprosy laws abolished. In Senegal, its member organisation DAHW is campaigning for the abolition of a law that segregates people living with leprosy in so-called social rehabilitation villages.
The physical and health impacts of NTDs have a knock-on financial impact on individuals, families and communities. The physical conditions caused by NTDs may mean that individuals are unable to work or go to school, and family members may need to stop attending work or school in order to care for people with those conditions. Many of those confined to social rehabilitation villages in Senegal are wholly reliant on the state for financial support.
Innovative research
Monitoring the spread and decline of NTDs is an important part of controlling and eradicating them. The London Centre for Neglected Tropical Disease Research (LCNTDR) is a collaboration set up to carry out cutting-edge research into NTDs. One of LCNTDR’s current research projects is on schistosomiasis – a water-borne disease that is spread by snails, and causes organ damage. It will look at the interaction between snails, the environment, and the way in which the schistosome parasites are spread by the snails.
The Tumikia project, an initiative led by the London School for Hygiene and Tropical Medicine, was set up to see whether school and community deworming projects were more effective in eliminating intestinal worms than projects based solely within schools. As part of this trial, all residents of 150 communities on the Kenyan coast were treated for worms over a two-year period, which ended in May this year. The results of the study are due to be released at the end of 2017. If the approach proves to be a success, it could be adopted in other communities where worm-related NTDs are endemic.
How partnerships are helping NTDs become a thing of the past
Partnerships between public bodies and private organisations play an important role in reducing the burden and spread of these diseases. For example, Gilead is working with the WHO to combat visceral leishmaniasis (VL), the world’s second most deadly parasitic disease after malaria. Gilead’s partnership with the WHO has contributed to drastically reduced the incidences of VL in south-east Asia. In some cases, it has been eliminated entirely.
The challenge of eliminating NTDs is being taken on by various organisations with different expertise. According to the WHO, a billion people received treatment for an NTD in 2015 (the last year for which figures have been published). Some of these NTDs are definitely on their way to eradication (guinea worm disease, for instance, had just 25 cases in 2016). Even those that are still prevalent, such as sleeping sickness, showed a reduction in the number of cases, from 37,000 in 1999 to under 3,000 cases in 2015. Although there is still a long way to go, the WHO are confident that by 2020 – the year earmarked for the elimination of NTDs – these ancient diseases will either be confined to history or, at the very least, under control.
Content on this page is paid for and produced to a brief agreed by Gilead, a sponsor of the Guardian’s Global Development Professionals Network.
Date of preparation October 2017 (HIV/IHQ/17-03//1363g)
