Connecting The Dots To Eliminate Neglected Tropical Diseases

Neglected tropical diseases (NTDs), a group of poverty-related infectious diseases, affect 1 out of 2 people in Africa, and 1.5 billion people globally. These diseases are highly debilitating, can cause life-long disability and cost billions of dollars in developing countries. Many people have never heard of these diseases despite their human and economic costs.

Another astonishing part – the infection routes are preventable$17 billion worth of medicines have been committed by the pharmaceutical industry, between 2012 and 2020, and key interventions such as mass drug administration (MDA) are known to be effective. And yet, these diseases prevail among top causes of medical consultations and school absenteeism in affected countries. How can we connect the dots to see the end of NTDs in our lifetime?

The most affected populations live in poverty and lack adequate water sources and sanitation, putting them in close contact with infectious vectors. A report launched recently by the END Fund shows that the numbers are compelling. Over 1.5 billion people require treatment for intestinal worms, nearly 200 million suffer from river blindness and 856 million people are affected by lymphatic filariasis – one of the most painful and stigmatized diseases in the world.

The numbers are also undeniable as there are huge returns on investment. It costs less than $0.50 per year to treat someone with NTD medicines, and every dollar invested in NTD control and elimination results in $27 to $42 of economic benefit. Even more compelling, if the WHO’s 2020 goals for NTDs are met, Africa could save $52 billion by 2030 if the most prevalent NTDs are eliminated.

Countries like Rwanda have made impressive strides in reducing the prevalence and incidence of NTDs. These countries have shown what is possible with strong partnerships and high-impact initiatives. To maintain the progress toward elimination, however, requires a focus on developing key partnerships and strategies. Beyond maintaining critical interventions like MDA and education around water, proper sanitation and hygiene, below are 5 key strategies to keep in mind:

  1. Sustainable solutions come from communities : affected populations understand constraints that impede prevention and control, and their active participation should be a priority for partners looking to close the gap in eliminating NTDs. Although this is not a new concept, efforts to empower these communities must be front and center and any sustainable strategy should align with their unique perspective. This implies developing strategies from within, with community members as implementers and not just recipients of programs. It is also important to include strategies for those already affected by lifelong disability due to NTDs leading to severe limitations to a productive livelihood and stigmatization.
  2. Identify positive deviance in behavior change : NTDs are closely linked to hygienic practices and can be avoided through hand-washing, wearing proper footwear, and using latrines. These positive practices are often known across communities, but their adoption is not always straightforward. An example is that building latrines does not guarantee that the community will use them. In some instances, open defecation – a major infection route for NTDs – has continued even after latrines are introduced in the community. In this context, it is crucial to identify positive deviance – households or communities that have been able to eliminate NTDs despite having similar challenges – and facilitate cross-learning.
  3. Economic development as a powerful incentive: fighting NTDs is a road to economic development, and the latter can be a driver for the fight against NTDs. A part of promoting behavior change could be linked with social and economic incentives. For instance, if a community can significantly increase and sustain the number of people with access to latrines, adequate water sources and hygienic practices, could that be translated into advantages towards getting out of poverty? Here, one could even posit that an impact bond model could be developed with an incentive mechanism linking investment in health to actual economic gains. It could start at  the village level with socially-minded investors ready to scale up these incentives while maintaining focus on results – avoiding re-infections and achieving elimination of NTDs.
  4. Women as strategic partnersNTDs disproportionately affect girls and women which makes them key beneficiaries. However, women are also strategic partners in the front-line, to encourage compliance in treatment, advocate at the household-level to promote social mobilization efforts to fight NTDs. These efforts can also be aligned with other related programs such as early childhood development (ECD) activities to impact children – a group highly vulnerable to NTDs – from an early age.
  5. Community health workers (CHW) as linkage: CHW are involved in providing treatment, carrying out surveillance and in health promotion. Their involvement facilitates complementarity with various other interventions and avoids any perceived silos. This is particularly important since there is co-endemicity among diseases within the same individual or target groups. Many countries have well established networks of CHWs that promote control and treatment of various diseases at  the community level. In Rwanda, 3 CHWs are embedded in each village to follow assigned households daily, and it has undoubtedly contributed to overall increase in health outcomes. Building the knowledge and capacity of community health workers to tackle NTDs leads to a more sustainable delivery channel, rather than a vertical approach.

Currently, major players in the fight against NTDs such as Ministries of Health, the World Health Organization and the Bill & Melinda Gates Foundation are considering ways to further tackle remaining challenges.

A recent END Fund roundtable provided a platform to start exploring different ways to approach the issues. Sessions that bring together government institutions, private sector, philanthropy, academia and NGOs embedded in the community are great first steps.

The tools to eliminate NTDs are in place, but with the end targets in mind, are we connecting the dots?

How millennials can help to end neglected tropical diseases

A few months ago I had no idea what neglected tropical diseases (NTDs) were, until I went into rural Zimbabwe with a team of people on a mission to combat the five most common of these diseases: intestinal wormsschistosomiasislymphatic filariasistrachoma and river blindness. I was amazed at the level of impact very little resources can make in a community and a nation.

NTDs are a group of infectious diseases that inflict suffering and chronic disability on over a billion of the world’s most impoverished people. They are causing worldwide economic losses due to their disabling impact on people’s lives.

In Zimbabwe, organizations like the END Fund and Higherlife Foundation are working together with the Ministry of Health and Child Care (MoHCC) to find a way to combat them. Below are some of the key statistics of these neglected diseases:

  • People at risk globally: 3 billion.
  • People already suffering from at least one disease globally: 1.6 billion.
  • Annual deaths if not treated: 500,000 people

Think of what these statistics mean: billions of people are already suffering from these diseases. I can almost imagine the questions you are asking yourself now:

“How can this be?”

“How do we not know about this?”

“Is there a cure for these diseases?”

“What exactly are they?”

“Could I be suffering from them?”

“How can I help?”

These are the exact same questions I asked myself when I was introduced to NTDs. What really struck me was my own ignorance. I hadn’t heard much about these diseases before and when I asked a few of my friends, it didn’t surprise me that they were equally in the dark.

What I learned really saddened me, along with other members of the Global Shapers community, a network of “hubs” developed and led by young people. After a presentation on NTDs, We decided to get involved in the fight. Just 72 hours later, I was on the road, heading to witness a mass drug administration (MDA) taking place in rural Zimbabwe.

We traveled to a rural primary school, where we were excited to find all 500 students at the school undergoing treatment. I watched in amazement as this quick and simple, yet effective way of treatment was immediately impacting hundreds of children while using very little resources.

Once back in Harare, members of the Shapers hub decided to work towards launching #EndNTDsZW, a millennial-led awareness campaign launched to educate Zimbabwean citizens through social media.

So why should millennials care, let alone get involved in the fight against NTDs? Because in today’s world, they can make a huge impact.

  • We are the biggest group since the baby boomers, making us an influential part of any population.
  • We are the ones taking over the workforce now.
  • Investing in a future generation that is productive is in our best interest and will help shape the overall economy.
  • Being the largest and most influential part of any population means we are also likely to be the most affected by the diseases.
  • We are responsible for the success and wellbeing of the future generations, and it’s up to us to pass onto them an NTD free inheritance.
  • Not only would we change millions of lives suffering from death, stigma, depression and disability, which can be caused by NTDs, we could save $52 Billion by 2030 in Africa alone by ending these diseases.

And now here are four reasons how millennials can help us put an end to NTDs:

1. Knowledge and use of social media

Nobody knows how to use social media like a millennial. The number of connections they have and the amount of time they spend on social media is an invaluable contribution to any cause. Because of us, information travels faster and farther.

2. Creativity

We are creative individuals and that stems from a place of passion, where we want to see the causes we are involved in become a success. Our creative minds will paint a picture of hope in any situation.

3. Energy

We are highly energetic individuals and we are able to use some of our energy to fuel a fire in the lives of people, and in this case, fight these diseases.

4. Big givers

According to the 2015 Millennial Impact Report, 84% of millennials in the US made a charitable donation in 2014. This shows that we millennials are big givers and also big influencers, with 67% of millennial employees saying that they would be likely to donate if their peer co-workers also participated. Apart from financial resources, we are big givers of our time and skills.

I strongly believe that the future belongs to our generation. It is important for us to take action and begin to directly confront issues like NTDs, which will affect our future productivity and the generation after us.

Due to the global impact of NTDs and the number of people who suffer from them, it is not enough for the Global Shapers Harare Hub to embark on this campaign alone. This challenge requires a global approach with a generation that is active on social media playing their part in creating awareness for and of these diseases.

My call to young people is this: let’s begin to shape the future we want to live in now. After all, it is our inheritance. Let the movement begin to #EndNTDs!