WASHINGTON, D.C. — The Neglected Tropical Diseases (NTD) Program is a great example of what United States leadership in global health can achieve. The fight against NTDs remains one of the best investments in the health and economies of some of the fastest-growing markets in the world. While global progress against malaria, HIV/AIDS and other infectious diseases is more prominent in the public consciousness, the fight against NTDs is one of the largest global health accomplishments to date.
NTDs are defined by the Kaiser Family Foundation as “parasitic, bacterial, and viral infectious diseases that primarily affect the most impoverished and vulnerable populations in the world and, as such, have received scant attention until recently.” They are transmitted by flies, mosquitoes and worms. NTDs can cause death and disability, including blindness, skeletal deformity, disfigurement, and enlargement of limbs.
An estimated 1.6 billion people across 149 countries are at risk, and each year, half a million people die as a result. The cumulative sickness, disability, and death from these diseases is roughly the same as HIV/AIDS or malaria. NTDs have low mortality but high morbidity rates and are the fourth most devastating group of communicable diseases, ranking higher than either malaria or tuberculosis. The United States, which recognizes this epidemic, has been the leader of efforts in the fight against NTDs. The London Declaration, as the original commitment to end NTDs has become known, has evolved into one of the biggest and most successful global health initiatives in history. The international fight against NTDs reached nearly a billion people in 2015 alone.
The Americas are on the brink of eliminating river blindness, and Guinea worm disease is down to its last few cases. The U.S. Agency for International Development NTD Program has improved lives of hundreds of millions of people since its first efforts in the fight against NTDs in 2006. It distributes 300 million treatments annually, reaching 743 million people with 1.6 billion NTD treatments across 31 countries to date. The program has also invested in research and development to ensure that promising new breakthrough medicines for filarial diseases can be rapidly evaluated, registered and made available. The U.S. government has affirmed its support for global NTD goals, including the goals that outline eradicating, eliminating, and controlling several NTDs.
Reaching current World Health Organization goals for these diseases would save around $600 billion in lost economic productivity between 2011 and 2030. It would also promise greater global health security, strengthen the health systems within communities, save thousands of lives and spare millions more from suffering. Although many interventions are relatively inexpensive, with NTDs being concentrated in low and middle-income countries in Africa, Asia and Latin America, challenges remain in delivering the necessary tools and services to the most at-risk populations. Total funding for NTDs from the U.S. increased from $15 million in Fiscal Year (FY) 2006 — the first year Congress appropriated funds for the fight against NTDs — to $100 million in FY 2016. Our current president’s FY 2017 budget request included $86.5 million for NTDs, a $13.5 million (14 percent) decrease from the FY 2016 enacted level.
The United States should maintain steady contributions into the USAID NTD program and urge other nations to do the same. It must ensure that the appropriate tools are developed to reach the populations most in need. The signatories of the London Declaration must keep their promise to sustain the fight against NTDs, a legacy that will benefit generations to come.
– Rilee Pickle