SEATTLE — In less than 10 years, the U.S. Agency for International Development’s Neglected Tropical Disease Programs has made substantial progress in the elimination of seven of the 17 NTDs. On April 15, Ariel Pablos-Méndez, the agency’s Assistant Administrator of Global Health and Child and Maternal Survival Coordinator, testified before the U.S. House subcommittee on Africa, Global Health, Global Human Rights, and International Organizations. Affirming this progress, he stated: “Given that the tools are available and the drugs are being generously donated the elimination of these diseases of extreme poverty as a public health scourge is within our grasp.”
Neglected tropical diseases affect one-sixth of the world’s people. These are people who primarily live in poverty and rural areas in the developing countries. These areas have no access to safe water, sanitary conditions, and medical care. The 7 NTDs targeted for elimination are the most common NTDs: onchocerciasis (river blindness), schistosomiasis, trachoma, lymphatic filariasis, and soil-transmitted helminthiasis (whipworm, hookworm, and roundworm). These diseases, while they do not necessarily cause death, leave their victims with disabilities and deformities such as blindness and acute inflammation and swelling of limbs, known as elephantiasis. These disabilities are long-term and trap people in poverty by impairing lives, intellectual development in children, and economic productivity.
The most significant successes in the fight to eradicate NTDs include:
In 2014, 92 million people no longer needed treatment for lymphatic filariasis. By 2018, 250 million people, 50 percent of the target population, are expected to be free of this NTD.
Onchocerciasis is close to elimination in Latin America; Colombia was the first country to obtain verification of oncho elimination by WHO. The only region where oncho still exists is a hard-to-reach area between Brazil and Venezuela.
Eight countries no longer need treatment for at least one disease.
Twenty-one of the 31 USAID-supported countries are on the right course to achieve the 2020 goals for one or more diseases.
In 2014, due to the above successes, USAID was able to begin supporting the Morbidity Management & Disability Prevention program aimed to treat the disabling effects of NTDs.
Reasons for these successes include:
USAID’s program provided 1.2 billion preventive treatments to people in 31 countries.
USAID led the way in establishing integrated (public-private) programs endorsed by the World Health Organization that distribute the most cost-effective and wide-spread treatments possible through community and school-based platforms.
Partnerships with the pharmaceutical companies Merck& Co., Inc., GlaxoSmithKline, Pfizer, Johnson & Johnson and Merck Serono contributed $8.8 billion in drugs since 2006.
USAID’s partnership with the United Kingdom’s Department for International Development provided a collective reach to almost 50 countries and provided 340 million treatments in 2014.
Since the fight to prevent and eradicate NTDs is on track, USAID is planning the transition to the second phase in the war. This next phase consists of actively conducting post-treatment surveillance to be certain that the NTDs have not returned. The final phase is a transition from active surveillance to passive surveillance. At the same time, USAID will be preparing strong documentation to support certification of disease elimination from WHO.
While USAID’s 2020 goals are on track to eradicate NTDs, realistically, there are roadblocks. Eight hundred million people still need treatment. Disease hotspots exist due to population displacement and climate changes. Soil-transmitted helminthiasis and schistosomiasis cannot be eliminated without large investments in sanitation. And questions still need answering, such as how long disease surveillance needs to be carried out in order to be certain of its elimination.
In spite of these roadblocks, Pablos-Méndez stated, “The progress to date, along with generous support from Congress, has made this program a clear success and continues to put the U.S. government in a position of leading the global effort to combat NTDs.”
– Janet Quinn