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Ending the ‘Neglect’ in Neglected Tropical Diseases

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Posted by Rabab Pettitt and Katherine Sanchez

“If you refuse to take the drug, you invite disease into the community. These drugs fight the disease and stop blindness.” That’s what Madam Mary Becheyiri tells people in Asubende, Ghana, the village where she lives and works as a community drug distributor for the country’s Neglected Tropical Diseases Program.

The disease that Mary is referring to is onchocerciasis, also known as oncho or river blindness. Spread from person to person through contact with parasite-carrying flies, oncho causes people to lose their sight if left untreated. Yet, when a drug called ivermectin is periodically given to everyone in the community, people can be kept safe from the disease.

USAID’s Reach: More than One Billion Treatments

For almost a decade, USAID has supported the delivery of preventive drug treatments for neglected tropical diseases–also known as NTDs–to millions of people, working with programs such as the one in Ghana and others around the globe. These neglected diseases affect one-sixth of the world’s population–primarily the poor and those living in rural areas with no access to safe water, sanitation, and essential medicine.

USAID’s support allows 25 countries to implement programs through which multiple diseases can be simultaneously treated on a national scale, using drugs donated by pharmaceutical companies such as Johnson & Johnson, Pfizer, Merck and GlaxoSmithKline. The Agency’s neglected tropical diseases program is the largest public-private partnership in USAID’s 50-year history, having secured $8.8 billion in drug donations to date. We estimate that for every tax dollar spent by USAID, more than $26 in drugs is donated in-country.

Now that our neglected tropical diseases program has matured, we have recently expanded it to include two new components: support for programs addressing existing disabilities caused by these diseases–which lead to long-term suffering and trap individuals in poverty–and support for research to discover new drugs and accelerate progress toward disease elimination.

From Prevention to Elimination

USAID focuses on prevention of the seven most common neglected tropical diseases—river blindness, lymphatic filariasis (elephantiasis), schistosomiasis (snail fever), soil-transmitted helminthiasis (round worm, whipworm, and hookworm), and trachoma, and is working toward targets to control or eliminate them.

In the case of river blindness, the Agency aims to eradicate the disease in the Americas by 2016. We are close to achieving this goal. We helped Colombia in 2013 become the first country to obtain certification of oncho elimination from the World Health Organization, and now the only remaining area in Latin America where oncho is being transmitted is a hard-to-reach border area between Brazil and Venezuela.

Several other countries are also getting close to applying for certification of elimination of one or more neglected tropical diseases. The future holds much hope.

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“Last Mile” Toward Control of Neglected Tropical Diseases

As countries get to the so-called “last mile” of disease elimination, surveillance will be critical to make sure no pockets of disease remain. USAID will continue to focus on activities associated with mass drug administration for disease prevention, including disease mapping and surveillance, drug distribution and training of health workers.

However, countries have a role to play. They need to invest domestic resources in ongoing surveillance and control of neglected tropical diseases. This is especially true for managing public health threats like snail fever and intestinal worms, which cannot be wiped out without strengthened water and sanitation infrastructure.

With the training provided with USAID support, committed community drug distributors like Mary Becheyiri are diligently educating and treating residents in even the most remote communities. As these dedicated people, drug companies and governments combine their efforts, hopes are high that soon diseases such as river blindness will be gone for good.

ABOUT THE AUTHORS

Rabab Pettitt is a Senior Communications Advisor at USAID’s Bureau for Global Health. Katherine Sanchez is a Knowledge Manager for USAID’s END in Africa Project, managed by FHI360, which works toward NTD control and elimination in Burkina Faso, Ghana, Niger, Sierra Leone and Togo.