The World Bank is committed to ending extreme poverty and increasing shared prosperity by 2030. Improving health and development through the control of neglected tropical diseases (NTDs) [1] is a key strategy to meeting this goal. As global leaders and health experts convene in Paris for a forum on Uniting to Combat Neglected Tropical Diseases, we reflect on the success of NTD partnerships and remaining opportunities to target the roots of poverty.
NTDs are coined “diseases of poverty” as they largely affect impoverished populations living at the periphery of health systems. These diseases affect one in six people globally, with more than 50% of the burden concentrated in Africa. NTDs can cause disability, disfigurement, and cognitive impairment, and yet most can easily be controlled by simple, safe, and infrequent mass treatment. The insidious effects of these diseases lock people into poverty and undermine the resilience of communities.
This week marks a significant milestone in the global NTD control, elimination, and eradication agenda. Representatives from development agencies, pharmaceutical companies, nongovernmental organizations (NGOs), and endemic countries are meeting to assess progress made since the London Declaration on Neglected Tropical Diseases and to catalyze novel approaches to reach more children infected with intestinal worms.
The far-reaching impact of effective NTD treatment programs on health, agricultural and human development can be illustrated by the 40-year commitment of the World Bank Africa Region to fight river blindness. The African Programme for Onchocerciasis Control (APOC), led by the World Health Organization (WHO) and supported by a partnership of some 30 donors through a World Bank trust fund, reaches 100 million people in 31 endemic countries in Africa each year.
This model has successfully interrupted transmission in previously intense transmission areas and put the continent on track to eliminate the disease from nearly all endemic countries by 2025. The overall impact of these programs has allowed communities formally affected by river blindness to develop greater market-oriented land use, cultivate 25 million hectares of arable land, and enjoy improved access to basic services, such as electricity, telephone service, and education.
Through the London Declaration, pharmaceutical companies have donated the necessary medicines for all the major NTDs; the challenge now is to help countries create community-directed health systems and case management systems to distribute the medicines. According to the 2013 Lancet Commission on Investing in Health , the “elimination of (high-burden NTDs) for such low costs… represent[s] very good value for money.”
At the Paris event, the World Bank will show how increasing numbers of countries are using World Bank International Development Association (IDA) funds, the World Bank’s main fund for low-income countries, to help distribute the medicines. This year the World Bank Group has helped countries in Africa to access an additional US$120 million for NTDs, in projects in Madagascar, the Senegal River Basin and the Sahel Region.
A major innovation at the Paris event is a new consortium to assist countries to develop appropriate mechanisms to address intestinal worm infections among schoolchildren, with potentially significant benefits for educational achievement and development in endemic countries. Intestinal worm infections are typically most intense in school-age children, where they are associated with constraints on learning, growth, and school attendance. School-based deworming programs improve cognitive outcomes, growth, and school participation. Although the pharmaceutical industry donates enough medicine to treat all children in Africa for intestinal worm infections, only one-third of children are currently receiving treatment.
Harmonizing efforts across the health and education sectors to implement national school-based deworming policies may prove to be the best path forward to treat children. In 2010, the World Bank and the Global Partnership for Education (GPE) partnered with multi-sectoral health and education teams from Liberia, The Gambia, and Sierra Leone to develop national school-based deworming programs. Within 12 months, all three countries developed programs that have subsequently proven to be sustainable. Mainstreaming deworming efforts through school-based initiatives is increasingly becoming a critical component of integrated NTD treatment programs.
The convening of committed partners at the Uniting to Combat Neglected Tropical Diseases event this week demonstrates that the tide is changing. Partners are moving forward to encourage multi-sectoral collaborations and build sustainable partnerships to reach affected populations. NTDs, as well as those impacted by these diseases, will no longer be neglected.
Follow the World Bank health team on Twitter: @worldbankhealth
Related
Fact Sheet: The World Bank and Neglected Tropical Diseases: Building on a History of Helping Countries Address Diseases of the Poor
Press Release: Global Partners Are Taking the “Neglect” Out of “Neglected Tropical Diseases”
[1] Lymphatic filariasis, onchocerciasis, schistosomiasis, trachoma and soil-transmitted helminths (STH), which includes ascariasis (roundworm), trichuriasis (whipworm) and ancylostomiasis (hookworm).
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