A child receives a treatment for worm infection during a door-to-door vaccine campaign in Adia, Cameroon. © Gates Archive/Dominique Catton

January 30th, 2021 — Neglected Tropical Diseases Day (NTD), that affect 1,7 billion people each year

The scientific community reacted with speed to #COVID19. But neglected tropical diseases, which affect 1.7 billion people, don’t get the same comparable funding or attention.

Celebrating the Second Annual World NTD Day: A Q&A with Katey Owen

Let’s start with two questions that often come to mind when people hear “neglected tropical diseases.” What are NTDs, and why are they considered “neglected”?

While NTDs do not usually kill, they cause pain and disabilities, keeping children out of school and adults from earning a living.
In other words, in areas where economic development is most needed, NTDs trap communities in cycles of poverty.

At the foundation, we believe that ending the suffering caused by these preventable and treatable diseases is both a moral imperative and a chance to maximize human and economic potential.

Despite these challenges, impressive gains have been made against NTDs in the past decade. What is driving that progress?

The declaration was the first time that partners from many sectors — from nonprofits and pharmaceutical companies to governments and the World Health Organization — united behind a concerted effort to beat NTDs.
This moment, whose anniversary is marked by World NTD Day each year, ushered in an era of unprecedented commitment, collaboration, and progress.

Since 2011, the number of people reached with NTD treatments has increased almost 40% — to nearly 1.2 billion people in 2019.
The number of people at risk of NTDs has also fallen by 300 million since 2011.
Since 2012, 33 countries have eliminated at least one NTD.

The pace of these gains is in large part driven by the strong multi-sectoral collaboration that sets the NTD community apart.

  • Innovative partnerships between pharmaceutical companies;
  • donor governments such as the U.K., U.S., and UAE;
  • philanthropic partners like the END Fund and Sightsavers;
  • the World Health Organization (WHO);
  • and, of course, endemic country governments enable the delivery of 1.7 billion NTD treatments annually.
  • A large portion of these treatments are generously donated by industry partners — in fact, more than 11.5 billion treatments have been donated since 2012.

Without such partnerships, we would not see such impressive NTD R&D initiatives that are helping to fill treatment and diagnostic gaps needed for the last mile.

Can you tell us about a specific country or disease area that has been a success story in recent years?

Another example from India is its commitment to the elimination of lymphatic filariasis (LF).
India was among the first countries in Southeast Asia to adopt the WHO-approved Triple Drug Therapy (IDA) to accelerate the pace of LF elimination. Since December 2018, the country has successfully reached 57 million people with IDA, which is one of the largest scale-up stories in the world.
India’s resilience in innovating with locally relevant solutions to deliver LF treatment during COVID-19 is a benchmark for the global NTD community.

And then came COVID-19. How are NTD partners addressing the challenges presented by the pandemic’s interruption of community-based health interventions?

Fortunately, the NTD community is not new to challenges and disruptions — delivering treatments to the most remote, underserved communities with often limited resources is our specialty — and NTD partners have once again risen to the challenge.

Where programs are resuming, health workers and communities are taking steps against COVID-19.

In Guinea, partners like USAID’s Act to End NTDs, Helen Keller International, and FHI 360 worked with the Ministry of Health to adapt mass drug administration (MDA) campaigns to be safer.
In addition to rigorous mask-wearing and hand washing, health workers went house to house instead of gathering the community in one fixed location, as before. Ultimately, they delivered 20 million treatments to 4.4 million people.

Countries also need reliable tools to help them decide how and where to resume NTD activities.
USAID’s Act to End NTDs and WHO AFRO’s ESPEN published guides to help countries do exactly this, and ESPEN and the NTD Modelling Consortium developed a modeling tool that analyzes how much delay programs can tolerate before seeing a negative impact.

Last but not least, as soon as COVID-19 emerged, NTD partners mobilized to support the pandemic response as well.
The END Fund launched a COVID-19 emergency fund to help implement communications campaigns about sanitation and hygiene to prevent COVID-19 and NTDs alike.
Government partners like FCDO’s ASCEND program have helped support 11 countries’ COVID-19 responses, including with mass media behavior change campaigns, health worker training, and supplies.

What do these delays and disruptions mean for the NTD community’s 2030 goals? Can we get back on track?

But our window of opportunity won’t last forever.
We need to act decisively and rely on data to target limited resources where they’re needed most as NTD programs resume.

The strain COVID-19 has placed on health systems and economies — in both endemic and donor countries — means we must adapt existing approaches so they stretch resources further — for example, by delivering treatment for more than one NTD and other disease areas together.
We must also prioritize investing in systems that will sustain and pay for themselves long-term.

What does success look like to you for NTDs in 2021 and beyond?

While we have made impressive gains in recent years, many of the goals for 2020 from the previous roadmap were not reached, which makes embracing the new roadmap’s shifts even more critical if we want to achieve the 2030 targets.

One such shift is a focus on systemic solutions that leverage the entire health system, not just disease-specific approaches.

To address long-term resource constraints, we will also need to optimize NTD interventions by identifying new tools that can help deliver NTD programs in quicker, smarter, and more impactful ways, such as adopting microplanning tools used in polio and routine immunization campaigns.

Investment in NTD R&D is also urgently needed.
Compared to other disease areas, particularly those that affect high-income countries, NTDs receive far less funding for research, despite key gaps.
For example, for some NTDs we don’t have diagnostics sensitive enough to identify when MDA can be stopped.
For other NTDs, existing treatments can’t kill the adult parasite, so many rounds of MDA are required to break the transmission cycle.

This June, NTD partners will come together at the Kigali Summit on Malaria and NTDs to repledge their commitment to addressing these diseases and to achieving the goals laid out in the WHO NTD roadmap for 2030.
If we can maintain commitment, embrace new ways of working together, and push for innovative approaches that more effectively utilize available resources, I am confident that we will protect hard-fought gains against COVID-19’s disruptions and beat NTDs for good.

About the author:

Director, Neglected Tropical Diseases, Gates Foundation

Katey Einterz Owen, Ph.D. leads efforts in controlling, eliminating, and eradicating the diseases of the London Declaration on Neglected Tropical Diseases. This includes active investment in lymphatic filariasis, onchocerciasis, schistosomiasis, STH, trachoma, Guinea Worm, HAT, and visceral leishmaniasis, diseases that collectively put at risk more than one billion people in the world.

I know that with the right R&D investments, we can #beatNTDs.

- Travel Mundell, CEO of Gates Foundation —

Edited for Brazil by

Joaquim Cardoso do Rosário

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Joaquim Cardoso @ BCG

Senior Advisor for Health Care Strategy to BCG — Boston Consulting Group