More funding needed to tackle neglected diseases

African countries need to increase domestic funding to reduce the burden of neglected tropical diseases (NTDs)—which affect four in 10 people in Sub-Saharan Africa — otherwise, they will not be eliminated.

World Health Organisation (WHO) Regional Director for Africa Matshidiso Rebecca Moeti said that while “tremendous progress” has been made, the global control and elimination targets “cannot be met without increased financial support, stronger political commitment and better tools to prevent, diagnose and treat the diseases.”

NTDs are parasitic and bacterial infectious diseases that thrive where there is little or no access to clean water and/or proper sanitation. The diseases cause disability and can be fatal in some cases. They keep children out of school and parents out of work and thus perpetuate cycles of poverty.

There are 18 such diseases including sleeping sickness (human African trypanosomiasis) transmitted by tse tse fly bites, bilharzia (schistosomiasis) caused by a parasitic worm found in snails and elephantiasis (Lymphatic filariasis) which spreads from infected mosquitoes and is characterised by swollen legs, breasts and testes.

“Countries need to increase financing for NTD programmes and they should be integrated into national health systems. But above all, strong leadership is key especially in the face of competing health priorities such as malaria and HIV,” said Dr Moeti, on the sidelines of the five-day Global Partners Meeting on NTDs, in Geneva, Switzerland, two weeks ago.

RECURRENT EPIDEMICS

Her sentiments came shortly after governments (UK and Belgium) and private donors (such as The Bill and Melinda Gates Foundation) pledged US$812 million towards the collective efforts to control and eliminate neglected tropical diseases.

Locally, Kenya is training staff and equipping labs in a bid to achieve the 2020 NTD goals which include eradicating the Guinea worm and eliminating elephantiasis, leprosy, sleeping sickness and trachoma. In addition to diagnosis, these labs will also support disease mapping surveys.

Kenya is on course to be declared free from Guinea worm this year. The waterborne parasite, which causes dracunculiasis can grow up to a metre long inside a person before it emerges through the feet. Head of the NTD programme at the Ministry of Health Dr Sultani Matendechero, told HealthyNation: “We last had a case nearly 22 years ago and we are preparing for certification by WHO in November.”

Globally, Guinea worm disease nears eradication with reported cases having reduced from an estimated 3.5 million in 1986 to just 25 in 2016, in just three countries: Chad, Ethiopia and South Sudan. Another notable success story from Kenya is the school-based deworming programme which has reduced absenteeism by 25 per cent and added one year to the average duration of a child’s education.

However, a WHO report released during the global NTD meeting notes that there have been recurrent epidemics of visceral leishmaniasis, also known as Kala-azar in East Africa, particularly in Kenya, Ethiopia, South Sudan and Sudan. The disease is fatal if left untreated and is characterised by irregular bouts of fever, weight loss, enlargement of the spleen and liver, and anaemia.

The report shows that in 2015, nearly one billion people were treated for at least one neglected tropical disease using drugs donated by pharmaceutical companies. The drugs were disbursed to 150 countries for mass administration, whereby an entire population in a region is treated without being tested for NTD infection. Here though lies a problem.

“While these drugs are given once a year and for free, only 12 per cent of the donated drugs are used by communities. We need to know why this is happening and address it otherwise, we risk rolling back the gains,” said Prof David Molyneux, the head of neglected tropical diseases at the Liverpool School of Tropical Medicine.

So far eight countries in the world have eliminated elephantiasis while 10 others are waiting for  surveillance results that will verify elimination.

Further, there were fewer than 3,000 cases of sleeping sickness worldwide – an 89 percent reduction since 2000. However, in Kenya, the disease can be difficult to identify.

CONTINUED SURVEILANCE

“Given that where there is sleeping sickness, there is malaria, there needs to a simultaneous test for both. There is need for sustained surveillance by ensuring that populations who are reservoirs of these diseases are screened. You can be a carrier of sleeping sickness and if you do not have symptoms, you are most infectious to others,” said Prof Joseph Ndung’u, the head of NTDs Programme at Foundation for Innovative New Diagnostics, an international organisation that develops diagnostic tests for a variety of NTDs.

The summit concluded that NTDs are not just a public health concern, if addressed they have economic gains. Eliminating the diseases could by the 2020 target set by WHO could add $52 billion to economies in sub-Saharan Africa by 2030.

Neglected diseases in numbers

•  One in six people suffer from neglected tropical diseases worldwide.

•  170, 000 people die from neglected tropical diseases every year.

•  875 million children suffer from neglected tropical diseases every year.

•  120 million people in Africa have elephantiasis and 40 million of them are incapacitated or disfigured by the disease.

•  Roundworms can lay 200, 000 eggs a day in a child’s stomach, blocking the intestines and causing severe pain, vomiting or bloating.

•  21.4 million people suffer from trachoma worldwide, of which 2.2 million are visually impaired and 1. 2 million are blind.

•  13 pharmaceutical companies have donated over Sh7 billion worth of treatment for neglected tropical dseases in five years.