Let’s take trachoma as an example. It’s the world’s most common infectious cause of blindness and like many other NTDs, is very much linked to living in poverty – in crowded and unclean environments with poor access to water, sanitation and hygiene services. Each episode of ‘active trachoma’ infection causes scarring on the inside of the eyelid and without treatment, this scarring can make the eyelashes turn inward, scraping against the eye and slowly causing blindness.
Trachoma infection is most common in children. This means that women, as primary caregivers, are much more exposed than men to episodes of infection over their lifetime.
At the same time, through activities such as hygiene promotion, acting as community health volunteers and workers and disseminating health information through peer networks, women are uniquely placed within their communities to lead efforts to combat diseases like trachoma. Often it is participation, not skillsets, that is the major barrier.
Studies from another blinding NTD, onchocerciasis (also known as river blindness), show that women’s involvement in and delivery of preventive treatment can yield significant successes.
The same review found that community members reported women’s networks and their soft skills were a major asset to the programme, with women being viewed as more committed, persuasive and more patient than men in the distribution of Mectizan. And in some cases, a lack of women’s involvement in delivery of these treatments was cited as one reason for the limited effectiveness in the distribution of community treatments.
We know that elimination of trachoma and onchocerciasis is possible, and thanks to initiatives like the Global Trachoma Mapping Project we know where we need to target resources to eliminate these diseases.
But it requires more than just the usual calls for health promotion, political will and effective resource allocation. It requires the meaningful inclusion of women in the process as leaders and genuine participants, not simply service users or passive treatment recipients.
We need to establish more and stronger mechanisms for women’s active participation in NTD programmes. The participation of women like Evodia, Abena and Mariama in designing and implementing programmes that meet their needs and those of their communities is critical to achieving elimination of these diseases.
By Helen Hamilton, Policy Adviser at Sightsavers