Five years ago I was one of the people that gathered together in London in a groundbreaking meeting to talk about neglected tropical diseases (NTDs).
The result, on 30 January 2012, was the London Declaration on Neglected Tropical Diseases. I and others from pharmaceutical companies, donors, endemic countries and non-government organisations made a commitment to control, eliminate or eradicate 10 diseases by 2020.
Neglected tropical diseases are a group of preventable and treatable diseases that affect over one billion people. I gave a contribution at the London meeting, as I often do, about not forgetting the communities where these diseases actually exist, diseases that affect the poorest communities in the world. They disfigure and disable, and keep children out of school and parents out of work – limiting their potential.
The London Declaration meeting outlined that the gaps in terms of treatment were enormous. It talked about gaps in research, drug donations, coverage rates, and diagnostics – just about every gap you could imagine in a health programme. Yet by last year (2016) nearly one billion people around the world were being treated for NTDs annually. Sightsavers’ share of that impressive figure is an equally impressive 143 million give or take a few thousand.
And yes, I am very proud of our contribution to the global effort in eliminating NTDs. This year alone, a Sightsavers-led integrated NTD programme in northern Nigeria, targeting blinding trachoma, schistosomiasis, lymphatic filariasis, onchocerciasis and soil transmitted helminths (hookworm, whipworm and roundworm), gave 39.1 million donated drugs to 25 million people in one of the most endemic NTD countries in the world.
Funded by the UK government’s Department for International Development and supported by the UNITED consortium, the drugs are distributed by community volunteers, who in many cases have first-hand experience of how the diseases impact on lives, having seen a family member or a neighbour infected with an NTD.
These community directed distributors (CDDs), as they known, are given training and the confidence to administer drugs twice a year. As part of the programme, women are actively recruited to ensure that women and children are reached because, in the words of 22-year-old Hawau (pictured), a volunteer from Zamfara State, “As a man there is a limit to where you can go to get into people’s houses, but there isn’t a limit for me, so I’m able to go into people’s houses and explain, to sensitise them on the diseases and the treatments.” What does Hawau herself get out of the experience? “I am happy… I can help my people to be free of the diseases.”
This kind of community-focused intervention gives me hope, not only because it is the communities themselves at the centre of efforts to combat the diseases, but because in the long-term, when we move from elimination to control, this helps ensure sustainability.
The London Declaration started a change in thinking. It certainly changed mine. Thinking big and thinking that what we may have previously thought was impossible was, in fact, possible. Since the London Declaration, trachoma, for example, has been mapped globally in what has been described as “a demonstration of the pivotal importance of quality data in efforts against neglected tropical diseases, and a landmark in the history of public health.”* This ambitious Sightsavers-led project collected and transmitted data from 2.6 million people in 29 countries using Android smartphones, giving us an accurate map of the disease for the first time ever.
Is there more to do? Of course there is. We are not yet there on meeting elimination targets in many countries. Challenges are there and new ones will confront us. But the London Declaration has given me a confidence – confidence that we will achieve the elimination of NTDs in my working life.
By Simon Bush, Director of Neglected Tropical Diseases at Sightsavers