Poverty is both a cause and consequence of NTDs: the diseases keep children out of school and parents out of work, limiting their potential.
It wasn’t until fairly recently that the word ‘neglected’ was first used in connection with tropical diseases. This association started because of the gaps in funding, research and programmes to treat communities endemic with NTDs. These diseases continue to affect some of the world’s poorest people, whose voices are far too often neglected, even today.
Yet there has been significant and positive progress since the term ‘neglected tropical diseases’ was first coined. A significant turning point was on 30 January 2012, when I, with the team representing Sightsavers, joined a global community of organisations, including endemic countries, donors, pharmaceutical companies and non-government organisations, who made a commitment to control, eliminate or eradicate 10 diseases by 2020. We each made our pledge by signing the London Declaration on Neglected Tropical Diseases together on that day.
Since then, the growth in momentum is palpable, particularly to end trachoma, the world’s leading infectious cause of blindness. In 2012, Oman became the first country to eliminate trachoma as a public health problem. Morocco followed and last year Mexico, Cambodia and Laos also celebrated the end of trachoma in their countries. Another five countries – China, Iran, Myanmar, Gambia and Ghana – are believed to have reached their elimination targets and are awaiting validation by the World Health Organization. But despite this success, trachoma is still officially a public health problem in 39 countries.
With just two years to go to deliver the pledges made in the London Declaration, we must re-focus our efforts and prepare to adapt our approach to challenges that lie ahead. This was recently put into perspective for me while listening to Professor Stephen Hawking as he led global celebrations in December 2017 to acknowledge the one billion treatments that Sightsavers and partners have delivered to people affected by NTDs.
During his keynote speech, Professor Hawking said: “The smallpox, polio and Guinea worm programmes all demonstrate that the last mile on the journey to elimination is always the most difficult. Therefore, much still remains to be done if we are to reach our elimination targets. In any ambitious programme, be it research into the farthest corners of the known universe or the planned growth for an international health programme, none of us can rest and assume that our current tools and resources are sufficient to achieve success.”
His words about not being complacent with the tools and resources we currently use should be listened to. I believe that as we draw closer to consigning NTDs to the history books, this next chapter will be our most challenging – yet also the most rewarding.
Developments in technology, particularly smartphones, are increasingly playing a frontline role in the control and elimination of NTDs. For example, later this year Sightsavers and partners will launch an app to monitor the progress of people who have had sight-saving trachoma trichiasis (TT) surgery, to ensure they receive the follow-up care they need.
This is just one example of how technology can be used to improve service uptake and programme delivery.
What’s more, if we, as a global community, are to be successful in eliminating NTDs, we must reach people in the most hard-to-reach places and situations, such as those affected by wars, conflict and crisis. In Sudan, Sightsavers has worked with the ministry of health to carry out the first mass distribution of medication for trachoma in the states that make up Darfur.
After years of conflict in Darfur, relative stability meant that health workers were able to collect data on trachoma and then provide treatment. In a year, more than 300 trained volunteers (90 per cent of whom were women) reached 1.9 million people – the first time people in this part of the Sudan have been treated for trachoma. The second round of treatments, where required, will continue this year.
Part of our responsibility as a development organisation is to help ensure that programmes have long-term benefits. I believe the key to this is ensuring communities are involved and have ownership at every stage of the process.
This must be at the forefront of our minds as we approach a vital stage in the elimination journey.
Simon Bush is Director of Neglected Tropical Diseases at Sightsavers. He lives in Ghana, West Africa and joined the organisation in 1999, having previously worked in Eritrea, Ethiopia, Sudan, the West Bank and Gaza.