Head of World Health Organisation (WHO) has vowed to “end the scourge of neglected tropical diseases”, which affect more than a billion mainly poor people, and thrive where there is little access to quality health services, clean water, and sanitation.
Last November, a bold new blueprint to tackle all neglected tropical diseases was agreed at the UN health agency’s World Health Assembly, which involved a radical shift in approach by member states and non-state actors.
At the time, WHO Assistant Director-General for Universal Health Coverage, Communicable and Noncommunicable Diseases, Dr Ren Minghui, said “we now have the consensus and the commitment of every country to work in an integrated, cross-cutting manner in tackling all the neglected tropical diseases.”
2030 targets
The freshly-inked roadmap sets global targets and milestones to prevent, control, eliminate and eradicate 20 neglected tropical diseases and disease groups, which affect hundreds of millions of people.
It replaces the first blueprint published in 2012, whose targets will not be achieved, despite significant progress, WHO explained.
In addition to a focus on improved coordination and collaboration among health partners in the next decade in all countries, another distinct feature is a drive for greater ownership by governments and communities.
The 2030 targets include a 90 per cent reduction in the number of people requiring treatment for neglected tropical diseases and a call to eradicate dracunculiasis – also known as Guinea-worm disease – and the chronic skin disease yaws, that affects mainly children below 15 years of age.
“The new road map addresses critical gaps across multiple diseases, integrates and mainstreams approaches within national health systems and coordinates action across sectors”, said Dr Mwelecele Ntuli Malecela, Director, WHO Department of Control of Neglected Tropical Diseases. “It also provides us with opportunities to evaluate, assess and adjust programmatic actions as needed over the next decade.”
The emphasis of the new approach is on sustainability and follows a decades-old discussion about the relative merits of so-called “vertically” funded programmes that target specific illnesses, compared with the longer-term “horizontal” approach that involves comprehensive primary health care services offering greater overall protection.
“To do so effectively…countries must change their operating models and culture to facilitate greater ownership of (disease eradication) programmes”, Minghui added, in a call for “smarter investments and high-level political commitment” to reduce the social and economic consequences of neglected tropical diseases.
While most neglected tropical disease-control programmes rely on medicines to treat sufferers, WHO has also warned that emerging drug resistance threatens decades of advances.
It remains crucial to monitor drug efficacy closely and develop “an appropriate arsenal of second-line drugs” to ensure that populations continue to be protected against neglected tropical diseases, it said.
In a related development, COVID-19 had played its part in making communities more vulnerable, the UN agency noted, as some people have taken antibiotics in the mistaken belief that they would protect them from the virus.
Antibiotics alarm
While some countries have seen their antibiotic use dramatically decline during pandemic lockdowns, physical distancing and improved hand and respiratory hygiene, “in other situations, antibiotic use has risen alarmingly”, WHO said.
These challenges are on the agenda at the annual World Antimicrobial Awareness Week (WAAW) from 18-24 November.
Its aims are to increase awareness and understanding of global antimicrobial resistance and encourage best practices among members of the public, health workers and policy-makers, to avoid the further emergence and spread of drug-resistant infections.
Member states recommended the adoption of two resolutions on meningitis control and epilepsy at the World Health Assembly.
Committee A, which focuses on programme and budget matters, decided to recommend the adoption of the first-ever resolution on meningitis, which would approve a global roadmap to defeat meningitis by 2030 – a disease that kills 300,000 people annually and leaves one in five of those affected with devastating long-term consequences.
The Committee also recommended the adoption of a resolution calling for scaled-up and integrated action on epilepsy and other neurological disorders such as stroke, migraine and dementia. Neurological disorders are the leading cause of disability and the second leading cause of death worldwide.
However, in a statement by WHO on Wednesday, Tedros Adhanom Ghebreyesus, declared that a new approach is needed if diseases such as guinea worm and yaws are to be tackled: “This means injecting new energy into our efforts and working together in new ways to get prevention and treatment for all these diseases, to everyone who needs it”.
In a 10-year plan which targets a 90 per cent reduction in the need for the treatment of neglected tropical diseases (NTDs). The plan contains several concrete proposals in areas such as programme delivery, cost-effectiveness and improved coverage, and calls for programmes to be sustainable, with measurable outcomes and adequate domestic financing.
As well as causing pain and disability, NTDs hinder economic development, by preventing children from going to school and adults from going to work. Those affected by disabilities and impairments caused by NTDs, often experience stigma within their communities, leading to social isolation.
Ambitious targets
The WHO plan, developed in consultation with a wide selection of countries, partners, stakeholders, scientists, and academics, contains several ambitious targets, including the elimination of a minimum of one NTD in at least 100 countries, completely eradicating guinea worm and yaws, and vastly improving access to basic water supply and sanitation.
The progress made in fighting NTDs over the last ten years is an encouraging indicator of what can be achieved in the coming decade, the UN health agency said.
Around 600 million fewer people are now at risk of these diseases; 42 countries have eliminated at least one NTD; and global programmes treated at least one billion people in the five year period between 2015 and 2020.
Significant threats still need to be overcome, however, including climate change, the threat of new diseases crossing over from animals to humans, conflict, and continued inequalities in access to healthcare services, adequate housing, safe water and sanitation.
