The World Health Organization (WHO), pharmaceutical companies, authorities, charitable foundations…: they all join forces to eradicate once and for all neglected tropical diseases (NTDs). This was the message of a summit on NTDs held in Geneva on 19 April 2017.
The tropics are facing a series of painful fatal diseases that are found nowhere else (Glo.be, 4/2014, p. 19). These diseases are often characterized by horrible malformations of the body. Examples are leprosy or elephantiasis, caused by parasitic nematodes that make the limbs swell to massive proportions. Guinea worms cause a burning pain when, in a certain phase of the infection, they migrate underneath the skin to the lower legs. It was precisely this horror that gave Margaret Chan, Director-General of the WHO, an extra motivation to combat NTDs.
For malaria, tuberculosis and AIDS there exist important global funds, whereas the other tropical diseases have lagged behind far too long. Yet, 1 of 6 persons worldwide are affected by these ‘neglected tropical diseases’, including half a billion children. Especially the poorest of the poor – who are living in bad sanitary conditions - are victims. Their disease forces them even further on the margins of society. NTDs are a consequence as well as a cause of poverty.
Yet, 1 of 6 persons worldwide are affected by these ‘neglected tropical diseases’, including half a billion children. Especially the poorest of the poor – who are living in bad sanitary conditions - are victims.
In the seventies, the pharmaceutical company Merck developed ivermectin, a veterinary antiparasitic medicine. Willam Campbell, parasitologist at Merck, believed that ivermectin could also be effective against river blindness. He was right but the patients had no money to pay for the pills. In 1987 Merck decided to deliver ivermectin free of charge. However, it soon became apparent that there were not enough healthcare workers to identify, convince and follow up the frequently hidden patients affected by river blindness.
Gradually, various other partners joined in: the WHO, the Bill & Melinda Gates Foundation, the Carter Center, the World Bank, authorities and companies such as GSK, Pfizer and Novartis. An appeal by parasitologist David Molyneux in 2004 gave the awareness an extra boost. Margaret Chan and Bill Gates stepped up their efforts and in 2012 the London Declaration was a fact. An international coalition – including 13 pharmaceutical companies – undertook to fight against 10 NTDs.
The declaration undeniably speeded up things : eight countries (among them Cambodia, Togo and Sri Lanka) succeeded to eradicate elephantiasis. Mexico, Colombia, Guatemala and Ecuador eliminated river blindness and hundreds of millions of people were treated for various tropical diseases, partly thanks to donations from the companies involved.
Five years later, on 18 April 2017, on the eve of a conference on NTDs in Geneva, different ceo’s of pharmaceutical companies confirmed their commitment to fully eradicate the diseases, not only by donating the medicine but also by developing better treatments, e.g. specifically for children.
Also foundations such as the Bill & Melinda Gates Foundation and the Carter Center are maximising their efforts. Bill Gates announced to provide 335 million dollars in the next four years. In a video message, Jimmy Carter promised to resolutely pursue the fight against the guinea worm disease. Besides, academic institutions as well as various authorities committed themselves to fully cooperate. In conclusion, the general message we retain from Geneva was a message of optimism and determination. Moreover, Geneva was the place where Alexander De Croo, Minister of Development Cooperation, together with Bill Gates announced his initiative to eradicate sleeping sickness (see box).
The power of partnerships
Margareth Chan, Director-General of the WHO, could not emphasise enough this aspect. ‘By this initiative we demonstrate the power of partnerships. No type of organisation can handle this alone, we need to join forces. Although NGOs are criticising our cooperation with pharmaceutical companies, we wouldn’t be able to achieve this without them. Let this be an example for other diseases and sectors!’
The authorities of the countries affected by the diseases were applauded as well: their constant commitment is of utmost importance to bring this fight to a successful conclusion. The tireless efforts of the local health workers deserve even greater praise, as they bring the medicines to the people. By scooter, by bike, on foot on bumpy, muddy roads, wading through rivers, they always manage to reach the most remote areas.
More than pills
Nevertheless, pills alone are not sufficient to eradicate diseases. The WHO recommends to eliminate the carriers of the diseases – e.g. mosquitoes and other insects - as well. Furthermore, the bad hygienic conditions of the poor must change. If not, we will keep on fighting a running battle. Hence, the WHO pays particular attention to sanitation and potable water. Besides, the UN organization considers its fight against NTDs to be part of the Sustainable Development Goals (SDGs). These SDGs are meant to make the world a more liveable place for everyone by 2030. Different SDGs are closely linked to health, such as SDG1 (No poverty), SDG2 (Zero hunger) and SDG11 (Sustainable cities).
Also the basic idea of the SDGs is heard in this initiative by the WHO and the international community: building a better world with no one left behind! The fight has to carry on until the last patient has been cured. The stars are clearly aligned, as stated Minister De Croo in Geneva, not only for eradicating sleeping sickness but also for permanently banning all tropical diseases from the world.
Belgium and the neglected tropical diseases
Alexander De Croo, Minister of Development Cooperation, announced in Geneva the investment of 25.3 millon euros (27 million dollars) in the fight against sleeping sickness. Bill Gates announced an investment of 27 million dollars. The Institute for Tropical Medicine will coordinate the programme. Belgium shall also accede to the London Declaration.
The ITM is Belgium’s biggest asset in the fight against NTDs. With the support of the Belgian Development Cooperation among others, the institute performs pioneering research into a more user-friendly diagnosis of the diseases. In the tropics, the ITM can call on a vast network of partners who submit the medicines developed by pharmaceutical companies to clinical trials. A team of anthropologists examines the reaction of people to campaigns for the distribution of mosquito repellent or mosquito nets: do they use them or not, and why?
The ITM’s outstanding reputation is widely known. In Geneva, Bill Gates sung the praises of the institute.
Development cooperation helps
The fight against NTDs confirms that development cooperation definitely does help. As a matter of fact, it removes obstacles that prevent the poor from improving their living conditions. There is a general feeling that the rapid growth of Japan and South Korea after WW II was partly due to the control of parasitical worms in schoolchildren. At the same time the fight against NTDs implies the development of a stronger healthcare system.