While African leadership is considered key to building the resilience of control programmes, scientists are joining forces to contain the spread of Neglected Tropical Diseases (NTD’s) on the continent.
NTD’s are a diverse group of 20 diseases that affect 1.7 billion people, mostly in poor communities in the tropics, especially in Africa. They compromise the early development of children, reproductive and sexual health and quality of life, as well as economic development.
Rwanda leading the Way
Kigali in Rwanda is once again at the forefront with The Kigali Declaration on NTD’s, launched in the country, to mobilise political will and secure commitments to fight NTD’s. This would be done in order to achieve the targets set for the Sustainable Development Goals (SDG’s) and the World Health Organization’s Roadmap on NTD’s (2021-2030).
This declaration, constituting the largest global public-private partnership, is essential to advance the health and development agenda across affected countries and strengthen global health security. As long as NTD’s continue to burden national health systems, countries’ contributions to global surveillance and control of new and emerging pathogens will be compromised.
People affected by NTD’s have already benefited from the 2012 London Declaration on NTD’s, a predecessor to the Kigali Declaration which saw global partners commit to controlling, eliminating or eradicating 10 diseases by 2020, improving the lives of more than a billion people. So far, 46 countries have already eliminated at least one of these diseases.
However, calls for more to be done, are made, especially in the light of lost funding and disruption of NTD programmes in 44 countries as a result of the Covid-19 pandemic. The United Kingdom’s withdrawal of more than £150 million of NTD funding, as part of cuts to that country’s aid budget, has wiped out a third of donor funding, affecting treatment of 250 million people and at least 180,000 surgeries to prevent disability.
Country Ownership and Prevention Key to Success
African countries had been urged to take steps towards building resilience of NTD programmes. An important feature of the Kigali Declaration is endemic country ownership of the NTD agenda, led by Rwanda and Nigeria. Local ownership enables affected countries to manage all stages of NTD control, starting with increased local funding for control programs to ensure self-sufficiency and investing in functioning public health structures such as drinking water management and sanitation. At the same time, affected countries were called on to invest in finding local solutions and innovations to reduce the need for treatment.
NTDs are considered diseases of people left behind. Current programmes focus disproportionately on treatment with drugs or surgery, rather than disease prevention and management, only when prevention and treatment have failed. People with NTD-related disfigurement or blindness caused by leprosy, elephantiasis, yaws, trachoma or onchocerciasis are the most neglected of all. Affected countries must urgently lead the way by investing in low-cost local innovations and approaches and implementing them to meet patient needs.
The main objective of the declaration is to ensure that those affected by NTD’s, in particular women and girls, people with disabilities, minorities and underrepresented groups, are at the centre of programmes and decision-making processes relating to NTD’s.
This is easier said than done, as very few countries currently have structures in place to effectively engage with these groups. The WHO showed that rural African women’s non-compliance with proper toilet was linked to their need for safe spaces. This again highlighted the need to co-create solutions with affected communities. Local leadership is essential to implement NTD interventions, locally acceptable and relevant. The Kigali Declaration kicked off the inclusive engagement of all parties involved and with the assistance of the global scientific community to pave the way toward better future outcomes.