For governments and charities who wish to see aid money well spent, tackling neglected tropical diseases should be a priority, writes Jeremy Lefroy MP.
Neglected tropical diseases (NTDs) is the collective name for 17 infections which affect more than two billion people across the world. Among them, the most common are the helminths (three types of intestinal worms – 2.3 billion infections), schistosomiasis (bilharzia – 200 million infected), lymphatic filiariasis (elephantiasis – 120 m infected, 40m seriously disfigured) , leprosy (200,000 infected) and onchocerciasis (river blindness – 37 m infected). Trachoma (6m,) caused by bacteria, is also included.
They are called 'neglected' because until recently they have not been given much attention by donors or pharmaceutical companies. If they were diseases of rich countries, they would have been either eradicated or controlled many years ago. But they are diseases of the world's poor, mostly rural populations in developing countries.
These NTDs sometimes kill, albeit usually over many years; but equally they incapacitate people, causing blindness, liver disease, disfigurement and stunting of growth. These complications make it very difficult for those who suffer from them to earn a living and hence perpetuate their poverty.
Yet the top seven of these NTDs can be treated, usually for as little as 50 pence per person per year. For governments and charities who wish to see aid money well spent, tackling NTDs should be a priority.
It used to be a struggle to attract the funds needed to make treatments available to those who need them. Diseases with a higher profile such as TB, malaria and HIV/AIDS have had priority as they are the major killers. Yet, as my predecessor as chairman of the All Party Parliamentary Group – Stephen O'Brien MP – appreciated when he included NTDs in the remit of the group alongside malaria, people who are already weak through suffering from and NTD are more likely to be severely affected if they contract malaria.
In recent years, the UK has recognised that working with developing countries to fight NTDs is one of the most effective ways of tackling poverty.
The previous government committed £50 million to NTD control over 5 years. The Coalition Government has recently increased this to £240m over the next four years. The US Government has joined in with a pledge of $450 million over five years.
A great contribution is also being made by the Pharmaceutical companies. MSD, GSK, Merck, Johnson and Johnson and Pfizer all donate hundreds of millions of products to treat NTDs every year; and they will continue to do so until everyone has been treated, we hope by 2020.
What we need now is a continuing commitment to pay for the delivery of these donated drugs. We also need to fund the work of research and development of new treatments for the other NTDs. The sum involved is not huge when compared with what is already committed to malaria, TB and HIV/AIDS. The estimate which the All Party Group quoted in our 2011 report was £2 billion over seven years.
The UK is a world leader in the work to tackle NTDs. The Liverpool and London Schools of Tropical Medicine and Imperial College London all have extensive programmes into several of the diseases; and British pharmaceutical companies are at the forefront of drug development. Vaccine development programmes, such as that of the Sabin Vaccine Institute in the USA, are also vital.
But, above all, this work must be a partnership with the countries in which NTDs are endemic. While campaigns supported by donors to treat individual NTDs can bring substantial short-term benefits, they will be more effective if they are delivered by local health workers as part of an established public health programme or teachers in school health programmes.
That depends on the countries themselves increasing the share of the national budget spent on health. Many have signed the Abuja Declaration which commits them to spending 15 per cent of their budget on health; however many are well short of this figure. They need to meet it as soon as possible.
Great progress has been made over the past decade in tackling NTDs, with almost one billion treatments now being delivered every year. If this continues, we could see the world largely free of many of them by 2020. Not only would it be a major advance in tackling extreme poverty and its effects, it would also be powerful evidence of the value of well-targeted aid.
(I am grateful to Professor Alan Fenwick OBE of Imperial College for his help with this article; I declare an interest as an unpaid Trustee of the Sabin Foundation Europe – related to the not-for-profit Sabin Vaccine Institute mentioned in the article).