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A Light at the End of the Tunnel: Eliminating the Menace of Neglected Tropical Diseases

Though much of the world has never heard of diseases like lymphatic filariasis or schistosomiasis, these and other neglected tropical diseases (NTDs) are a daily reality for many living in Africa and across the world. These terrible diseases affect more than one billion people worldwide, disabling, disfiguring and blinding their victims, and making it difficult for the world’s poorest communities to lift themselves out of poverty.

I have spent decades working to help combat these menacing diseases as a physician and official at the World Health Organisation, and I have been fortunate to witness increasing momentum from the global community to work together to control these NTDs. But significant gaps remain today – we still need better treatments for certain NTDs, more treatments for others, and more effective ways to deliver existing drugs to those who need them.

Now there is more reason to hope that we may soon see a future free of these diseases. In London this week, global health organisations, bilateral donors, pharmaceutical companies, private foundations and representatives from NTD-endemic countries came together to undertake a robust, collaborative response to these challenges. They launched the largest coordinated effort to-date to combat NTDs.

Working together, these organizations have created a real opportunity to help hundreds of millions of people affected by these terrible diseases build self-sufficiency. Their innovative partnership is changing how we approach global health problems and will increase the impact of previous NTD programmes, building on tremendous progress so far.

For decades, partnerships that combined the resources of public- and private-sector organizations have provided a viable alternative to the historically limited research and investment from for-profit drug companies. For example, thanks to the WHO Tropical Diseases Research Programme’s collaboration with the pharmaceutical industry, a variety of tools have been developed to combat river blindness, lymphatic filariasis, leprosy, sleeping sickness and other diseases.

The new coordinated action announced this week will take these previous efforts to a whole new level. Together, these partners have pledged to increase the supply of existing drugs and invest and collaborate on research to accelerate the development of new and better drugs. Additionally, global health organizations will provide critical funding to support strengthening and improving delivery systems to ensure existing treatments are delivered to those who need them. Partners have signed onto the “London Declaration on Neglected Tropical Diseases” – a document that pledges enhanced levels of collaborative efforts to combat NTDs.

Building off the tradition of “pharmaco-philanthropy” set forth by past public-private partnerships on NTDs, a number of companies have pledged to provide for as many drugs as needed to protect people from these diseases. As such, many companies will extend their donation programmes to the end of the decade, and companies will provide a total 1.4 billion treatments on average each year. This follows in the footsteps of past drug donation programmes, such as Merck &Co. Inc.’s historical pledge in 1986 to donate “as much as is required for as long as it takes” of its drugtofightriver blindness, as well as other programmes that successfully reducedcasesof leprosy, river blindness and other diseases.

Innovative partnerships such as this—that partner the resources of private-sector players with those of public-sector health programmes, governments, and aid organizations—have the potential to make immense progress against these diseases where individual efforts or bilateral partnerships are not enough.

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To ensure these commitments make a public health impact, it is essential that NTD-endemic countries, like Ghana, work to ensure that the newly available medications can be effectively delivered to those who need them. Ghana has already launched an integrated programme to combat neglected tropical diseases. The announcements made this week by international partners will undoubtedly help Ghana strengthen its current control programme.

Ghana and other African countries can build on the lessons learned in implementing the Mectizan Donation Programme. When the innovative, more efficient Community Directed Treatment with Ivermectin (CDTI) programme replaced traditional methods with health workers, more than 140,000 communities were empowered to take responsibility for collecting and distributing drugs to millions of people each year. This community approach has since been extended to distribute bed nets, Vitamin A, and other health care practices.

When the history of the elimination of river blindness based on the mass treatment with Ivermectin (Mectizan) is written, it will highlight the remarkable contribution of a Ghanaian doctor, the late Dr. Kwablah Awadzi.  His work at Tamale Hospital guided the late-stage development of Ivermectin for the treatment of river blindness. His clinical research systematically established the efficacy of Ivernectin and its optimal dosage. This type of exemplary leadership is needed once again in Ghana.

I have spent decades fighting against neglected tropical diseases. In my 80 years, I have hoped to see a day when these neglected diseases will no longer blight the lives of the poor communities in Africa and worldwide. With this new innovative partnership, I see a light at the end of the tunnel.

Adetokunbo O. Lucas, MDwas the director of the UNICEF/UN Development Programme/World Bank/World Health Organization Special Programme for Research and Training in Tropical Diseases (TDR) from 1976-1986.

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