WHO promotes water, sanitation to battle neglected tropical diseases

Sep 8, 2015 | Blog, ILRI series, Latest news

WHO promotes water, sanitation to battle neglected tropical diseases

Water, sanitation and hygiene are part of a new World Health Organisation strategy to fight neglected tropical diseases which afflict more than 1.5 billion people, the WHO said on Thursday.

Those suffering from the 17 diseases, such as intestinal worms, river blindness, leprosy and sleeping sickness include many of the poorest people in the world.

“If we put in place universal access to safe water and sanitation and hygiene then the neglected tropical diseases in most cases will completely disappear or be put under control,” Maria Neira, head of public health at WHO, told the Thomson Reuters Foundation.

Including water and sanitation in local and national programmes would reduce infections, improve treatment, and reduce the discrimination and stigma that people disfigured by diseases often face, the WHO said.

“Those terrible diseases require hygiene and sanitation and we hope that this contribution will add to our argument that access to safe water and sanitation is one of the most important determinants of our health,” Neira said at the launch of the initiative at a global water conference in Stockholm.

Neglected tropical diseases thrive where people live in extreme poverty with poor sanitation and little access to healthcare – usually in remote rural areas, urban slums or conflict zones.

“Water and sanitation require resources that exceed what WHO can generate for neglected tropical diseases, so we want to make sure that interventions both in public health and water and sanitation reach the poorest as a matter of priority,” Dirk Engels, director of the Department of Neglected Tropical Diseases at the WHO, told the Thomson Reuters Foundation.

The new strategy was announced just weeks before a new set of development objectives – known as the Sustainable Development Goals – is due to be adopted at a U.N. summit in September.

The new goals include eradicating extreme poverty by 2030 and providing universal access to water and sanitation.

More than 660 million people around the world live without access to clean water, and 2.4 billion do not have access to proper sanitation, according to UNICEF and the WHO.

WaterAid, an international charity which has been working with communities affected by neglected tropical diseases, gave the example of leprosy, saying that nearly 5,000 new cases are reported each year in Ethiopia.

“Once you have the severe form of a disease like leprosy, you pretty much have it for life and the people affected often suffer from exclusion,” Yael Velleman, WaterAid senior policy analyst on sanitation and health, told the Thomson Reuters Foundation.

The stigma associated with those diseases mean that people who have them may not be allowed to use the same washrooms as family members and may be unable to access water, because if they have a disability it is harder for them to carry water, Velleman said.

“It’s not just about controlling a disease, it’s making sure that the poorest of the poor and the most marginalised have access to these basic services,” she said.

The new strategy was launched as a partnership between the WHO, WaterAid and other charities.

This article can also be found on the ILRI Livetock matters online paper and credited to Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers humanitarian news, women’s rights, corruption and climate change.

Sustainable Development Goals Must Tackle Neglected Tropical Diseases

Sep 8, 2015 | Blog, ILRI series, Latest news

Sustainable Development Goals Must Tackle Neglected Tropical Diseases

With the Millennium Development Goals (MDGs) about to expire, the global health community is looking back on major accomplishments in reducing poverty and improving health over the last 15 years. Perhaps one of the greatest surprises has been the success of international efforts to tackle neglected tropical diseases (NTDs).

The World Health Organization estimates that nearly 1.8 billion people, including more than 800 million children, require annual treatment for NTDs. These parasitic and bacterial infections affect people for years or decades, mostly striking the world’s poorest, most marginalized communities.

Adults and children living with chronic NTDs in Africa, Asia, and the Americas endure horrific disfigurement, blindness, and often extreme and debilitating pain. Children with NTDs often do not attend school, or have great difficulties learning in school, while adults cannot work. As a result, NTDs are leading causes of poverty in less developed nations. Yet, despite the scale of the NTD problem, just over 40 percent of those at risk receive the treatment they need.

Neglected tropical diseases fail to generate MDG interest

When the MDGs were created, NTDs were placed in a category of “other diseases.” To nobody’s surprise, this vague label did not generate much interest, compared to specifically named diseases like HIV/AIDS and malaria. In fact, AIDS and malaria stimulated multibillion-dollar initiatives for mass treatment and prevention, including the President’s Emergency Plan for AIDS Relief, the President’s Malaria Initiative and the Global Fund.

In response to the lack of interest, a group of committed investigators who have devoted their lives to research, treatment, and prevention of NTDs worked with the World Health Organization to target these diseases through mass drug administrations, using a package of pills that could be delivered annually for only 50 cents per person.

By 2006, USAID initiated an NTD Program that produced achievements as impressive as those of other bilateral and multilateral organizations. According to USAID’s statistics, this program has delivered more than one billion NTD treatments in 25 low- and middle-income countries over the last decade. This support is complemented by the UK Department for International Development’s (DFID) efforts, demonstrating a good case of donor harmonization.

By 2012, the average cost of treatment was reduced to 22 cents per person per year, by delivering treatment for many diseases at the same time. This freed more resources for distribution of the expanded drug donations that were pledged in the London Declaration on NTDs by 13 pharmaceutical companies.

Impressive gains in control and elimination

Following its Global Burden of Disease Study (GBD) in 2013, the Institute for Health Metrics and Evaluation at the University of Washington released data for 301 diseases and conditions, and some of the numbers reflect impressive gains in NTD control and elimination. This progress is due in large part to USAID- and DFID-sponsored interventions. It includes a 39 percent decrease in the prevalence of trachoma and a 32 percent drop in lymphatic filariasis (LF). Impressive reductions in the prevalence of Ascaris roundworm (45 percent) and onchocerciasis, or river blindness (51 percent), have been achieved through other mass drug administrations.

But this is a modest reflection of the true impact of NTD programs. When researchers looked at age groups that tend to have the most infections, the decrease in trachoma and LF prevalence was even greater: 65 percent for trachoma and 53 percent for LF. The world is on track to achieve USAID’s objective of eliminating these diseases by 2020.

Thankfully, NTDs have been included in a number of critical inputs into the post-2015 development agenda process, including the High Level Panel report released in May 2013 and the Open Working Group (OWG) proposal for Sustainable Development Goals (SDGs) released in July 2014. The OWG reportincluded a specific target for NTDs, alongside AIDS, tuberculosis, and malaria.

Choose the right indicator for SDGs

The next critical step for NTDs in the post-2015 process is to ensure that the right indicator is used to measure progress over the next 15 years. The NTD community strongly recommends the following indicator, as a global measurement tool: A 90 percent reduction in the number of people requiring interventions against NTDs by 2030.

In addition, we also need to consider the overlap between NTDs and other factors: nutrition; water, sanitation, and hygiene; maternal and child health; and education. Development goals cannot be achieved in isolation. In fact, NTDs are so inextricably linked to these development issues that their prevalence is seen as an effective proxy for broader socioeconomic and human development. The recently-published “worm index” demonstrates a high correlation between the prevalence of intestinal worms and development.

Finally, the SDGs need to incorporate a research and development agenda for NTDs, particularly for diseases not currently benefiting from major gains in mass treatment. This would include developing vaccines for hookworm infection, whose prevalence has decreased only five percent, and schistosomiasis, which has not decreased at all.

Hookworm vaccines are under development by our Sabin Vaccine Institute Product Development Partnership (Sabin PDP) in collaboration with the European HOOKVAC consortium, as is a vaccine for river blindness through The Onchocerciasis Vaccine for Africa Initiative. Most likely, vaccines would be combined with mass drug administrations.

In addition, NTDs such as Chagas disease and leishmaniasis urgently require new interventions, including new drugs being developed by the Drugs for Neglected Disease Initiative, and the Sabin PDP’s therapeutic Chagas vaccine. Despite the lack of traditional market incentives to develop drugs for poor communities, the pharmaceutical industry has engaged in product development partnerships, and many have opened their compound libraries to academic and NGO partners.

Out of the spotlight, the NTD community has made significant strides. With explicit inclusion of these diseases in the SDGs, we can do even more. We have the opportunity to eliminate LF and trachoma before 2030, and reach key milestones in combating all NTDs through mass treatment efforts and the creation of new tools through research and development.

View this item also on the ILRI Livestock Matters online paper

Global initiative to advance river blindness vaccine

Aug 18, 2015 | Blog, IGH series, Latest news

Global initiative to advance river blindness vaccine

Researchers at the University of Liverpool, together with UK and international partners, have launched a new global initiative to advance the development of a vaccine for river blindness.

Onchocerciasis, or river blindness, is a parasitic disease caused by a nematode worm and transmitted through the bite of blackflies. An estimated 17 million people are infected with more than 99% of these cases spread through 31 countries in sub-Saharan Africa.

Infections can lead to blindness, but over 70% of infected individuals will suffer from an eruptive skin disease which can be severe and debilitating, with a particularly serious negative impact on the lives of women.

Over 30 years of research

The new partnership, called The Onchocerciasis Vaccine for Africa Initiative (TOVA), involves 14 international organisations, including the University of Edinburgh, the University of Glasgow, Imperial College London and the Sabin Vaccine Institute Product Development Partnership.

The Initiative builds on over 30 years of research by partner laboratories in Africa, Europe and the United States. This involved the development of preclinical models, as well as detailed immunological investigations of human infections, which ultimately led to the identification of several protective antigens as lead vaccine candidates.

Dr Benjamin Makepeace, from the University of Liverpool’s Institute of Infection and Global Health, said: “As part of this important global initiative, we plan to take one vaccine candidate to a phase one safety trial by 2017 and phase two efficacy trials by 2020.

“Following successful trials, this would be the world’s first vaccine for this long-neglected disease and will help us eradicate the parasite from the African continent.”

Future plans

The longer-term plan is to administer an onchocerciasis vaccine to children as part of national immunisation programme.

Vaccination aims to complement the current use of a drug called ivermectin, particularly in regions where mass drug administration cannot be implemented for safety reasons, and could make a major contribution to eliminating one of the most serious public health risks for African communities.

More information on TOVA can be found in an editorial by Dr Benjamin Makepeace and colleagues and on the TOVA website.

Researchers to evaluate local green health programme

Aug 18, 2015 | Blog, IGH series, Latest news

Researchers to evaluate local green health programme

A green health and well-being programme launched in Liverpool, St Helens and Sefton will be evaluated by researchers at the University of Liverpool.

The Mersey Forest Nature4Health programme, funded by the National Lottery, plans to use the power of nature to help improve people’s minds and bodies.

The programme will include woodland walks, therapeutic gardening and practical conservation sessions to increase heart rate. It will also offer the evidence-based taught meditation technique of mindfulness in a natural setting.

Key recommendation

Dr Catrin Eames, from the University’s Institute of Psychology, Health and Society, who is part of the evaluation team, said: “Time spent in natural environments can improve physical and mental health, and is a key recommendation of the 2014 All-Party Parliamentary Group on Wellbeing Economics to improve health and wellbeing within our cities.

“By exploring the natural environment as therapeutic interventions, we can evaluate their benefits in reducing the impact of health inequality, chronic ill health and stress.

“Nature4Health is an innovative programme, with real impact within communities in accessing and developing local green space as wellbeing hubs.

“We will be working with MerseyForest to evaluate the benefits of the programme in terms of mental health and wellbeing, and particularly evaluating mindfulness-based interventions within the natural environment in enhancing and maintaining positive change and outcome. “

Healthier and happier

Paul Nolan, Director of the Mersey Forest, said: “There’s a wealth of evidence that being out in woodlands and green spaces makes us healthier and happier. This programme will enable people to enjoy their local green spaces and get fitter at the same time.”

Physical Activity Exchange at Liverpool John Moores University will also study the new programme to see how it impacts on people’s health.

Nature4Health sessions will be available in Colliers Moss, St.Helens; Mab Lane, Liverpool; Dam Wood, Croxteth Park, Liverpool; Bootle South Recreation Ground, Sefton; Rimrose Country Park, Sefton with further venues to be announced.

Closer intersectoral collaboration using existing tools can defeat zoonoses affecting humans

Jul 16, 2015 | Blog, Latest news

Closer intersectoral collaboration using existing tools can defeat zoonoses affecting humans

New WHO report urges ‘now is the time for action’

A new WHO report urges the global community to accelerate action against neglected zoonotic diseases as most of them can be controlled through existing knowledge and tools. The report urges to accelerate action by the global community in line with World Health Assembly resolutions that provide the policy framework to act collectively against these diseases.

The report acknowledges the momentum generated over the past decade and highlights the need to focus on operations for those neglected zoonoses included in the WHO Roadmap on neglected tropical diseases.

“The international community must rise up and take responsibility in pushing ahead for the control and elimination of these neglected zoonotic diseases,” said Dr Bernadette Abela-Ridder, Team Leader, Neglected Zoonotic Diseases, WHO Department of Control of Neglected Tropical Diseases. “These infections affect mainly poor segments of populations that interact closely with animals and our role should be to implement proven measures now that can contribute to the health and improved livelihood of affected families.”

Neglected zoonotic diseases prevail in low-resource settings worldwide where they impose a dual burden on affected communities and that of the livestock they depend upon.

WHO estimates that nearly two-thirds of all human pathogens originate from zoonoses, making it important to adopt a global ‘one-health approach’ involving veterinary and human sectors to control and prevent zoonotic pathogens. The report highlights the potential for intersectoral collaboration, particularly at the subnational level, and calls for more work to be done.

Initiatives by many governments have been endorsed by the Food and Agriculture Organization of the United Nations (FAO), the World Organization for Animal Health (OIE) and WHO and are financially supported by members of the broader international community, including the Bill & Melinda Gates Foundation, the UK Department for International Development, the European Union, the International Development Research Centre and the CGIAR (formerly known as the Consultative Group on International Agricultural Research).

“We have existing knowledge and evidence that can be transformed into strategies and applied on a large-scale,” said Dr Dirk Engels, Director, Department of Control of Neglected Tropical Diseases. “We need to be able to capitalize on experience and the growing political commitment to involve other sectors, with community participation, to speed up the elimination agenda.”

Achieving a world free from dog-mediated human rabies by 2030 is feasible with current tools and increased investment, as demonstrated by recent rabies success stories. However, the report notes other endemic zoonoses such as echinococcus have a low political profile, attract scant investment and are unlikely to achieve their 2020 target.

Control tools are available against fish-borne trematode infections and Taenia solium cysticercosis , now it is time to validate integrated and cost–effective programmes so that strategies can be evaluated and validated in order to reduce human suffering and loss to income and to attain WHO NTD roadmap targets.

The meeting report advocates the application of cross-sectoral approaches that require a combination of leadership and community-level engagement for greater impact. It also discusses opportunities for innovative funding mechanisms to support control outside traditional donor models. These include initiatives stemming from national bodies and the private sector.

The fourth international meeting on neglected zoonotic diseases “From Advocacy to Action” (Geneva, Switzerland, 19–20 November 2014 ) was hosted by WHO, attended by more than 120 delegates and financially supported by the European Union seventh framework programme through the ADVANZ (Advocacy for neglected zoonotic diseases) programme.

Discussions focused on increased recognition of zoonotic diseases and initiatives by national governments to mitigate their impact on citizens by implementing control programmes.

Although not specifically included in the WHO Roadmap on neglected tropical diseases, the meeting addressed other diseases such as anthrax, bovine tuberculosis, brucellosis and leptospirosis. For example, Mongolia has successfully implemented programmes for brucellosis control through a ‘One Health’ approach, but experience also shows that diminishing financial resources could put human and animal lives at risk once again. The emergence of brucellosis during the current war in the Syrian Arab Republic has illustrated the importance of conflict as a driver for the emergence of such a disease as people rely more on their animals for sustenance.

Many countries provided examples of programmes that are advancing control of some neglected zoonoses, both at national and local levels, from across three continents. There is now an important opportunity to mobilize existing knowledge, experience and political will, and move from advocacy to action.

WHO’s 2012 Roadmap on accelerating work to overcome the global impact of neglected tropical diseases and Resolution WHA66.12 adopted by the World Health Assembly in May 2013 have enhanced the visibility of neglected diseases with zoonotic components – notably rabies, cysticercosis, echinococcosis, human African trypanosomiasis, foodborne trematodiases and leishmaniasis.

Background

Much of the initial momentum for action against neglected zoonotic diseases was catalysed by the inaugural meeting on neglected zoonotic disease control in 2005. In 2008, experts met to formulate a global One Health concept to encourage an interdisciplinary, intersectoral approach across to tackle disease risks that emerge when humans and animals share a common environment.

Efforts to consolidate collaboration gained momentum in 2010 when a Tripartite Concept agreement between WHO, the FAO and the OIE was established. Enhanced advocacy and multisectoral collaboration have since added to the knowledge and experience for a more concerted intersectoral approach.

To view the original post on the World Health Organization website Click here

Kenyan perspective

Kenya has launched a rabies elimination strategy, as outlined in the Strategic Plan for the Elimination of Human rabies in Kenya, developed collaboratively by like minded ministries coordinated by the Zoonotic Diseases Unit.

“The medical costs associated with treatment after a person has been bitten by a rabid dog is estimated at US$170.00 in Kenya,” says James Macharia, Cabinet Secretary for Health. “This represents considerable financial hardship to a poor household.”~adopted from the WHO website

The contribution by ZED group

The new Zoonoses in Livestock in Kenya (ZooLink) project is the newest activity by the ZED group that seeks to enable Kenya to develop an effective surveillance programme for zoonoses , which is, by design, integrated across both human and animal health sectors. To achieve this goal we will work in close collaboration with Kenyan government departments, working in western Kenya initially and using this as a model for a national programme. The rationale for ZooLinK is that the presence and burden of zoonoses is greatly underestimated. To learn more about the ZooLink programme visit our page by Clicking here