NTDs Neglected

 Globally, more than one billion people are infected by Neglected Tropical Diseases (NTDs). Of these, almost one third lives in Africa. Now the plague of these neglected diseases has collided with the COVID-19 pandemic, and the result could be disastrous.

The number of NTDs is rising and threatens a new generation of African youth as never before. Governments have concentrated scarce health resources on fighting COVID-19;  field campaigns to fight NTDs have been suspended; and the pandemic is pushing millions of more people into poverty, making it even more difficult to afford basics like healthy food, much less medicines.

In Africa, governments must  protect 560 million people at increasing risk of death and permanent disability from neglected tropical diseases. Children go blind from parasites. Adults suffer disabling pain from Guinea worm disease. Men and women are disfigured with swelling limbs by elephantiasis. Some 20 different neglected tropical diseases kill, impair or permanently disable millions of people every year.

Less than 50 cents  is needed to treat five common NTDs per person per year, limited investments to eradicate NTDs have reflected an insufficient attention to human suffering. It is not just the diseases.  It is a collective negligence of the poor and the voiceless who are the primary target of NTDs, which are spread by unsafe water, poor housing conditions and poor sanitation. Efforts have fallen well short of the need, and have often benefited the wealthy over the poor.

 10 key facts about Neglected Tropical Diseases:

1. Affecting over 1.7 billion globally, NTDs are responsible for thousands of preventable deaths each year. The number of people affected has fallen from 2 billion in 2010 to 1.6 billion in 2017.

These diseases blind, disable and disfigure and perpetuate a cycle of poverty, keeping millions of children out of school and adults from work.

2. The number of NTDs was increased to 20 from 17 in 2016 with three new diseases added - mycetoma, chromoblastomycosis and other deep mycoses; scabies and other ectoparasites; and snakebite envenoming.

3. NTDs are primarily found in poor populations living in tropical and subtropical climates across Africa, Asia and South America.

4. The diseases afflict those without access to clean water, sanitation and the basic health services required to protect themselves against infection by bacteria, viruses and other pathogens. These include communities in remote, rural areas, urban slums or conflict zones.

5. Scientists have voiced concerns that global warming could increase the number of people exposed to mosquito-carrying viruses including dengue fever and Zika virus by one billion by 2080 if the climate continues to warm at current rates.

6. High-income groups are rarely affected. More than 70% of countries and territories that report the presence of NTDs are low-income or lower middle-income economies, according to the World Health Organization (WHO).

7. Many NTDs are chronic, slowly developing conditions that become progressively worse if undetected and untreated - and the damage they cause can be irreversible.

For example, trachoma - a bacterial eye infection - damages the eyelids, causing the eyelashes to turn inwards and rub painfully against the eyeball. If not corrected with surgery, it can lead to irreversible vision loss and blindness.

8. NTDs can cause severe pain and life-long disabilities, with long-term consequences for the patient and their family.

People with NTDs are often stigmatized and excluded from society such as people with leprosy. In some countries, leper colonies continue to exist where sufferers are ostracised from society, often with adverse impact on their mental health.

9. In 2012, the WHO and member states agreed on the first global road map aimed at eliminating or eradicating 17 NTDs. Three more diseases: dengue, rabies and snakebite envenoming have since been defined as NTDS.

10. Health experts say efforts to alleviate NTDs are being hampered by the worldwide pandemic, which is pushing already strained healthcare systems to breaking point.

The WHO said in September the outbreak had hit NTD programmes, with countries having to suspend mass treatment interventions and active-case finding and delay diagnosis and treatment.

Critical personnel have been reassigned to deal with COVID-19 and the manufacture, shipment and delivery of medicines has been disrupted, it said, warning of "an increased burden of NTDs".

The impact of COVID on efforts to tackle NTDs could be disastrous (trust.org)