Neglected tropical diseases (NTDs) mainly affect populations living in poverty, in close contact with infectious vectors. The African Leaders Malaria Alliance (ALMA) added NTDs to its annual scorecard on disease progress at the 30th African Union Heads of State Summit.
The scorecard is personally reviewed by African heads of state every year, putting NTDs alongside malaria and maternal and child health as top health priorities for the continent.
Developed by the World Health Organization in collaboration with Uniting to Combat NTDs, this index reports progress for the 47 NTD-affected countries in sub-Saharan Africa in their strategies to treat and prevent the five most common NTDs: lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminths and trachoma. By adding NTDs to the scorecard, African leaders are making a public commitment to hold themselves accountable for progress on these diseases.
A Health Priority for Well Over A Billion
NTDs are a group of diseases that affect the world's poorest and most vulnerable people, often living in the most remote communities. More than 1.5 billion people are at risk for NTDs globally, including more than 620 million in Africa. Whilst NTDs cause hundreds of thousands of deaths each year, their primary impact is on the millions that are left trapped in endless cycles of poverty. They cause blindness, disfigurement, disability, stigma and discrimination. Parents are left unable to work and children unable to go to school.
Fortunately, the five diseases that are being monitored in the ALMA scorecard respond well to cheap, safe medicines, which are donated by pharmaceutical companies and are broadly distributed to treat and prevent the diseases. As a result of a global public-private coalition, more people than ever before are being treated for NTDs, and the number of people at risk of infection globally has dropped by more than 400 million in the last five years.
Good NTD coverage also promotes universal health coverage: NTD programs have trained over a million health workers and brought a variety of services, including family planning tools and vitamins, to people in remote communities otherwise unreached by the health system. This connection is discussed in more length in Uniting to Combat NTDs' recent progress report, "Reaching a Billion: Ending Neglected Tropical Diseases: A Gateway to Universal Health Coverage," launched last month.
"When it comes to diseases that affect the very poorest and most marginalised communities, it is up to political leaders to make them a priority," said Thoko Elphick-Pooley, Director, Uniting to Combat NTDs Support Centre. "Beating NTDs is essential for Africa's economic development, and we are thrilled that African Heads of State will be reviewing their progress every year and holding themselves accountable for equitable health outcomes."
Progress in Africa, But More to Do
The scorecard shows the evidence of progress in Africa:
In 2016, 40 million more people were reached with preventive treatment for at least one NTD than the year before.
More than half of all countries improved their coverage index between 2015 and 2016, with 12 countries having doubled their coverage index.
Togo was certified by WHO as eliminating lymphatic filariasis, Malawi has stopped treatment for lymphatic filariasis and is in the process of being validated by WHO, and both Ghana and the Gambia report having eliminated trachoma.
While most data points to progress, the scorecard shows areas of concern. Nearly two-thirds of countries have a NTD coverage index of less than 50%. The percentage of affected countries implementing disease-specific interventions ranges from 92% for trachoma to just 72% for schistosomiasis, suggesting that there is still much more to do.
"Beating NTDs will help lift millions out of poverty, improving the lives of some of the world's poorest and most marginalised people. There is a huge amount at stake and we know that eradicating these diseases is too big a job for one sector alone," said Tanya Wood, chair of the NTD NGO Network and CEO of the International Federation of Anti-Leprosy Associations.
African Leadership in Health
Established in 2009, the African Leaders Malaria Alliance is a groundbreaking initiative, established by heads of state themselves and designed to foster collaboration in order to solve a crisis that affects the entire continent. The ALMA Scorecard empowers national leaders to battle Africa's most devastating diseases by:
Providing a forum to review progress and address challenges in meeting the malaria targets.
Implementing a monitoring and accountability system through the ALMA Scorecard for Accountability.
Action to track results, identify bottlenecks, and facilitate appropriate action.
Identifying and sharing lessons learned for effective implementation of national programs.
Because some NTDs are transmitted in the same manner as malaria, and shared community distributions platforms are used for both malaria and NTDs, ALMA has chosen to include NTDs in its scorecard. "Malaria and NTDs both lay their heaviest burden on the poor, rural and marginalised. They also share solutions, from vector control to community-based treatment," said Joy Phumaphi, Executive Secretary, ALMA. "Adding NTDs to our scorecard will help give leaders the information they need to end the cycle of poverty and reach everyone, everywhere with needed health care."
The addition of the index happens just before the 6th anniversary on 30 January of the London Declaration on NTDs: a multi-sectoral partnership of pharmaceutical companies, donors, endemic countries and non-governmental organizations committed to control, eliminate or eradicate 10 diseases by 2020.