Neglected tropical diseases (NTDs) have plagued humans for thousands of years. Thanks in large part to the availability of drugs that were created in recent decades, we now have a chance to solve the NTD crisis, which affects over 1.5 billion people globally. For people at risk for the five major NTDs (schistosomiasis, blinding trachoma, elephantiasis, river blindness, and intestinal worms), these drugs offer a precious window of opportunity, inhibiting the parasites and bacteria from growing inside the human host and, in some cases, offering immediate relief from excruciating symptoms, for example, the intense non-stop itching that comes with one form of river blindness.
NTD treatments are mainly donated by the pharmaceutical companies that make them. These donations are as historic as the discovery of the drugs themselves. Some of the companies work together to integrate donations where a combination would be more helpful or effective, for example, Mectizan from Merck plus albendazole from GlaxoSmithKline treat river blindness, elephantiasis, and intestinal worms. Pharmaceutical companies donate over $4 billion dollars’ worth of drugs each year so that people who live in endemic regions can get out from under the burden of NTDs—diseases that severely harm a person’s ability to attend school, earn money, and participate in family and community activities.
NTDs are solvable in part by having a better understanding of how to deliver medicines effectively in NTD-plagued communities.
Communities at-risk for NTDs typically are rural and hard to reach and the drugs must be taken on an annual or bi-annual basis, which complicates delivery and adherence to the necessary regimen. The answer to this challenge is, first, the communities themselves. Villagers choose a Community Drug Distributor (CDD), a type of community health worker who receives training in treating NTDs. The CDD obtains drugs from the closest dispensary, manages distribution from schools, local clinics and even door-to-door in their community, and keeps records of who has taken the drug. The CDD knows who is pregnant (and shouldn’t take the drug) or away on the day, the drug is given out—a date chosen by the community so it doesn’t interfere with major events such as harvest. CDDs also help educate the community on prevention of these diseases. This highly effective method of drug distribution, in which communities hold the ultimate responsibility, lies at the heart of the NTD movement.
In order to establish a connection with remote villages, a local NTD program leader is needed. They often ask local political or religious leaders to propose the distribution of medicine. They go to the governors of the state for more financing to be invested in NTD programs. Their staffs work with the Ministries of Health to move the medicines from customs to the local dispensaries. Dr. Francisca Olamiju, founder and executive director of a local NGO in Nigeria, MITOSATH, told me: “When you get to a community, the first thing you do is you go and notify the traditional rulers that you have arrived, and explain your mission. Once they buy into that mission, they will even tell you, ‘Come, treat my family first.’ The community people will be there when you’re treating the leaders’ families, and if the drug is good enough for their family, you can be sure that everybody will want to take it. But before the intervention, they will ask you to come, they will invite all the other subclan leaders, they will tell you, ‘okay, explain to them.’ They will ask you a lot of questions like, Why are you giving us this drug? What is the way forward? What is the solution? Do we have to pay for this? Once the community is well sensitized, compliance is high.”
NTDs are solvable in part by having a better understanding of how to deliver medicines effectively in NTD-plagued communities. In just the past decade, we have seen several hundred million people previously at risk of NTDs free of these diseases. If the world continues to rally around the movement to end NTDs, the global NTD disease burden is expected to fall by 90 percent, ensuring over a billion people have a chance for healthier lives and greater choices ahead of them.
As Dr. Olamiju told me: “Nigerians, once they are convinced that this will improve their health, they go for it. They want to hear the solution… If you are used to suffering, you probably forget that there is a solution and there is a better life. And that’s where we come in. We are Nigerian, so we use that language. And the language is simple. It’s just the truth. Say the truth. Tell people that there is a way out.”
Learn more about how we can end the suffering caused by the five Neglected Tropical Diseases – watch the #Solvable mini-film here.
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