Monday, 26 January 2015

Integrating Leprosy and Disability into the Sustainable Development Goals

By Charlotte Walker and Francis Peel on behalf of the UK Coalition against NTDs

World Leprosy Day 2015 on 25 January focuses attention on a truly debilitating disease, but whilst world commemoration days often stand in splendid isolation when it comes to development initiatives the same should not be said for leprosy control and treatment programmes. The UKCNTD believe leprosy-affected people and those living with disabilities need to be included in mainstream and NTD-specific development programmes so that they can experience the same benefits as their able-bodied counterparts.
The UKCNTD believe leprosy-affected people and those living with disabilities need to be included in mainstream and NTD-specific development programmes..

Globally one billion people live with a disability, 80 per cent of these in low and middle income countries (DFID 2014).  Disability is a reality for many of the 1.5 billion people living with the consequences of NTDs.

A Human Right


The UN Convention on the rights of persons with disabilities states that people with disabilities have equal rights and must be included in development processes. Yet many development programmes do not include disability, with claims that it is too expensive, does not offer value for money or is simply too difficult to implement.

Interviews conducted by UKCNTD member, the Leprosy Mission England and Wales, with more than 5,000 leprosy-affected people from nine countries across Africa and Asia revealed that although they had seen changes around them, they did not feel they had benefited from the Millennium Development Goals (MDGs).

2015 provides the global community with an opportunity to put this right. In 2016 the MDGs will be replaced by the SDGs (AKA the Sustainable Development Goals), what exactly these goals are is still open to debate but if we are to reduce poverty and improve the health, education and lives of disadvantaged communities we need to ensure no-one is left behind. We need inclusion to be our watchword.

Walking with heads held high


Disability-inclusive development can have truly impressive impacts on some of the poorest and most marginalised communities. An example of this is the EC-funded Food Security for the Ultra Poor in Bangladesh in which a consortia of development partners provided a range of interventions to poor communities in Bangladesh  The Leprosy Mission provided technical expertise and spearheaded the leprosy and disability components of this life-changing project which has seen more than 900 leprosy-affected families (out of a total of 40,000 beneficiaries) benefit from a new source of income.

Leprosy suffer Momina was provided with livestock
 to enable her to earn a living. 
Image courtesy of Leprosy Mission
The majority are women-headed families, some as a result of their husbands being unable to work because of leprosy-caused disabilities.  Others are leprosy-affected women desperately needing an income.  Women living with disabilities are doubly disadvantaged and subject to high levels of abuse (DFID, 2014).

One woman who has faced these issues is Momina, a 50 year mother of four from Gaibandha in northern Bangladesh. When Momina’s husband found out she had contracted leprosy he divorced her and took their children with him.

Despite being shunned by villagers, Momina’s brother gave her a place to stay.  Her feet are numb as a result of leprosy-caused nerve damage and she cannot walk far without developing ulcers that, if they become infected, could result in her lower legs being amputated.  This greatly limits her earning capacity.  But Momina wants to work, not least to repay the debt she feels she owes her brother.

As part of the project Momina was provided with livestock to earn a living and was able to access rehabilitation services including physiotherapy, occupational therapy and the provision of assistive devices including protective footwear, wheelchair and crutches.  70 per cent of people who received these services noticed positive changes in their ability to perform livelihood activities.

Empowering self-help


Another example of this approach is provided by fellow UKCNTD member, Lepra, which in 2014 led on a project supporting 155 self-help groups in Bangladesh with a total of 1,069 members.

All members are leprosy-affected and as well as offering emotional support to one another, they receive training in self-care and, crucially, skills to rebuild lives and incomes. Over the last three years, beneficiary income has increased by one third in the Bogra district of Bangladesh as a result of the groups.

Disability-inclusive interventions such as these empower individuals to hold their heads up high within their communities by providing them with the ability to live a normal life.

For the sake of people like Momina, the UKCNTD, through its members, will be working with policy and decisions makers so that by World Leprosy Day 2016 the SDGs will enshrine a development approach that is truly inclusive and integrated.

Thursday, 22 January 2015

A Pivotal Year for NTDs



The release of the Bill and Melinda Gates Annual Letter includes a call to action for the international development community to prioritise neglected tropical diseases and commit to ending four diseases – guinea worm, elephantiasis, river blindness and blinding trachoma - by 2030.

As Bill and Melinda Gates have emphasised, we’re at a pivotal moment in the fight to combat neglected tropical diseases (NTDs)- which affect over one billion people living in poverty.

Investment in NTDs is a smart bet- they’re known to be one of the ‘best buys’ in global health. The NTD community knows what works to combat these diseases and has a clear and ambitious plan to end the misery and ill health caused by these diseases.

The UK is a world leader in its commitment to the global effort to rid the world of neglected tropical diseases. UK investments by the Department for International have supported world’s largest disease mapping project for trachoma, and support efforts to make guinea worm only the second human disease in history to be fully eradicated.

"We call on all UK parties to make NTDs a development priority for the next UK government."

2015 is a pivotal year for NTDs.  As we approach the UK general election we call on all UK parties to make NTDs a development priority for the next UK government. The investment made in combatting these diseases to date is paying off and we’re making huge strides. It’s crucial now that we protect these successes and continue to build on them.

Wednesday, 16 July 2014

Nigeria champions integrated approach to NTDs at the World Health Assembly


The first six months of 2014 has already seen a number of milestones reached for the international neglected tropical disease (NTD) community, including the successful NTD-focused side event at the 67th World Health Assembly (WHA) in May and the celebration of progress made on eliminating river blindness by the African Programme for Onchocerciasis Control  at the World Bank.  A running theme throughout the discussions at these events has been the importance of taking an integrated approach to eliminating a number of NTDs by the end of the decade.

UKCNTD's Dr Wendy Harrison.
Image courtesy of US Mission
But what does ‘an integrated approach’ mean in practice? It may mean integration of disease specific interventions into broader public health systems, across different groups of diseases, or integration across sectors. Integration is not just another buzzword, but a real approach to effectively controlling this group of diseases.  Both evidence and common sense tell us that we cannot expect to achieve and sustain our NTD control and elimination goals unless we also tackle the underlying causes – namely the provision of safe water, sanitation and hygiene facilities (WASH) and  health care access - and do so in a joined-up way.

One example where integration is yielding results is in Nigeria.  As a country with one of the heaviest burdens of NTDs globally, and one which has successfully launched its ‘NTD masterplan’ (a multi-year national plan to control and eliminate several NTDs under the London Declaration), it offers a wealth of valuable insights.  The WHA side event in May, which was hosted by the Nigerian government and supported by the UK Coalition against NTDs, south-south sharing of learning was central to the discussion.   

Nigeria’s Minister of Health, Professor Onyebuchi Chukwa, and the Director of Public Health, Dr Bridget Okoeguale, highlighted what they see as the foundation of success in combating these diseases: building stronger health systems, equipped to deliver and sustain effective control programmes alongside interventions grounded in a public health approach. To this end, Dr Okoeguale highlighted that Nigeria is working to embed NTD care within primary health care structures to bring together preventive and curative care. She called on the NTD and WASH sectors to work together across departments responsible for Environment, Water, Education, Housing and Media.

This is certainly an approach supported through the Nigerian NTD elimination programme led by Sightsavers, where both local government and global donors such as the UK government aid agency, DFID, have committed funds to control several NTDs.  The success of this programme rides on all parties collaborating under a united goal and sharing knowledge and resources. The programme is designed to support the strengthening of the Nigerian health system alongside delivering targeted interventions to eliminate NTDs.

During the WHA event, this approach was supported by both the World Health Organization and international donors, including representatives from DFID and USAID, who emphasised the investments being made into WASH programmes in NTD endemic countries.  Dr Wendy Harrison, Chair of the UK Coalition against NTDs reiterated the importance of cross-sectoral collaboration to meet the WHO 2020 roadmap goals and the need to embed and standardise monitoring of the impact of NTD programmes on health systems. 

All parties at the event were in clear agreement that cross-sectoral integration is vital and that without access to safe effective WASH and health services, NTD elimination will not be possible.  However, whether or not this happens will depend on the level of political will, leadership and resources dedicated to achieving our goals in a sustainable way.  As the recent  announcement of £39m  by the British Government to help support the elimination of trachoma in highly endemic countries in sub-Saharan Africa reminds us, NTDs have never been as well supported or as prominent on the global health agenda. However there still remains a global $200million per year funding gap that needs to be addressed if we are to meet the ambitious goals of control and elimination as laid out in the 2012 London Declaration.

We need to make sure that we leverage these global commitments and this momentum to achieve our goals in a way that builds systems to provide safe and effective WASH and health services, and delivers on our commitment to control and eliminate these diseases in a sustainable way.


Friday, 9 May 2014

Be part of the NTD discussion at the World Health Assembly on 22 May

The UKCNTD are joining forces with the Federal Ministry of Health in Nigeria to host a special session to discuss the evolution of integrated and cross-sectoral approaches to the control and elimination of NTDs. 
Entitled 'The Power of Integration: Achieving the control and elimination of Neglected Tropical Diseases', this interactive forum will hear from internationally renowned experts, policy makers and donors about current best practices and the latest innovative implementation strategies being employed by endemic country governments and their development partners. 
Speakers include:

Chair: Dr Maria Neira, Director, Public Health and the Environment Department, WHO
Opening: Prof Onyebuchi Chukwu, Minister of Health, Nigeria
  • Dr Bridget Okoeguale, Director of Public Health, Nigeria
  • Dr Dirk Engels, Director, Dept of Control of NTDs, WHO
  • Ministry of Health, Tanzania
  • Dr Wendy Harrison, Chair, UK Coalition against NTDs
  • Nichola Cadge: Health Adviser, DFID
We hope to announce additional high profile speakers in the run up to this event.

For those who will be in Geneva on the 22nd the meeting's vital statistics are:

Time: 12.15 – 13.45
Venue: Room XXIII (23)
Lunch and refreshments will be provided

For those who can't make the meeting you can follow the proceedings live on @UK_NTD



Friday, 11 April 2014

Taking the Neglect out of Neglected Tropical Diseases - Paris 2014

​​Two years after the landmark London Declaration on Neglected Tropical Diseases which set out the ambition to control and eliminate 10 NTDs by 2020, global leaders gathered in Paris yesterday to announce increasing momentum to fight the diseases that put one in six people worldwide at risk of being sickened, disabled or disfigured. 

NTDs disproportionately affect the world's poorest and most vulnerable populations. Since the London Declaration which put the collective weight of 13 leading pharmaceutical companies, global health organizations, private foundations, and donor and endemic country governments behind a new push to reduce the global burden of NTDs—the partnership has made strong progress in ramping up efforts to reach the World Health Organization (WHO)'s goals to control or eliminate a number of these diseases by the end of the decade.
Researchers in Africa assess worm prevalence in child samples through microscope


The gathering coincided with the release of a new report highlighting gains over the past two years, including pharmaceutical companies meeting 100 percent of requests for drugs, and endemic countries taking ownership of NTD programmes.

"The tremendous progress we have seen over the past two years is proof of the power of partnerships and the generosity of companies that made commitments under the London Declaration," said Dr. Margaret Chan, Director-General of the WHO, who spoke at the event.

"Together with the governments of endemic countries, we are fast approaching the goal of controlling or eliminating many of these ancient causes of human misery. This is a pro-poor initiative that is improving the lives of more than a billion people."

Funding Announced for School-Based Deworming


The day's big announcement saw the commitment of a $120 million fund to combat soil-transmitted helminths. These intestinal worms are among the most common infections found among children living in poverty and they severely impact on child health, nutrition and learning abilities.

Jamie Cooper-Hohn, Chair of Children's Investment Fund Foundation (CIFF) announced that, "CIFF is now committing an additional US$50 million over the next five years to implement large-scale systematic approaches to deworming in a number of countries, with the hope that, ultimately, we can break the transmission of worms and achieve the vision of: every child, everywhere, free from worms forever."
Other organisations also announced their commitment to rid children of worms including:
  • The World Bank - committing US$120 million toward the goal of NTD control and elimination in low-income countries in Africa, including funding for school-based deworming efforts.​ 
  • The Bill & Melinda Gates Foundation - investing US$50 million to explore the feasibility of interrupting transmission and mitigating the risks of drug resistance, as well as the most effective cross-sector approaches.
  • Dubai Cares - designing programmes that will integrate nutrition, WASH (water, sanitation and hygiene) and deworming interventions in schools to increase student enrollment and learning outcomes.
  • The Global Partnership for Education - collaborating with the World Bank to assist education sectors in developing countries to deliver donated deworming drugs to children.
  • The World Food Programme working to ensure deworming is provided to millions of children as part of current school feeding programmes.

Useful Links

 ​

Wednesday, 12 February 2014

UK House of Lords welcome UK Coalition's expertise and call for increased global support

On 7th February a special Neglected Tropical Diseases (NTD) debate was held at the UK's House of Lord's to mark the second anniversary of the London Declaration on NTDs. Tabled by Baroness Helene Hayman the discussion welcomed the high levels expertise brought by UKCNTD members to the research and implementation of effective NTD programmes and called for the UK Government to encourage donor government partners to follow its lead in supporting and advocating for improved NTD control strategies.

A key success of the 2012 London Declaration is that NTD control strategies are beginning to be prioritised by the global community, as noted by Baroness Hayman "[NTDs]inclusion in the 'healthy lives' goal of the high-level panel on the post-2015 development agenda, published in May last year, was, I believe, a crucial step forward”.

Baroness Hayman highlighted the work that the UK Coalition against NTDs, and like-minded alliances in NTD endemic countries were undertaking to develop sustainable and effective NTD control programmes. "The academic and voluntary sector, both of which are so strong in the UK, have much to offer both in research and in resource. Such technical support [from coalitions] will be essential for plans such as the recently drawn-up Africa regional NTD strategy if it is to be successful."

However, even with the wide ranging support offered by the London Declaration financing remains an issue. Baroness Hayman said, "Given the relative cheapness—we know that many would argue that treating NTDs was the best bang for your buck that you could get in public health expenditure—and the cost efficiency of NTD control work, given the extensive drug donations, it has been estimated that there is still a £200 million funding gap to be bridged if we are to meet the goals of the London Declaration."

She continued, "I am not asking Her Majesty’s Government to meet this gap themselves; they have already been generous and committed in this area. However, I ask the Minister what progress the Government is making in championing investment in NTD work with other key international donor governments, particularly perhaps France, Germany and Australia."

"Combating NTDs punches above its weight in broader health and wider development terms. We need to renew and reinvigorate our commitment to research, prevention and treatment programmes."

Baroness echoed the UK Coalition's call for increased coordination and integration of development initiatives by saying, " Integrating existing strategies such as mass drug administration with broader public health programmes such as those on water, sanitation and education, we not only enhance the effectiveness of those strategies but start to build from the bottom up the sort of universal health coverage and health systems needed to underpin development."

  • Download the Minutes from the NTD debate
  • Thursday, 28 November 2013

    UK Coalition Against NTDs Launches 4th Annual NTD Report

    4th Annual Report of the UK Coalition Against NTDs
    This Friday 29 November the UK Coalition Against Neglected Tropical Diseases (NTDs) will launch its 4th Annual Report to the All-Party Parliamentary Group on Malaria and NTDs (APPMG) which outlines key recommendations to see the control, eradication and elimination of NTDs.

    NTDs continue to place a huge burden on the poorest and most vulnerable communities in the world; they are keeping the bottom billion at the bottom. These insidious diseases hinder development by affecting the most marginalised and voiceless communities living in poverty and conflict zones, keeping individuals and communities trapped in a cycle of poverty as a result of pain, disfigurement, and disability (mental and physical).

    The 4th report outlines NTD elimination progress and needs within the development context, the integrated and inter-sectoral approaches necessary to help achieve this, surveillance of countries post-elimination as well as presenting current ideas in the NTD debate. The report also provides a global picture on NTDs displaying a map illustrating areas identified for control and elimination and factsheets on common NTDs.