A new report from the World Health Organization claims “unprecedented” progress toward the elimination of neglected tropical diseases, or NTDs — a set of debilitating infectious diseases that threaten 1.6 billion people around the world — as experts gather in Geneva to discuss further commitments.
The report suggests that huge strides have been made in tackling the diseases since the 2012 London Declaration, a collaborative commitment made between several governments, foundations, nonprofits and private sector companies with the goal of controlling or eliminating at least 10 NTDs by 2020.
The number of people at risk for NTDs has fallen by 20 percent in the five years since then, according to WHO. In 2015 alone, nearly 1 billion people received treatment — many donated by pharmaceutical companies — for at least one NTD, a 36 percent increase since 2011.
The announcement was made as leaders from governments, NGOs and pharmaceutical companies convene today in Geneva, Switzerland, for a summit that runs through Saturday, where global partners will announce new commitments and targets to build on this progress.
The U.K. government announced an extra 200 million pounds ($256 million) to tackle NTDs ahead of the summit and the Gates Foundation will commit a further $335 million in grants over the next four years to support drug development, delivery, and disease surveillance and control for a range of NTDs.
“Millions of people have been rescued from disability and poverty, thanks to one of the most effective global partnerships in modern public health,” said Margaret Chan, director-general of the WHO, in a press release. “WHO has observed record-breaking progress.”
A group of 17 diseases, including lymphatic filariasis (commonly known as elephantiasis), onchocerciasis (known as river blindness), and human African trypanosomiasis (known as sleeping sickness), were collectively identified as neglected tropical diseases in 2005, due to the lack of attention they received.
As uncertainty about the direction of U.S. policy persists, representatives meeting in Seattle discussed collaboration between organizations, disciplines and countries in a renewed effort to tackle global health challenges.
While awareness among the public may remain low, the global health community has been mobilizing behind NTDs, particularly since the London Declaration and due to a number of coalitions that have formed since.
“NTDs are some of the most painful, debilitating and stigmatizing diseases that affect the world’s poorest communities,” said Bill Gates, co-chair of the Bill & Melinda Gates Foundation, which hosted an event Tuesday evening highlighting the partnerships that have made progress against NTDs possible.
The Gates Foundation helped to launch the London Declaration, which laid the foundation for the partnerships between the public and private sector that Chan and others have pointed to as being critical to progress.
“There have been many successes in the past five years, but the job is not done yet,” Gates said. “We have set ambitious targets for 2020 that require the continued commitment of pharmaceutical companies, donor and recipient governments, and frontline health workers to ensure drugs are available and delivered to the hardest-to-reach people.”
The report lists five public health approaches as key to progress on NTDs: “innovative and intensified disease management; preventive chemotherapy; vector ecology and management; veterinary public health services; and the provision of safe water, sanitation and hygiene.”
Success stories include Guinea worm disease, which has been reduced from an estimated 3.5 million cases in 1986 to just 25 human cases in three countries — Chad, Ethiopia and South Sudan — last year. The new Gates Foundation funding includes $42 million to support the Carter Center’s Guinea worm eradication initiative.
Partners working to end lymphatic filariasis are also nearing the finish line, with eight countries eliminating the disease over the past year and 10 countries waiting on confirmation of elimination.
However, stakeholders say that the key to further progress will be convincing donors that a need for funding remains.
“We want others to be part of this global victory as well,” said Julie Jacobson, a program officer at the Gates Foundation, mentioning the Guinea worm funding in particular. “What I don’t want to see happen is for other people to go, ‘Oh, it’s covered.’ That’s definitely not true. We need other donors to step up.”
Jacobson told Devex that the most significant thing about the London Declaration was donors and grantees working together for collective impact — and the same could happen at this week’s summit.
When a major donor, especially the Bill & Melinda Gates Foundation, supports an organization or takes on a global problem, there is a risk that other funders will turn their attention away. What can be done to address this sector-wide problem?
“That reshifting of perspective brought people into a place where they realized they are completely dependent on others for anything they do to have any meaning whatsoever,” she said. “It’s enabled conversations in which organizations that might have felt they were in competition can come into collaboration.”
Key organizations working on this task include Uniting to Combat NTDs, a collective of partners working to fulfill the London Declaration that is co-hosting the summit; the NTD NGO Network; the Coalition for Operational Research on NTDs; and The END Fund — which was founded by the global investment firm Legatum after Alan McCormick, a partner at the firm, read a line in a 2006 Financial Times article: “many of the world's most neglected diseases, such as lymphatic filariasis and schistosomiasis ... do not need innovation but simply modest funding and a little imagination in order to distribute drugs to those in need,” it read.
“They spent a whole year looking at the landscape of the entire space asking what would it take to end these diseases across Africa,” Ellen Agler, CEO of The END Fund, said of its founders. “It was this enormous exercise that ended up having a price tag in the billions. And they realized — OK, this is way bigger than what we can do as philanthropists — and decided to create a platform for collaboration.”
The NTD effort has benefited from an increasingly big tent approach, she explained, mentioning the engagement of the Archbishop of Canterbury, telecommunications companies in Africa and the effective altruists who follow GiveWell’s recommendations for deworming initiatives as examples. Given concerns over the future of official development assistance, the engagement of the private sector is more critical now than ever, Agler said.
But research and development will also be key, according to Bernard Pécoul, CEO of DNDi, a nonprofit drug research and development organization that appears throughout a new report released today highlighting the range of industry investments in NTD R&D. “We are yet to see the breakthroughs that will bring newer, safer, better drugs, diagnostics or vaccines to the most neglected,” he said.
“Collectively, we need to sustain our scientific, political and financial commitments, particularly on research and development, to provide neglected people with the modern health technologies needed to sustain elimination of many of these diseases.”
Stay tuned for more Devex coverage from Geneva as representatives of the public and private sector gather to discuss the gains and gaps as they work toward the 2020 targets.