The path to global health equity is through neglected tropical diseases. Here’s why

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The path to global health equity is through neglected tropical diseases. Here's why
The path to global health equity is through neglected tropical diseases. Here's why
  • Commonwealth leaders meeting in Rwanda turned their attention to neglected tropical diseases (NTDs), spurring the Kigali Declaration, an agreement to combine forces to end many NTDs.
  • NTDs affect one in five people worldwide, can cause suffering, death and other conditions, such as anaemia and malnutrition, and can lead to long-term health consequences, social stigma and economic problems.
  • Evidence already exists to show that progress in eliminating NDTs is possible despite previous declining funding, particularly via combined efforts.

Leaders of the Commonwealth, a group of 54 countries that are home to a third of the world’s population, met in Kigali, Rwanda, between 20-25 June, with the aim of strengthening international cooperation on some of the most pressing challenges facing humanity.

After more than two years of the COVID-19 pandemic, the gathering marks a key moment for global health equity as leaders turn their focus to the widespread and devastating tropical diseases that the World Health Organization classifies as “neglected” due to a gross lack of attention and resources. If the meeting spurs concrete action, it will be a turning point for addressing one of the planet’s most critical health and economic development challenges.

Success against NTDs requires a multi-stakeholder approach.”— Dr. Lutz Hegemann, President, President of Novartis Global Health & Sustainability, and ad interim Chief Strategy & Growth Officer

Significant human impact

Neglected tropical diseases (NTDs) – illnesses like Chagas disease, dengue fever, leishmaniasis, and more than a dozen others – affect one in five people worldwide and are a key impediment to economic development. In addition to causing unbearable suffering and death, NTDs lead to other conditions like anemia and malnutrition, stunting growth and causing lifelong health and cognitive problems.

The effects of NTDs have been associated with poor educational outcomes, limited job opportunities, and social stigma on a wide scale, consequences that have trapped millions of communities in a vicious cycle of poverty and disease.

Despite the enormous human toll, there is neither a traditional market nor a coordinated strategy for expanding access to treatment for NTDs. Globally, funding for research on NTDs has declined in each of the last four years, according to Policy Cures Research, a think tank that tracks investment in neglected disease research.

There is evidence, however, that the world can make progress on NTDs. Since 2012, when governments and civil society came together to start tackling NTDs on a global scale, public-private initiatives have helped deliver 14 billion treatments for at least one NTD, and 45 countries have eliminated one or more disease. Compared to 2010, half a billion people are no longer susceptible to NTDs.

Making additional gains, however, will require expanding access to effective and sometimes novel treatments, controlling the species of flies, mosquitoes and other vectors that transmit disease, and addressing underlying, systemic factors like poor water quality, undernutrition, and weak health systems. Carried out at scale, each of these steps would yield enormous returns.

According to the US Centers for Disease Control and Prevention, six NTDs, including lymphatic filariasis, onchocerciasis, schistosomiasis and others, could be eliminated through expanded access to treatment and related health services. Meanwhile, a 2021 survey showed that more than half of people in African countries are impacted by water shortages or poor sanitation, showing the potential for gains by improving water and hygiene infrastructure.

Rallying cry

We have reason for optimism. At the summit, Commonwealth governments rallied around the Kigali Declaration, an agreement to combine forces to end many NTDs, starting this year. Rooted in the United Nation’s third sustainable development goal to ensure healthy lives and promote well-being, fulfilling the agreement would strengthen NTD programmes and ensure the long-term sustainability of disease-fighting efforts.

As part of this global effort, Novartis, is committing $250 million over five years to research and developing novel treatments and cures for NTDs and malaria. By applying modern drug discovery technologies, we aim to find therapies that can support national programmes in addressing some the most destructive NTDs, including Chagas disease, leishmaniasis, dengue and cryptosporidiosis. But this is only part of the solution.

Success against NTDs requires a multi-stakeholder approach.

Political leaders should follow their endorsement of the Kigali Declaration with new investments in national NTD programmes, building capacity to supply higher volumes of treatments, deliver better diagnosis and treatments to patients and carry out routine epidemiological surveillance. Governments should invest more in academic research centres and laboratory infrastructure in developing countries as an opportunity to improve basic scientific understanding of NTDs and spur new technological innovations.

Similarly, companies involved in health innovation should invest more in research and development for NTDs while philanthropic organizations should increase their support for advocacy networks. These should be modelled after those successful in the fight against HIV/AIDS, tuberculosis and malaria and which can help strengthen policies and ensure accountability for achieving results.

The rapid spread of COVID-19 has shown how turning a blind eye to health needs in some parts of the world puts all of us at risk. With rising rates of drug resistance and worsening effects of climate change, allowing microbes to expand their geographic reach, NTDs are poised for resurgence with global consequences.

The Kigali Declaration is a watershed moment for global health equity. We can eliminate the scourge of NTDs by ending the neglect that has allowed them to persist in the first place.