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Neglected tropical diseases are preventable and cheap to treat, but they will blight a new generation of Africans if we do not act now to tackle them
Anatole Manzi is the deputy chief medical officer at Partners In Health
Growing up in rural Rwanda, I thought that my constant abdominal pain was an inescapable condition of childhood. I was surrounded by my friends, all with distended stomachs, hair loss from malnutrition, chronic conjunctivitis, or worse. Without available treatments, parents would coach their children to endure the pain.
Thirty years later, I visited my home village as a public health specialist overseeing health systems strengthening at Partners In Health, a leading global health organization. There, I met old friends suffering from blindness, and chronic physical and mental impairments. They were afflicted from advanced forms of the same Neglected Tropical Diseases (NTDs) we had experienced as children.
Globally, more than one billion people are infected by NTDs. Of these, almost one third lives in Africa. Now the plague of these neglected diseases has collided with the COVID-19 pandemic, and the result could be disastrous.
The number of NTDs is rising and threatens a new generation of African youth as never before. Governments have concentrated scarce health resources on fighting COVID-19; field campaigns to fight NTDs have been suspended; and the pandemic is pushing millions of more people into poverty, making it even more difficult to afford basics like healthy food and soap, much less medicines.
In Africa, governments and their partners must take action. It is not enough to control COVID-19, we must also protect 560 million people at increasing risk of death and permanent disability from neglected tropical diseases. Children go blind from parasites. Adults suffer disabling pain from Guinea worm disease. Men and women are disfigured with swelling limbs by elephantiasis. Some 20 different neglected tropical diseases kill, impair or permanently disable millions of people every year.
If nothing is done to prevent their resurgence, the slow death and long-term complications will be unbearable.
Not just neglected diseases, rather, neglected people
While less than 50 cents is needed to treat five common NTDs per person per year, limited investments to eradicate NTDs have reflected an insufficient attention to human suffering. It is not just the diseases. It is a collective negligence of the poor and the voiceless who are the primary target of NTDs, which are spread by unsafe water, poor housing conditions and poor sanitation.
To be sure, countries have taken steps to stop these diseases. They have improved water and sanitation, mounted deworming and vector control campaigns, and distributed medicines. However, these efforts have fallen well short of the need, and have often benefited the wealthy over the poor.
Now, COVID-19 is also disproportionately affecting the poor. Stringent public health measures such as lockdowns are hardest on the poorest people, who can only eat if they work. Globally, it is estimated that between 119 and 124 million people will be pushed into extreme poverty in 2021 due to the pandemic.
Not too late to act
As a second wave of COVID-19 rises across the continent, so, too are neglected tropical diseases. There are several steps countries must take to head off disaster.
First, health systems must address both COVID-19 and Neglected Tropical Diseases together, rather than as siloed problems. The integration of NTD screening and prevention services into COVID-19 campaigns of contact tracing and vaccination could yield remarkable improvements. For example, while screening for COVID-19, public health workers should educate people on NTDs and distribute essential resources to prevent or treat them.
Second, public health programming a paradigm shift to emphasize community-defined solutions. Many past NTD initiatives have had limited involvement of local communities. But community members are the real experts. They understand the social conditions that drive disease, and are key to identifying effective interventions for improved health delivery and health literacy.
Third, in addition to the existing community health workers, teachers, faith leaders, and traditional healers should become an extended health workforce. With targeted training, they could accelerate control of COVID-19 and NTDs.
But none of this will happen without an expanded vision of health as a right for all and dedicated funding--by global and national funding agencies and public and private sector investors. It is too early to know the ultimate toll of COVID-19 on the African continent. Vigilance is essential.
At the same time, we do know the price exacted by Neglected Tropical Diseases. Only by addressing both can we realize the African dream to rise, grow wise and lead.
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