Neglected Tropical Diseases (NTDs) are still major public health concerns globally, particularly in Africa where millions of people are still under the bondage of the disease.
The term NTDs is used to describe a group of 20 communicable diseases that prevail in tropical and subtropical countries and affect more than one billion people globally, according to the World Health Organisation (WHO).
The 20 NTDs are buruli ulcer; chagas disease; dengue and chikungunya; dracunculiasis; echinococcosis; foodborne trematodiases; human African trypanosomiasis; leishmaniasis; leprosy; lymphatic filariasis; mycetoma, chromoblastomycosis and other deep mycoses.
The rest are: onchocerciasis; rabies; scabies and other ectoparasitoses; schistosomiasis; soil-transmitted helminthiases; snakebite envenoming; taeniasis/cysticercosis; trachoma; and yaws.
NTDs mainly affect populations living in poverty and in close contact with infectious vectors— viruses, bacteria, parasites, fungi and toxins.
NTDs also fester in places where people do not have access to clean water or safe ways to dispose off human waste. What it means is that the diseases thrive in places where water quality, sanitation, and access to health care are substandard.
The disease cause devastating health, social and economic consequences on those affected by it even though it rarely leads to death.
Sadly, in spite of the devastating havoc NTDs cause, the diseases have historically received and continue to receive less attention as compared to other diseases, hence the term “neglected.”
But experts believe that controlling the vectors that transmit the diseases and improving basic water, sanitation, and hygiene could help to overcome many of the NTDs globally.
This is why the WHO as part of its global efforts to prevent, control, eliminate and eradicate a diverse set of 20 diseases and disease groups, has set built its strategies on three pillars— accelerate programmtic action; intensify cross-cutting approaches, and change operating models and culture to facilitate country ownership.
Some health experts have expressed the hope that through mass administration of safe and effective medicines or other effective interventions, some NTDs, including lymphatic filariasis, dracunculiasis (Guinea Worm Disease), onchocerciasis, schistosomiasis, soil-transmitted helminths (STH), and trachoma, can be controlled or even eliminated.
Ghana situation
Ghana like many countries in the tropics is not immune to NTDs. Of the 20 NTDs identified by the WHO, 14 are found in Ghana, with prominent among them being trachoma; buruli ulcer; yaws; leprosy; human African trypanosomiasis (HAT or sleeping sickness); leishmaniases; lymphatic filariasis; onchocerciasis (river blindness); schistosomiasis, and soil-transmitted helminthiases.
The Deputy Programme Manager of the Neglected Tropical Diseases (NTDs) Programme of the Ghana Health Service (GHS), Dr Joseph Kwadwo Larbi Opare, in an interview said “every district in Ghana has at least two NTDs,” stressing the need to create sustained awareness on NTDs in order to reduce the impact of the disease on people, saying “the disease keep children out of school and parents out of work.”
He also called for a sustained financing and cross-sectoral approaches to fight the disease in Ghana, noting that NTDs are endemic in poor communities and promotes poverty and intense stigma.
For him, “NTDs tend to affect regions without quality healthcare, leaving poor populations vulnerable to these often debilitating diseases and newly emerging threats.”
Dr Opare expressed the concern that even though attention has been on Universal Health Coverage, “NTDs are almost absent from the global health agenda”, a situation he noted, ought to be changed urgently.
For him, NTDs have very limited resources and are almost ignored by global funding agencies, encouraging funding agencies and organisations to prioritise NTDs as they are afflicting the world’s poor and compounding their poverty levels.
“NTDs are diseases of neglected populations that perpetuate a cycle of poor educational outcomes and limited professional opportunities and are associated with stigma and social exclusion,” Dr Opare observed.
He expressed the concern that the lack of resources has become a significant barrier to the control, elimination, and eradication of NTDs in Ghana and many of the countries where NTDs still persist.
Financing NTDs
He said ending NTDs will make “our health systems more resilient and our world a more equitable and safer place.”
He expressed the hope that by bringing renewed attention to NTDs, building political will and mobilising resources, and putting individuals and communities at the centre of the response, “we can collectively generate the attention and resources needed to deliver against the targets outlined in the WHO 2030 NTD road map and SDG3.”
Dr Opare explained that investing in NTD programmes would create a ripple effect in society, touting that “it leads to better education, health, and employment outcomes, and transforms lives and communities.”
He further observed that investing in NTD programmes would equally help to reduce gender inequity, stigma, and preventable mortality and morbidity, pointing out that “the case for investment is clear.”
For him, addressing NTDs would not only help in making universal health coverage a reality, but would help to relieving the associated mental health burden of NTDs as well as tackling fundamental human rights issues.
Dr Opare believes that progress towards NTDs elimination and eradication is possible should world leaders commit more resources and efforts to the disease.
Youth participation
Just like Dr Opare, many health experts share the view that NTDs could be eliminated and even eradicated in the world should all critical stakeholders, including the youth are involved in all the NTDs activities.
This is because young people across all NTDs activities will help to bring innovative thinking, new solutions and also help to mobilise change.
More so, young people will be able to bring increased access to NTDs interventions in the sense that they are more capable to create and raise awareness on the disease to the larger society.
The Director of Neglected Tropical Diseases Department at WHO, Dr Ibrahima Socé Fall, is one of the health experts who believes that the youth has a greater role to play in the elimination efforts of NTDs.
In an article “A Pivotal Moment For The 2030 NTD Road Map Targets” published on www.africa.com on January 25, 2023, Dr Socé Fall observed that “the participation of young people, too, across all NTD activities, will also be key if we want to effect positive change and harness energy, values-based motivation and social connectedness, in order to spread information, generate innovative solutions and change communal behaviours and norms.”
In addition, he noted, these are principles that underpin the pillars of the road map – and which need to apply across the spectrum of global public health interventions, within and beyond the NTD world.
He further called for the country ownership of key health interventions to help win the fight over NTDs.
For Dr Socé Fall, “The insistence on programmes that respect a ‘bottom up’ principle, rather than ‘top down’, on initiatives that promote country ownership of key health interventions, rather than imposition by external agencies, and on cross-cutting initiatives – otherwise known as collaboration between disciplines – laid the foundation for the work we now have before us.”