The past eighteen months have reiterated the importance of strong, resilient health systems, as the COVID-19 pandemic has all but brought communities around the world to their knees. As the world struggles to contend with this raging crisis, other public health threats risk falling off the radar, as services are disrupted and difficult decisions are forced. In one example, a group of devastating diseases known as Neglected Tropical Diseases (NTDs) – some of which are on the cusp of being controlled or even eliminated – are in danger of becoming even more neglected. Thankfully, a resilient model is uniting partners, mobilizing resources, and galvanizing investors to help meet the demands of this critical moment and ensure this is not the case.
NTDs are closely linked to poverty, inadequate sanitation, hygiene, and unclean water, often found in remote, rural areas, informal settlements, and conflict zones. They, therefore, affect some of the world’s most resource-constrained and vulnerable communities. NTDs, including the likes of soil-transmitted helminths, schistosomiasis, river blindness, visceral leishmaniasis, and others are collectively estimated to affect nearly 2 billion people globally. Nearly half of those impacted live on the African continent.
As Amujae women leaders (The Ellen Johnson Sirleaf Presidential Centre’s flagship initiative) from Cote d’Ivoire, Gambia, Nigeria, and Sierra Leone, we have witnessed first-hand how these communicable and yet preventable diseases have devastated many of our remote and historically excluded communities, especially women and children. NTDs condemn those affected to many years of living with disability and stigma. They keep adults out of work, burden families with enormous healthcare costs, trap communities in endless cycles of poverty, and cost developing economies billions of dollars every year. For children, NTDs cause malnutrition, impair intellectual and cognitive development, stunt growth, keep children out of school, and result in reduced future earning potential.
Combatting NTDs is not only a moral decision; it is also a smart economic one. For every $1USD invested in treating a school-aged child, communities stand to gain $25USD in investments and opportunities. Interestingly, research data reveals that eliminating two of the most common NTDs (soil-transmitted helminthiasis and schistosomiasis) in Ethiopia, Kenya, Rwanda, and Zimbabwe by 2030 could boost these countries’ GDP by $5.1 billion. Preventing and eliminating NTDs will therefore help countries alleviate poverty, keep children in school, and improve education, advance gender equality, and disability inclusion, thus advancing sustainable development, community, and economic goals.
These funding gaps mean that millions of affected people will go untreated, either due to reduced availability of treatments and medicines
But recent cuts to foreign aid threaten this progress. Earlier this year, amid complex and competing priorities, the United Kingdom’s Foreign, Commonwealth & Development Office (FCDO) announced a £4 billion cut to its foreign aid budget. This ostensibly ends funding for the FCDO’s flagship NTD programmes, including those in West and Central Africa.
These funding gaps mean that millions of affected people will go untreated, either due to reduced availability of treatments and medicines, or in cases where medicines are already in-country, supply chain disruptions, and a lack of funds for distribution. Additionally, vital surveys for decision-making by governments and non-governmental partners, surgeries, and health promotion activities would also be negatively impacted.
For the world’s most vulnerable populations, these consequences could be catastrophic, reiterating the importance of resilient and nimble approaches like that of the END Fund to ensure sustainable financing. Through its unique model and three investment funds, the END Fund unleashes private capital, builds networks and partnerships, and acts as a trusted advisor to governments, allowing for quick, adaptive responses to fill in crucial gaps and continue the fight against NTDs.
In response to the UK foreign aid cuts, the END Fund, working with a group of donors including the Bill and Melinda Gates Foundation and ELMA Philanthropies, unlocked more than $2 million to support programs to combat Visceral leishmaniasis (VL), or KalaAzar, which is caused by parasites transmitted by the bite of infected sandflies. This funding will be directed to critical programs in Uganda and South Sudan, as well as in Bangladesh and Nepal, where the disease is endemic but has the potential to be eliminated by 2022 and 2024 respectively. Through its resilient model, the END Fund provides a new approach to global public health that is changing the course of history for individuals, families, and communities.
Ensuring widespread access to NTD treatments yields clear health and humanitarian gains, which directly translate to high and sustained social and economic returns to society. In the World Health Organization’s Roadmap for NTDs, we have a framework for action to ensure these diseases are neglected no longer. To do so will require bold commitment and new approaches that maximize resources and incentivize integration. We owe this to our children, our women, and our communities.