When you work in global health, you get to witness some of humankind’s greatest achievements. Together, the world has cut child deaths by more than half since 1990, we’re on the brink of eradicating polio, and we’re reaching more people than ever with lifesaving vaccines. Yet one of the most inspiring success stories is perhaps the one most overlooked: the global effort to eliminate neglected tropical diseases, or NTDs.
Much of the recent success stems from a meeting in London on Jan. 30, 2012 — five years ago today.
NTDs affect nearly 1.5 billion of the poorest and most marginalized people around the world. And while 500,000 people lose their lives to NTDs every year, these diseases are more likely to disable and disfigure than to kill. Some, like trachoma, blind their victims; others, like lymphatic filariasis, commonly known as elephantiasis, cause disfigurement and enormous swelling of different body parts. Dracunculiasis, the scientific name for Guinea worm, means “afflicted with little dragons” because as the parasite that causes it travels through the body, you feel like you are on fire.
These agonizing conditions keep children from school and adults from work, trapping families and communities in cycles of poverty.
If this is the first time you’re hearing about these diseases, you are not alone. I didn’t really know what NTDs were until I saw my first sleeping sickness patient in Uganda, nearly 30 years ago. Another memory from that time is how we never went swimming in beautiful, beckoning Lake Victoria because of the risk of snail fever, which can damage major internal organs like the liver and kidneys.
I saw every day how scary these diseases can be. But they were also incredibly frustrating because at the time we could barely diagnose them, let alone treat them, since drugs were expensive and rarely available at local clinics.
Today, the landscape is dramatically different. In 2015, nearly 1 billion people received NTD treatments — 20 percent more than just two years before. As a result, fewer people are suffering from these diseases than at any point in history. Onchocerciasis, also known as river blindness, has been nearly eliminated from the Americas, and seven countries have reported eliminating blinding trachoma. Today, there are just 25 cases of Guinea worm — a huge change from the 3.5 million cases in the mid-1980s.
Much of this success can be traced to the 2012 meeting in London. There, the World Health Organization, pharmaceutical companies, donors, governments, and non-governmental organizations committed to work together to control and eliminate 10 NTDs. The London Declaration unlocked unprecedented resources to combat NTDs that spanned drug donations, research collaborations, and program financing.
Pharmaceutical companies have been the engine driving this progress. Since the London Declaration, the industry has donated nearly 8 billion tablets — enough for 5 billion NTD treatments. Companies have also joined forces with academia and public organizations to collectively invest in innovative new tools to combat diseases.
The partners of the London Declaration don’t just work across sectors, they also work across borders. Since 2008, the US Agency for International Development and the United Kingdom’s Department for International Development have worked side by side to distribute 2 billion treatments and map more than 3,800 global districts for the five most common NTDs, helping to reach those who need treatment most. The Expanded Special Project for Elimination of NTDs, led by the WHO’s Africa Regional Office, is also working to tackle these diseases across the African continent, disseminating best practices, coordinating activities, and offering technical guidance where needed.
Although we are closer than ever to a world without NTDs, our work is not yet done. While there have been some admirable commitments from both affected and donor governments — as well as a growing commitment from philanthropists like the Legatum Foundation — significant gaps remain in funding for both the delivery of existing drugs and the development of new tools. Investments to tackle NTDs are well worth making — both in human and economic terms. According to one study, eliminating NTDs could return around $600 billion to the global economy by 2030.
At a time when questions loom large about funding global health and development, the success against NTDs is a powerful reminder of the incredible impact we can have when all of us — the public, private, and philanthropic sectors — work together. With the right partners and the political will, I’m convinced that not too far in the future, tropical diseases that are today known as neglected because they have traditionally gotten so little attention from the world will be the success story that everyone is talking about.
Sue Desmond-Hellmann, MD, is CEO of the Bill & Melinda Gates Foundation; she was formerly the first female chancellor of the University of California, San Francisco.
