“I could smell the patient, before I could actually see her. It was 1993, and I was an intern working in a public hospital in Chennai, India… I was a rookie, doing one of my first shifts in the emergency department. A middle-aged woman wanted me to clean her leg sores and bandage them. Both her legs were enormous, with ulcers I could smell a mile away. She had bilateral elephantiasis, caused by lymphatic filariasis.”
Just picture the scene as this intern at this hospital recounts the distressing story of what he went through while working on his patient at this hospital: “As I dressed her wounds, I saw maggots crawling out of them. I struggled to stay calm. She begged me to amputate her lower limbs and deliver her from her never-ending misery.”
“There was little I could do for her, beyond pulling off a few maggots and dressing her sores. The damage was done years ago, when filarial parasites, spread by mosquitoes, grew into adult worms in her body, and permanently damaged her lymphatic system”.
This story is told by Madhukar Pai a prolific writer, who recently shared this sad story in an article he wrote under the title: Record Funding for Global Health Research, But Neglected Tropical Diseases Remain Neglected.
He is a medical doctor who writes about global health, infectious diseases, and equity. He also serves as an adviser to non-profit institutions such as the WHO, Stop TB Partnership, FIND, and TB Alliance.
In sharing his experiences with the bilateral elephantiasis patient in 1993, Madhukar Pai noted that her story is a story of a group of preventable and treatable diseases that impact millions of people by compromising their health, livelihood and sense of dignity.
Growing up in India, he added that he had seen several cases of neglected tropical diseases (NTDs) in his community, and in his hospital.
“As a resident, I took care of patients who were cured of leprosy, but left with claw hands, damaged nerves, ulcerated, numb feet, and severe disabilities. In those days, the stigma around leprosy was so bad, that leprosy patients were segregated, far away from general medical wards. …..Even today, people with leprosy are stigmatized,” he added.
Over the years, the picture above has not changed. NTDs still leave their victims stigmatized and marginalized. They are known to cause disfigurement, considerable pain and they also hamper the routine activities of its sufferers.
NTDs come in different forms and include leprosy, trachoma, sleeping sickness, lymphatic filariasis, dengue, snake bite envenoming, river blindness, and guinea worm disease. These diseases compass 20 bacterial, parasitic and viral diseases that prevail in tropical and subtropical countries affecting over one billion people worldwide, especially among the poor in Africa.
On January 30 this year, Ghana joined other countries to commemorate the World Neglected Tropical Diseases (NTDs) Day.
Dr Benjamin Marfo, the Programme Manager of NTDs, speaking at a media briefing ahead of the commemoration in Ghana, noted that NTDs promote poverty among sufferers and added that some progress is being made in Ghana in eliminating some NTDs, including the elimination of leprosy, guinea worm and trachoma as public health issues.
The event was organized by African Research Network for Neglected Tropical Diseases (ARNTD), which is made up of eminent researchers, policy makers and implementers from more than 30 African countries researching into NTDs, such as snakebite envenoming.
In a document titled “Uniting to Combat NTDs” made available to journalists by the ARNTD during the briefing, Ghana’s President, Nana Akufo-Addo, is quoted as saying that in 2018, Ghana became the first sub-Saharan African country to eliminate blinding trachoma.
“A painful and disabling disease. We cannot achieve the SDGs without addressing the needs of the poorest members of our society who are disproportionately affected by NTDS. I urge my fellow African leaders to prioritise ending these diseases of poverty on the continent. We have shown that it can be done,” he added.
The Director-General of the World Health Organisation (WHO), Dr. Tedros Adhanom Ghebreyesus, is also quoted in the same document as saying: “If we are serious about universal health coverage, we must intensify our efforts and our commitment to control, eliminate or eradicate these diseases by 2020”.
Bill Gates of the Bill & Melinda Gates Foundation had also noted that “…There have been many successes in the past five years, but the job is not done yet.” Indeed the job of eliminating or eradicating NTDs is far from over.
However, it is gratifying that NTDs are now becoming a front burner issue globally, with Rwanda preparing to host the first-ever Global Summit on Malaria and Neglected Tropical Diseases in June 2020, on the sidelines of the Commonwealth Heads of Government Meeting (CHOGM) in Kigali.
The summit is expected to call on world leaders to meet the CHOGM 2018 pledge to halve malaria by 2023 and deliver the political and financial commitments of $1.5 billion to end the scourge of NTDs.
A press statement made available to ghanabusinessnews.com this February by the RBM Partnership to End Malaria, said over 1.5 billion people – one in five people alive today – are at risk of neglected tropical diseases.
It said these diseases thrive in areas of poverty and strike hardest against the most vulnerable – women, particularly when they are pregnant, children under five, and people living in remote, underserved communities.
“It is estimated that only 0.6 per cent of global healthcare funding is allocated for controlling”.
The statement said an expected outcome of the Kigali Summit is an “NTD Declaration’ galvanizing countries to deliver political commitments and to mobilise new financial commitments of $1.5 billion to accelerate progress towards the total costs of delivering the upcoming WHO NTD 2030 road map.”
It noted that the Kigali Summit would capitalize on the presence of Heads of State of countries that represent almost two-thirds of the malaria and NTDs burden, as well as major donors and partners working to end these diseases.
In addition to the host government, the RBM Partnership to End Malaria and Uniting to Combat the NTDs, the Summit is supported by a wide range of partners, including the African Leaders Malaria Alliance, the Bill & Melinda Gates Foundation, the END Fund, Malaria No More UK and the WHO.
“Ending malaria and neglected tropical diseases is an important part of achieving the Sustainable Development Goals agreed by the world’s governments in 2015 when, as part of the health goal – SDG3 – nations committed to reduce malaria and NTD cases by 90 per cent by 2030 as a key driver towards universal health coverage,” the statement further noted.
The WHO has recommended five public-health interventions to accelerate the prevention, control, elimination and eradication of NTDs.
These interventions include preventive chemotherapy, vector control and pesticide management, safe drinking-water, basic sanitation and hygiene services, and education through the prioritisation of improved sanitation.
The world body adds that although one approach may predominate for the control of a specific NTD or group of NTDs, more effective control results when these approaches are combined and delivered locally.
Noting that research underpins all interventions and that avenues for research and development must be pursued in order to find new approaches and simplified strategies as well as novel diagnostics, medicines, vaccines and vector control methods to enhance interventions and advance progress towards the targets.
By Eunice Menka