“If we are to end the scourge of neglected tropical diseases, then we urgently need to do things differently. This means injecting new energy into our efforts and working together in new ways to get prevention and treatment for all these diseases, to everyone who needs it.”
These were the words of Dr Tedros Adhanom Ghebreyesus, the Director-General of the World Health Organisation (WHO), when stakeholders and policymakers working in diverse Neglected Tropical Diseases ( NTD) landscapes across the globe, came together on January 30 to celebrate the World NTDs Day.
Neglected Tropical Diseases are a group of 20 infectious diseases that threaten 1.7 billion people living in the poorest and most marginalised communities worldwide.
Although these diseases do not kill, they cause blindness, disability, or disfigure people, taking away not only their health but also their chances of staying in school, earning a living, or even being accepted by their families or communities.
Experts say NTDs are responsible for thousands of preventable deaths each year and cause impairments that perpetuate the cycle of poverty, keeping millions of adults out of work and children out of school.
Research has also shown that NTDs affect more than one billion people globally and cause pain and disability, creating lasting health, social and economic consequences for individuals and societies.
In spite of the negative effects on the quality of life, NTDs generally remain out of the field of interest for policymakers, and there are little resources to address them.
In Ghana, 14 NTDs are prevalent. These are Buruli Ulcer, Guinea Worm, Human African Trypanosomiasis (sleeping sickness), Leishmaniasis, Leprosy, Trachoma, Intestinal Worms, Bilharzia, Elephantiasis, Yaws, Onchocerciasis (river blindness), Rabies, Scabies, and Soil-Transmitted Helminthiasis (worms).
The Ghana Health Service (GHS) is managing these diseases under respective programmes through Mass Drug Administration, morbidity management and health education across the country.
Dr Kofi Asemanyi-Mensah, the Programmes Manager of NTDs, said those were chronic diseases and victims had no option but to live with the disease for the rest of their lives.
He said NTDs were common in slums and very poor settings and created an empoverished cycle due to the low attention given to their prevention by policy makers and the health community.
“There is a neglect of the diseases in Ghana because most interventions to manage persons infected are partner sponsored; the drugs that we give during the Mass Drug Administration (MDA) are all donations from international organistions and every aspect of our programmes are partner driven,” he said.
Dr Asemenyi-Mensah said Ghana needed to equip its health systems with logistics and human resource to improve service delivery for persons living with chronic NTDs.
Presently, health workers, especially nurses, are unable to manage NTDs. They often refer to these infections as special cases leaving most patients to their fate.
Dr Asemenyi-Mensah said to eradicate NTDs health workers must be specifically trained on the best ways to alleviate the pains of victims, while empowering them to live productive lives.
Through training the health workers must be able to identify the infections and follow up on all cases, ensuring that each case is well attended to.
Dr Asemenyi-Mensah told the Ghana News Agency (GNA) in an interview that in 2020 about 12,000 men with swollen scrotum (suspected hydrocele cases) were registered by volunteers during the MDA. Some of the cases were, however, not hydroceles but hernias.
That same year, a total of 95 hydrocele patients were operated on for free in the Bono, Bono East, Central and Western regions.
Trachoma is endemic in the Northern, North East and Upper West regions of Ghana, Onchocerciasis is endemic in all the regions except Greater Accra, and Lymphatic Filariasis is prevalent in all except the Ahafo, Ashanti, Oti and Volta regions.
Similarly, Schistosomiasis and Soil-transmitted Helminthiasis are endemic in all districts with different levels of endemicity.
Thankfully, Guinea Worm, Trachoma and Leprosy have been eradicated from Ghana. Soon ‘Sleeping Sickness’ will be declared eradicated, while Limphatic Filariasis transmission is interrupted in 99 out of the 114 endemic districts.
Through annual mass treatments, the prevalence of Onchocerciais, Schistosomiasis and intestinal worms have been reduced to very low levels in most endemic areas in the country.
Dr Neema Rusibamayila Kimambo, the Acting WHO Country Representative, said treating affected populations and those at risk of NTDs was a key strategy for achieving the Sustainable Development Goal (SDG) Three.
The SDG-Three seeks to ensure health and well-being for all, including a bold commitment from government and health actors to end epidemics such as AIDS, Tuberculosis, and Malaria by 2030.
Mr Emmanuel Agumah, a Buruli Ulcer Survivor and Founder of the Buruli Ulcer Victims Aid Foundation, says life was always unpredictable after going through nine surgeries when he contracted the disease in 2000. That was at a time when there was no medication for cure and difficult for doctors to detect the disease.
“At that time, there was no treatment for this and we were only limited to surgeries, some lost their lives through the surgery and life was always in a form of anxiety, I was always scarred because the only way my condition could be treated was through surgery,” he said.
Mr Agumah appealed to the Government to provide scholarships to young people who got infected with an NTD to enable them to continue their education and live meaningful lives.
He stressed the need for society to stop stigmatising persons living with NTDs.
Stakeholders in health, during Ghana’s observance of the World NTDs Day on January 29, agreed that more needed to be done to eradicate these diseases from the country, as resources for their management have, so far, been solely dependent on foreign aid.
They said the COVID-19 pandemic had also resulted to even more neglect of the already fragile situation of NTDs management and treatment. Nevertheless, Ghana must remain committed to the fight against the NTDs in order not to derail the tremendous gains made.
Suffice it to say that the COVID-19 preventive measures like hand washing with soap under running water will help in reducing the transmission of NTDs like worm infestation.
Thirty three countries have eliminated at least one NTD since 2012, and with the right investments and actions, Ghana is likely to make incredible progress by strengthening the health systems to reach everyone with the available solutions.
The country needs to, as a matter of urgency, increase investments towards finding solutions to the existing challenges for populations currently at risk to stay safe of these diseases, while empowering them to live healthy and impactful lives.
Sight must also not be lost on the fact that everybody is at risk of an NTD infection. We, therefore, need to work together to eradicate these diseases to enhance our chances of achieving the SDG –Three and eliminate poverty.
The Government, policymakers, civil society organisations, health personnel and the public have a role to play in the fight against NTDs, be it through financial contributions or participation in the various intervention activities, to win this fight.
By Linda Naa Deide Aryeetey