As World Neglected Tropical Disease (NTD) Day approaches this 30 January 2023 with the theme of “Act now. Act together. Invest in Neglected Tropical Diseases,” Médecins Sans Frontières/Doctors Without Borders (MSF) is demanding an improved global response to treat and control NTDs, including through increased global investment for the integration of care for NTDs into primary healthcare services and research and development into NTDs. With recent funding cuts, a general forsaking of NTDs, and disrupted health systems in the wake of COVID, there is a real concern that progress towards ending NTDs could be undermined.
Over the past three decades, while treating neglected tropical diseases around the world, MSF has again and again witnessed the devastating impact they can have on peoples’ lives. This World Day dedicated to neglected diseases, we reiterate our call for an improved global response to the problem, as it’s past time to overcome the neglect and end the scourge of these diseases. The global community must urgently prioritise funding and investment in neglected diseases, with a particular focus on programmatic activities and implementation, so that there is better access to testing and safe, effective treatment and care for everyone affected by these diseases.
Julien Potet, Neglected Diseases Policy Advisor, MSF Access Campaign
Background
NTDs are widespread, affecting over 1 billion people and killing hundreds of thousands of people each year. However, as NTDs mostly impact the world’s poorest people, these diseases are often overlooked by policymakers, and so very few resources are made available to address them.
MSF is often present and providing care to people with NTDs in areas affected by conflict and natural disasters where resources are scarce and health systems are fragile. Over the past 30 years, MSF teams have treated hundreds of thousands of people with some of the most overlooked NTDs, such as Chagas disease (American trypanosomiasis), visceral leishmaniasis (VL or kala azar), and sleeping sickness (human African trypanosomiasis) – all parasitic NTDs which affect impoverished people living in very remote and underserved areas. MSF not only helped identify new treatments and ways to diagnose people, but also played an active role in reducing the incidence of VL in African and Asian countries and sleeping sickness in African countries. In recent years, MSF has also integrated care for people affected by snakebite envenoming, noma, and cutaneous leishmaniasis. For more information on MSF’s medical evidence on NTDs, visit MSF’s Science Portal.
Current Global Efforts
In June 2022, MSF joined public health actors and global leaders in signing the Kigali Declaration on NTDs, a high-level, political declaration aiming to ensure that these diseases are eradicated, eliminated or controlled by 2030. At the same time, MSF warned that the reduced funding for NTDs in the wake of the COVID pandemic could be devastating for people in low- and middle-income countries. Despite the commitments made at the Kigali Summit, there remains a real risk that NTDs will slide into further neglect due to a desperate lack of funding. MSF is therefore calling on policymakers, countries, and philanthropic actors to honour their existing commitments and increase these commitments to fund better integration into primary care and tools to find, diagnose, and treat more people with NTDs, and support the ambitious World Health Organization (WHO) NTD Roadmap which aims to greatly reduce NTDs by 2030.
In addition, as there are very limited functional NTD control activities in countries facing armed conflicts and other humanitarian situations, MSF is reiterating its commitment to offer diagnosis and treatment to people affected by NTDs in humanitarian settings where MSF can intervene, particularly to patients affected by life-threatening NTDs such as human African trypanosomiasis, VL and snakebite envenoming.
Some of MSF’s work and asks on specific NTDs
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Snakebite envenoming is a medical condition that results from a snakebite and causes more death and disability than any other NTD (around 81,000 to 138,000 people die each year because of snakebites). However, it received limited financial commitments at the Kigali Summit. MSF is calling for increased funding to improve access to quality antivenom and clinical training, which could result in a significant reduction of snakebite envenoming's high mortality rates. MSF treats over 7,000 snakebite patients every year, predominantly in the Central African Republic, South Sudan, Ethiopia, and Yemen. MSF gives regular trainings on clinical protocols; offers antivenom free of charge, although costly for MSF; provides other services such as surgery and, less systematically, health promotion at community level; and is calling for improvement of post-discharge care for follow-on conditions, including mental health care, as a priority.
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Visceral leishmaniasis (VL or kala azar) is a life-threatening parasitic infection that has nearly been eliminated in South Asia and could also be eliminated in East Africa. MSF is actively participating with other stakeholders in the development of a strategy for VL elimination in East Africa, as outlined in the Nairobi Declaration endorsed by MSF on 25th January 2023. And, between 1989 and 2020, MSF teams treated nearly 150,000 people for VL in South Sudan, Sudan, and Ethiopia.
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Noma is a disease which mostly affects children living in poverty and has not yet been recognised as an NTD by the WHO. MSF and other global health actors have called on the WHO to recognize noma as an NTD, as this could finally galvanize support and resources to tackle noma on a significant level. Since 2014, MSF has supported the Sokoto noma hospital in Nigeria with a program of activities for people affected by noma, including survivors and their families.
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Sleeping sickness (human African trypanosomiasis) is a parasitic, vector-borne disease transmitted by the tsetse fly. Thanks to successful international collaboration, the transmission of sleeping sickness on the African continent has been brought back to very low levels, though pockets of the disease still exist and may flare up again if surveillance and care are abandoned. MSF is calling for increased disease surveillance to maintain these very low levels. In addition, between 1986 and 2019 MSF screened nearly 3.5 million people for sleeping sickness and treated more than 50,000 patients in seven countries (Angola, South Sudan, Democratic Republic of Congo, Central African Republic, Congo Brazzaville, Uganda and Chad).
- Other NTDs that MSF treats in the places we work include rabies and dog-bite control, dengue fever and other vector-borne diseases, schistosomiasis, water-borne, and climate-sensitive diseases.