When the London Declaration on Neglected Tropical Diseases was signed in 2012 by a diverse group of partners, one sentiment was universal:
With a collaborative global effort, we can defeat these debilitating diseases of poverty and underdevelopment.
Five years later, this strong partnership has now reached over a billion people in a single year, making remarkable strides towards achieving the WHO goals for the control, elimination and eradication of 10 NTDs. During this key anniversary year, we celebrate the progress to date and rally forward towards 2020 and beyond.
NTDs place a heavy burden on over 1.5 billion people on the planet. They are diseases of the poor and vulnerable and affect the most impoverished, marginalized, hardest-to-reach communities, in both low- and middle-income countries. Their impact on individuals and on communities can be devastating. They reduce life expectancy and the educational and economic opportunities of affected individuals and of the communities they live in.
Numbers of people requiring interventions against NTDs
Global public–private partnerships are improving a billion lives
The London Declaration in 2012 was a historic milestone that enabled progress in treating and reducing the spread of NTDs. It demonstrated the impact of collaborative action between the public sector, the private sector, communities and nongovernmental organizations (NGOs).
Bill Gates, co-chair of the Bill & Melinda Gates Foundation and an endorser of the London Declaration, said at the fifth anniversary event:
“Thanks to this partnership, these neglected diseases are now getting the attention they deserve so fewer people have to suffer from these treatable conditions. There have been many successes in the past 5 years, but the job is not done yet. We have set ambitious targets for 2020 that require the continued commitment of pharmaceutical companies, donor and recipient governments, and frontline health workers to ensure drugs are available and delivered to the hardest to reach people.”
Bill Gates, Bill & Melinda Gates Foundation
Five years on, we have much to celebrate. The London Declaration has encouraged unprecedented global action and progress in the fight against NTDs. In 2016 alone, more than one billion people, in the world’s poorest countries were treated for at least one NTD. That’s one in seven of the world’s population who received treatment for an NTD.
In 2011, just under 2 billion people (1.9 billion) required interventions against NTDs. This figure dropped to 1.5 billion in 2016, representing a decrease of over 400 million who no longer require preventive chemotherapy, mainly due to control of lymphatic filariasis (LF).
With the record-breaking drug donation programmes that are a cornerstone of the London Declaration partnership, countries are eliminating these diseases, thereby reducing the overall public health burden. The drug donation programme was recently recognized in the Guinness Book of Records as the largest of its kind in history, with the most medication donated in a 24-hour period.
NTD programmes are a gateway to universal health coverage
NTD programmes reach some of the world’s poorest communities, and the creative strategies tailored for challenging, complex settings can provide a gateway to UHC. From the nomadic tribes in the deserts of Niger to the Yanomami tribe in the rainforests of Venezuela and the mountains of Brazil, NTD programmes are providing high-quality treatment and community-based care in remote rural areas never before reached by health systems, by training health workers and empowering health facilities with scant resources to reach more people more effectively. These programmes fuel ideas and blueprints for culturally relevant global health solutions.
The essence of UHC is ensuring that everyone has access to high-quality essential health care without suffering financial hardship. Population coverage is key to the UHC journey. NTD programmes can open access to populations that are some of the most challenging to reach.
Progress, year after year
Some of the numbers that give us much reason to celebrate:
Human African trypanosomiasis
In 2016, only 2,184 cases of sleeping sickness were reported worldwide, down from 6,747 in 2011.
Five countries have been validated by WHO as having eliminated trachoma as a public health problem: Cambodia, Lao People’s Democratic Republic, Mexico (2017), Morocco (2016) and Oman (2012).
In 2017, four countries – the Marshall Islands, Thailand, Togo and Tonga – eliminated LF as a public health problem, bringing the total to ten countries (with Cambodia, the Cook Islands, Maldives, Niue, Sri Lanka and Vanuatu).
Guinea worm disease
Guinea worm disease, which 30 years ago afflicted more than 3 million people in 20 countries, is on the brink of eradication, with just 26 cases in two countries.
Onchocerciasis has been eliminated in nearly all of the Americas. Colombia (2013), Ecuador (2014), Guatemala (2016) and Mexico (2015) have been validated as ‘onchocerciasis-free’.
These gains were made possible by three factors:
- Strong country programmes are reaching more people with NTD interventions than ever before.
- Billions of treatments are donated by the pharmaceutical industry. Within the drug donation programmes, more than 1.8 billion treatments were donated to impoverished communities, reaching over a billion people in 2016 alone.
- Government donors (led by UK aid and USAID) and private philanthropists are providing generous funding. US$ 812 million were pledged by governments and private donors at the NTD Summit in Geneva in April 2017.
Progress is driven by the commitment of the governments of countries in which these diseases are endemic, NGOs and front-line health workers who ensure that donated drugs reach the people who need them.
Investments in innovation and technology have given us better tools to prevent, detect and treat NTDs.
- New research shows that new combinations of three existing drugs (ivermectin, diethylcarbamazine, and albendazole [IDA]) can dramatically improve treatment for LF and decrease the duration of programmes. This finding has been endorsed by WHO for use in programmes to accelerate progress towards elimination and is now supported by an extended ivermectin donation from Merck.
- Technology has dramatically enhanced mapping, improving our ability to target efforts where they are most needed and share with countries and partners for planning.
- Through public–private partnerships, R&D breakthroughs are being made that could dramatically shorten the path to end some NTDs. For example, new oral treatment for sleeping sickness that is effective in all stages of the disease simplifies diagnosis and treatment, allowing patients to receive treatment closer to where they live and work.
Join us on the journey to defeat NTDs
The vision of a future free of NTDs is built on our successes, applying the lessons learnt and continually seeking additional tools, strategies and partners to help continue progress and address further challenges. Our collective action and partnerships have proven that we can achieve outcomes that were only envisioned a few short years ago.
However, the path to NTD elimination and universal treatment remains steep. The barriers in reaching the underserved are still high and will require financial resources, political commitment, new tools and other innovations.
Financial resources are needed to ensure that donated medicines reach everyone everywhere. Although over a billion people received NTD treatment in 2016, 500 million people did not. More funding is needed to ensure that NTD programmes reach all the people and communities affected by these diseases. WHO estimates that an additional US$ 300-400 million per year will be required through to 2020.
Political commitment in the form of strong leadership in affected countries is vital to sustaining progress against NTDs, particularly in the face of shifting economic climates and competing health priorities.
New tools and other innovations are the cornerstone of the NTD programme. Effective tools will move us faster and further along the path. Continuous innovation, development and adaptation will be required to ensure that no one is left behind.
Through the Uniting to Combat NTDs partnership, we have learnt from each other, in the service of and in partnership with the countries and the people affected by these diseases. The rewards of supporting a country’s NTD programme, of heralding news of progress to elimination, can scarcely be described in the pages of a report. They can best be illustrated by the transformation of communities into places where fewer people are held back and barred from full participation in and the possibility of contributing to their country’s development. We are geared towards a future in which we continue to grow and learn, welcome new partners, adapt programmes to new circumstances and embrace NTD prevention and disease management as part of universal health care.
We must continue to innovate in both programmes and tools. We now have a strong partnership. We share successes and set-backs, and together we will get the job done.
Uniting partners reaffirm their commitment to leave no one behind in the fight to end NTDs
In April 2017, partners from all over the world – endemic country governments, development funders, NGOs, academics and others – came together in an unprecedented gathering to unite around the common goal of ending the suffering caused by NTDs.
Reaffirming the commitments set out in the London Declaration, we commit to leave no one behind in the fight to end NTDs.
- support national efforts to beat NTDs
- embed NTDs in national systems and development priorities
- mobilize commitments and resources to elimination efforts
- collaborate across sectors
- work in a way that strengthens national health systems.