How the UK is leading the fight against diseases that affect 1.7 billion people

What are neglected tropical diseases?

Have you ever heard of neglected tropical diseases (NTDs)? Most people haven’t but NTDs affect over 1.7 billion people – that’s more than double the entire population of Europe!

NTDs cause immeasurable suffering. They disable, disfigure and can be fatal. NTDs rob individuals of what almost every person on the planet wants, no matter where they are born: For their children to have a healthy start in life, free from disease, and to be able to go to school and learn. And adults want the opportunity to do meaningful work and to provide for their families. NTDs don’t just rob people of this potential, they also strip them of their dignity.

So what are NTDs? They are a group of 20 diseases and conditions that are diverse in nature but have two things in common: The first is geography. NTDs affect people who live in the tropics. The second is social context. NTDs thrive in areas of extreme poverty, where there is little access to clean water or proper sanitation. Many NTDs have plagued humans for thousands of years but, together, we can beat them. You can learn more about all the 20 NTDs here but here are a few examples: 

  • Trachoma is a painful eye condition, which is caused by a contagious bacterial infection. Trachoma causes the eyelashes to turn inward and scratch the eye. Although it is treatable and/or preventable through antibiotics and/or surgery, if left untreated, trachoma can cause irreversible blindness.  
  • Intestinal worms affect over a billion children around the world. They cause stunting, impair children’s intellectual development and cause malnutrition. Intestinal worms can be treated, helping give children a fair start in life. 
  • Visceral leishmaniasis is caused by sandflies and, as the disease progresses, attacks the internal organs. Without treatment, visceral leishmaniasis can have a fatality rate as high as 100% within two years. 
  • Lymphatic filariasis (sometimes known as elephantiasis) is a mosquito-transmitted disease that is caused by parasitic worms, and which causes severe swelling and disfigurement. Over 890 million people were at risk of lymphatic filariasis in 2018 and over 35 million people are estimated to live with a chronic condition as a result of the disease.
  • Guinea worm disease is contracted when people drink water from stagnant water sources contaminated with Guinea worm larvae. The larvae develop and grow into worms that can be up to a metre long as they excruciatingly emerge through the skin! This can cause severe infection and disability. Guinea worm disease is on the verge of eradication and there are now only four countries in Africa where people still suffer from it.

Trachoma: Preventing blindness in western Zambia

Dr Kandei is a specialist in correcting blinding trachoma, the leading cause of preventable blindness in the world. He is currently working on behalf of international charity Sightsavers.

Trachoma, if untreated, causes in-growing eyelashes. With every blink, the lashes scratch the eye, causing great pain and ultimately, blindness. The disease thrives in very poor communities without access to a reliable supply of clean water, or toilets.

Eye surgeon Bruno Kandei jokes with Matakale Inonge, 76, as they discuss her forthcoming operation to correct blinding trachoma. The disease, which if left untreated, turns the eyelid and lashes inward which scrape against the surface of the eye, resulting in permanent blindness.

Matakale contemplates her forthcoming operation. She’s not overly concerned – she knows it is a relatively simple procedure. But Malumba village is in a remote part of the country, far from good roads, so Mrs Inonge is relieved her turn has come for treatment.

An eye surgeon operates on Matakale to reverse the effects of trachoma. The procedure is relatively simple and takes about 15 minutes.

Matakale is helped by her niece, Precious Mukelabai, after her operation.

As you can imagine these diseases truly disrupt and debilitate people’s lives and often are connected to wider issues of inequity and exclusion. Which is why we’re proud to say that the UK is demonstrating real leadership in the world by standing up for people who live in extreme poverty. The UK has mobilised the very best in science, industry, academic and research institutions, as well as the charity sector and among private philanthropists to end NTDs. The success of British investments targeting NTDs is something to be celebrated! Here are a few examples to be truly proud of:

Over ten years, GlaxoSmithKline (GSK), a leading UK pharmaceutical company, donated over nine billion treatments to fight both lymphatic filariasis and intestinal worms in school children. These donations have helped over 400 million children from 76 countries to stay in school and have contributed to the elimination of lymphatic filariasis in 17 countries so far.

Children at Be PA De Zouza school in Lomé, Togo receive Albendazole tablets to control intestinal worms. The nationwide deworming programme is a Togo Health Service initiative supported by GSK. Intestinal worms can lead to malnutrition and cognitive impairment.

In 2019, the UK Government launched Ascend, its flagship programme for the sustainable control and elimination of NTDs. Led and managed by a consortium of leading UK charities, academic institutions and companies (including a Sightsavers consortium, consisting of the Liverpool School of Tropical Medicine, Mott MacDonald, SCI Foundation and a Crown Agents consortium consisting of ABT Associates, Oriole Global Health and KIT Royal Tropical Institute) the programme will tackle six NTDs (intestinal worms, lymphatic filariasis, river blindness, trachoma, schistosomiasis and visceral leishmaniasis) in 25 countries across Africa and Asia, delivering close to half-a-billion treatments over three years, and protecting people from these devastating diseases.

These are some of the incredible achievements in just the first year of the Ascend programme:

  • Provided 59 million treatments in Nigeria, including 18 million for river blindness. 
  • Delivered 9.6 million treatments for trachoma, lymphatic filariasis and schistosomiasis in Zambia, Mozambique, Tanzania and Ethiopia. 
  • Provided 1.7 million treatments to school-age children across 28 districts in Côte d’Ivoire.
  • Supported health ministries in the Democratic Republic of Congo to deliver more than 48 million treatments for four NTDs – surpassing the original target by more than eight million.
  • Supported the training of more than 375,000 community volunteers and teachers to deliver the treatments for five NTDs.
  • Mapped NTDs in innovative ways, such as through the development of a mobile application in Bangladesh which can collect visceral leishmaniasis data in real time. 
  • Integrated COVID-19 screening into phone based outreach services for visceral leishmaniasis patients in Bangladesh.
  • Validated visceral leishmaniasis drug requirements globally and engaged with the World Health Organisation (WHO), Médecins Sans Frontières (MSF), and respective Ministries of Health to leverage and negotiate global pooled procurement of drugs for visceral leishmaniasis.  

You can learn more about successes in West Africa here and across Eastern and Southern Africa and South Asia here.

Another great example of great British leadership in tackling NTDs is The Queen Elizabeth Diamond Jubilee Trust’s Trachoma Initiative, a time-limited charitable foundation, established in 2012 to celebrate The Queen’s Diamond Jubilee. In the six years of its operations, (2014-2019), the Trust provided over 26 million antibiotic treatments to prevent the spread of trachoma and provided sight-saving surgery for 104,020 people and built or upgraded over 81,000 latrines and washing facilities to prevent the spread of infection.

Elimination of these diseases as a public health problem is possible, and this should give us cause for optimism. In 2018, the WHO announced that Ghana had eliminated blinding trachoma as a public health problem.

And, earlier this year, Malawi was certified for eliminating lymphatic filariasis as a public health problem. These are just two of the 33 countries that have achieved elimination of NTDs since 2012.

Wendy Morton, MP and Minister for European Neighbourhood and the Americas at the Foreign, Commonwealth & Development Office (FCDO), described the huge effect UK investments can have when directed toward preventing and/or treating NTDs: “I’m pleased to see that UK investment is really delivering tangible results” she said.

“In the last three years, our programmes have supported treatment or care for over 160 million people. We have distributed millions of pounds of medicine, generously donated by pharmaceutical companies. This has prevented the devastating effects of these diseases on family’s livelihoods and children’s school attendance. It is helping to protect so many future livelihoods.”

Wendy Morton MP

 These incredible achievements – in some cases, seeing diseases eliminated in countries where they have caused immense suffering for thousands of years – don’t only have benefits in countries affected by NTDs but, by building stronger health systems, can help to safeguard the world from future health shocks, like COVID-19.

With such huge contributions like the ones mentioned above, the United Kingdom continues to play a huge and important role in helping people live happier, healthier lives – thank you, Britain!