More than one billion people around the world are affected by one or more neglected tropical diseases (NTDs). These diseases can cause severe disfigurement and disabilities including blindness, developmental disabilities and malnutrition and result in the stigmatization of NTD-affected persons. Yet, in more than a decade of NTD programming, USAID and its partners have accomplished what many would have considered impossible: through close collaboration with the private sector—in which pharmaceutical companies have donated $29.9 billion worth of drugs to USAID-support countries—and technical support from the global development community, 13 USAID-supported countries have eliminated (and many more countries are expected to eliminate) at least one NTD within 5 years.
The Challenge
The U.S Agency for International Development (USAID) Act to End NTDs | East program is supporting 13 countries in Africa, the Americas and Asia to reach their NTD control and elimination goals. Building on a decade of experience, country-ownership of NTD programs is paramount to success and sufficient in-country technical and financial resources are necessary for program sustainability. This requires that NTD activities be incorporated into health planning, budgeting and financing, and connected to other sectors and ministries that support the delivery of NTD services.
The Opportunity
NTDs are a diverse group of 21 diseases that are often debilitating and causing life-long disability but are also preventable and treatable with safe and effective interventions. As a proportion, NTDs affect more people than HIV/AIDS, malaria and tuberculosis combined, but only receive a fraction of the support for implementation, research and primary care.
Treatment for NTD-affected populations requires a robust healthcare workforce trained to treat NTDs, established supply chains to transport and deliver medicines, and integrated health systems that can identify NTD-affected populations and track disease control and elimination. Through donor-support, many countries have responded to NTDs by establishing national programs but now these programs increasingly need a multi-sector government approach to remain viable in the longer-term. NTD interventions must be a routine part of national systems to expand services where needed and to maintain NTD control and elimination. Increased country awareness of NTDs among ministries and capacity to advocate for NTD interventions are required to fully incorporate NTD programs into national governance, finance and planning processes.
Our Work
RTI has been working with USAID to control and eliminate NTD’s since 2006. Through the ENVISION project, RTI has supported countries with on-the-ground implementation in 19 NTD-endemic countries, strengthening ministries of health and their national NTD programs.
Under Act to End NTDs | East, RTI leads a consortium of implementing partners to engage countries in the development and implementation of sustainable control and elimination plans for seven NTDs including lymphatic filariasis, trachoma, onchocerciasis, schistosomiasis and three intestinal worms known collectively as soil-transmitted helminths (hookworm, ringworm and whipworm). This work helps countries accelerate progress, address barriers with innovation, document and share successes, identify long-term control platforms and strengthen local capacity for planning, budgeting and delivery so that NTD programs can continue with high levels of effectiveness.
As a result of Act | East:
- 1.6 billion people have received treatment for an NTD
- 391 million people no longer require treatment for lymphatic filariasis
- 196 million people no longer require trachoma treatment
A consortium of partners carry-out this work, merging expertise across NTDs; water, sanitation and hygiene (WASH); health systems strengthening; education; governance; nutrition; and gender equity to support sustainable and country-led approaches based on proven, cost-effective NTD interventions. R4D plays a key role in the project’s ‘sustainability’ agenda, which aims to equip change agents at the national and community levels to more fully assume programmatic and financial responsibility for NTD programs. Currently, many national NTD programs are heavily reliant on donor funding, which threatens the long-term viability of NTD programs as new global health challenges and endemics emerge.
R4D’s approach to sustainability is focused on the local health system. This approach raises the visibility of NTDs in health resource allocation discussions and increases the efficiency of health interventions by leveraging existing delivery platforms such as universal health coverage or integrating NTDs into broader financing reforms. Often country-funding for the control and elimination of NTDs comes from the federal/national level, but the local health system (subnational) efforts are also crucial for achieving NTD goals. R4D equips countries with tools to advocate for increased NTDs at the subnational level during planning and budgeting processes. This increased capacity is particularly important in decentralized settings where local governments have more authority to approve health plans and budgets and prioritize and allocate funds for health interventions. By raising awareness of NTDs and then prioritizing these diseases in subnational health plans and budgets, local governments are held accountable for meeting their annual commitments to NTDs, all the while increasing domestic financial ownership of the NTD program.
Photo: RTI International ©
