An interview with Dr. Maria Rebollo Polo, Team Leader at ESPEN – World Health Organization, Regional Office for Africa
First things first Maria, can you please tell us about Neglected Tropical Diseases and how they impact communities across Africa?
NTDs are some of the most important group of diseases in the world. They make up a varied group of infectious diseases that, as the name would suggest, have long received little attention on a global scale. As a result, far less investment has been dedicated to NTD treatment and research, despite the devastating effect that this group of diseases has on public health.
Approximately one-third of those affected by NTDs live in Africa and diseases like NTDs like trachoma, onchocerciasis, lymphatic filariasis, helminthiasis and schistosomiasis can debilitate overall health and cause disability. Tragically as a result, communities across the continent suffer from the pressure that this places on their families, on the health care systems and the economy too.
But there is some good news. NTDs are both curable when you detect them early and preventable, and so the devastation that they cause can be minimised and even eliminated altogether over time. It is up to us to invest more strongly in their treatment and prevention so that we can alleviate this unnecessary suffering.
It’s devastating that NTDs don’t tend to receive the same level of funding and global attention as other more well-known diseases. Can you tell us about the wider benefits that investing in NTDs can have?
Only 0,6% of global healthcare funding goes to controlling NTDs, but the truth of the matter is that by investing in NTDs we can make massive strides against both NTDs and other problems that share the same origins. For example, poor sanitation and a lack of clean water are at the root of many diseases. In this sense, investing in sanitation systems and access to safe, clean water for hygiene and comsumption would not only prevent the onset of NTDs but it would also minimise other serious threats across Africa, such as COVID-19 or diarrheal diseases. Furthermore, NTD programs also offer an access platform for medical interventions against COVID-19 and other future health threats. Therefore, investing in NTDs is hugely beneficial, as it can help improve health conditions, strengthen health systems on the continent and advance sustainable development across Africa.
With the world currently battling COVID-19, do you think it is also important that we keep a focus on NTDs?
Whilst the world continues to battle COVID-19, it is critical that we do not allow the pandemic to reverse years of hard fought progress against NTDs. So far in 2020, NTDs have caused far more diseases, disability and mortality in Africa than COVID. Schistosomiasis alone cause up to 130,000 stimated deaths in the continent in the absence of the live saving treatment praziquantel. It’s up to us to keep the pressure on. Several African countries have diverted all their NTD workforce to the COVID-19 response and this has been extremely disruptive. It should be noted that those suffering from NTD morbidity fall into the higher-risk group for COVID-19 due to the way in which NTDs compromise sufferers’ immune systems and overall health. People affected by NTDs are also more at risk because they generally live in poverty, lacking resources, hygiene, and access to health systems. People suffering from NTDs, often live in poverty which typically equates to living in very crowded conditions and not being able to keep minimal social distancing and hygiene strategies. NTDs perpetuate the cycle of poverty and disease. We must therefore fight COVID-19 and NTDs in tandem, and by doing so help protect hundreds of millions of people at risk of NTDs across Africa.
This is clearly such an important cause. How does your work at ESPEN help contribute to fighting NTDs?
It really is vital, which is why the Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN) has made it its mission to fight NTDs and control and eliminate them entirely by 2030. ESPEN’s focus is to accelerate the elimination of the most prevalent NTDs in Africa that can be prevented and treated by Preventive Chemotherapy delivered through Mass Drug Administration, complemented by hygiene, water, and sanitation, the most cost-effective elimination strategy against NTDs.
We have seen one more time through the COVID pandemic how critical is to have access to good quality real-time data: ESPEN’s data portal enables health ministries and stakeholders to share and exchange subnational high-quality program data to help support the battle against NTDs. Those affected by NTDs often belong to the world’s poorest and most remote communities, and ESPEN is fighting to make sure that these people are not forgotten.
Congratulations to you and your team! How has ESPEN been able to facilitate progress?
Together with the help of international communities, ESPEN has already been able to accomplish a great deal so far! We have managed to improve access to data, scale up treatment and enhance the capacity of countries across 45 countries in Africa, like Congo and South Sudan, to effectively deliver NTDs interventions. Recently, Togo and Egypt managed to eliminate public health problems one NTD, and elephantiasis, and Ghana has eliminated trachoma as public health problem too, freeing millions from suffering, disability, and blindness. With amazing progress like this already being achieved, it is clear the goal of eliminating NTDs is within our reach if we truly keep focus and do not divert our resources and attention.
What do you think are the main obstacles that you currently face in achieving these goals?
With the fight against COVID-19 is still very much at the forefront of everyone’s minds, there is a risk that attention and funds could shift towards the prevention and treatment of coronavirus, which could threaten the progress we’ve achieved against NTDs. Yet, investment into NTDs is relatively inexpensive, with treatment for the top five NTDs costing less than $0.50 per person per year. We therefore now need to help spread the awareness that investing in NTDs will greatly help to protect those at risk while fighting COVID-19 at the same time. We have the tools, we have the drugs, we have the data, and we have the solutions. We are so close to the finish line and we need to keep the momentum going. Trying to combat COVID in a vertical manner doesn’t make any sense while relying on a very well-structured platform of NTDs at the community level provides an excellent strategy to tackle both COVID and NTDs.
Finally, what do you think the future holds for the fight against NTDs and what must we do together to help eliminate these devastating diseases?
2021 is set to be a big year for the fight against NTDs, as in early January the 2030 NTD roadmap will be launched by the World Health Organization. At the African Level, the ESPEN framework 2021-2025 and the Continental framework for NTDs from the African Union will be launched at the same time. The goals set out in these documents will be critical to guide the next decade of action and progress against neglected tropical diseases. We must work together in our battle to improve the wellbeing of the population, whether it’s NTDs or COVID-19 the threat they face, in order to ensure that those most vulnerable get the necessary support to prevent the spread and have access to treatment. In Africa, we cannot just accept avoidable deaths and complications from NTDs. As public health leaders, we must stand together and end this suffering for good. Our people deserve it.