How COVID Has Affected the Control of Neglected Tropical Diseases

A case of advanced liver pathology (hepatomegaly) due to schistosomiasis in a 5-year-old. Prof Takafira Mduluza

Mar 14 2022 (IPS) – is an umbrella term used to describe a group of 20 infectious diseases. These diseases affect over 1.7 billion people. They can disable, debilitate and even kill. The world’s most vulnerable and poorest are most affected.

In the past, the diseases in this group have been overlooked internationally and poorly funded domestically: hence the “neglected” in the name. Some common neglected tropical diseases are , and .

There are already these diseases. They include drugs, vector control, veterinary public health interventions and provision of safe water and toilets.

In the past 10 years there have been significant global efforts to control neglected tropical diseases. In 2012, pharmaceutical companies, donors, endemic countries and non government organisations came together to sign the . Together, they committed to control, eliminate or eradicate ten of these diseases by 2020 and improve the lives of over a billion people.

Support from the signatories ranged from to financing the of the drugs, research, and funding for sanitation and safe water. These concerted global efforts have yielded successes and are grounds for optimism.

To date, people no longer require treatment for neglected tropical diseases. Cases of some of these diseases, such as leprosy, sleeping sickness and Guinea worm disease, are at an all-time low. Forty-four have eliminated at least one neglected tropical disease as a public health concern. Most recently the and eliminated trachoma, a bacterial infection which causes blindness.

However, this progress is now at real risk of reversal as a result of the . Drug programmes have been interrupted, health budgets re-prioritised and aid cut.

As I have , interrupting control programmes could lead to rebound infections and disease. These could be worse than the original levels. This is now an imminent reality for neglected tropical diseases if control programmes do not resume quickly enough.

Interrupted disease control

One of the most important tools to use against neglected tropical diseases is . This involves treating every member of a population, regardless of their infection status, because treatment is cheaper than diagnosis and the drugs are safe.

Typically the national treatment programmes are annual events conducted in schools or health centres. It takes time, effort and money to plan and implement these programmes. And it’s critical to maintain momentum. Every dollar spent on these programmes yields a significant return on investment. This is why neglected tropical disease control has been termed a .

The pandemic has affected neglected tropical disease control in three ways.

First, mass drug administration was by the . And disruptions in global trade and transportation affected supply chains. A recent indicated that, as of early 2021, disruptions in neglected tropical disease control programmes occurred in 44% of countries.

Second, national governments in neglected tropical disease endemic countries have low health budgets. during and after COVID-19 has meant that the resources allocated to neglected tropical diseases may be shifted to .

Third, a significant amount of funding for neglected tropical disease control programmes comes from international development partners and foreign governments.

Post-COVID-19 economic contraction in their economies and shifts in funding priorities are threatening the gains made in controlling neglected tropical diseases. For example, recently withdrew over £150 million of funding to neglected tropical disease programmes as part of cuts to the country’s aid budget.

This out a third of donor funding for tackling neglected tropical diseases, with an impact on treatments to and as many as 180,000 surgeries to prevent disabilities.

Long term consequences

Continued neglect of these diseases has dire consequences. Those affected continue to suffer the devastating diseases, associated health inequities and cycles of poverty. The effects of these diseases are pervasive and wide-ranging.

As long as neglected tropical diseases are a huge burden on health systems in endemic countries, these countries will continue to haemorrhage resources, finances and lives to these diseases. This will further weaken their health systems, compromising their ability for timely surveillance, detection and containment of the next epidemic.

From the , we know that weakened health systems anywhere in the world compromise health security globally. Local health security is the foundation for global health security, as COVID-19 has amply demonstrated.

The opportunity to put global attention back on neglected tropical diseases will come later this year when the London Declaration is superseded by the . This high-level political declaration, led by Rwanda and Nigeria, aims to mobilise political will and secure commitments to achieve for these diseases.

It is important to remember that controlling neglected tropical diseases is in the best interest of all countries – those where the diseases are endemic and those where they are not.

, Professor in Global Health Infection and Immunity. and co-Director of the Global Health Academy,

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