Neglected Tropical Diseases in Pakistan
Neglected tropical diseases (NTDs) disproportionately impact vulnerable populations in some regions of Asia, Africa and Latin America. These conditions, such as intestinal worms, schistosomiasis and dengue fever, are preventable and treatable. They are common in areas with poor sanitation and limited or no access to clean water and health care. NTDs in Pakistan keep communities trapped in poverty and illness. Furthermore, NTDs harm physical and cognitive development, reduce school attendance and economic productivity and overwhelm underfunded health systems.

Pakistan faces significant health and economic challenges due to several NTDs that are considered high-burden. However, it has been effective in community engagement, prevention education, as well as diagnosis and treatment to control NTDs in outbreak areas. Assessing the impact of these targeted initiatives can inform comprehensive national strategies to alleviate the burden of NTDs and improve health equity across Pakistan.

Community-Based Efforts Against Intestinal Worm Infections 

Intestinal parasitic infections disproportionately impact children in underdeveloped countries. About 12% of illnesses that intestinal parasites cause in children aged 5 to 14 years occur in underdeveloped nations. In 2019, the First Lady of Pakistan, Samina Alvi, launched a school-based deworming program in coordination with the health and education ministries to treat intestinal worm infections in children. A national survey revealed alarming infection rates, with approximately 17 million school-age children across Pakistan requiring deworming, including around 574,000 in Islamabad. The Islamabad Deworming Initiative aims to treat 547,000 children aged 5–14 in Islamabad to overcome intestinal infections. It successfully treated more than 200,000 children in 2019 and planned to reach 574,000 in the next round.

Targeted Snail Control to Combat Schistosomiasis

Schistosomiasis is a chronic parasitic disease causing great morbidity and mortality, with more than 220 million people infected globally as of 2021, predominantly in sub-Saharan Africa. Schistosomiasis is a rare disease in Pakistan, but the risk factors of dams, irrigation, increased travel and proximity to endemic countries could lead to endemicity. At least one snail species that could potentially host the parasite is present locally. Though control efforts focus on eliminating snail populations and contamination sources, a case acquired from travel to an endemic country highlights the need for prompt treatment and health education to prevent the spread in Pakistan. Reducing schistosomiasis risks through these measures is important to alleviate poverty and improve health for vulnerable communities lacking access to clean water and health care.

Fighting Dengue Fever in Pakistan

Dengue is endemic in Pakistan with seasonal peaks, but the country has experienced a significant surge in cases in 2022 following severe flooding. From January to September 2022, more than 25,000 confirmed dengue cases and 62 deaths occurred nationally, with the majority of cases in September. Sindh and Punjab provinces have been the most affected. Pakistan’s health ministry and the Global Fund are conducting vector surveillance, control activities and enhancing clinical management capacity. The World Health Organization (WHO) provides additional coordination, training, diagnostic tests and other support. Priorities like piped water and waste management infrastructure remain vital to control dengue transmission long-term and reduce impacts on vulnerable urban populations. However, the current flood-driven outbreak highlights the need for ongoing readiness to mount coordinated responses that curb massive case surges.

Integrated NTD Programs with Broad Coverage

NTDs disproportionately impact vulnerable populations in developing countries like Pakistan, trapping affected communities in cycles of disease and poverty. NTDs impair childhood development, reduce school attendance, hinder economic productivity and overwhelm under-resourced health systems. Comprehensive multi-disease control initiatives with national reach are necessary to alleviate the overall NTD burden. Sustained political commitment and domestic and global funding focused on evidence-based interventions could help reduce the transmission and prevalence of neglected tropical diseases in Pakistan. 

Given appropriate investments and strategies, controlling multiple neglected tropical diseases in Pakistan could improve health security and economic outcomes among its poorest and most marginalized citizens. Fighting NTDs is an important component of equitable development and poverty reduction in affected countries.

– Asia Jamil
Photo: Flickr

the END FundNeglected tropical diseases (NTDs) are a group of diseases caused by a variety of pathogens that are common in low-income regions. The World Health Organization WHO) and the Centers for Disease Control and Prevention (CDC) categorize 20 diseases as NTDs. They affect more than one billion people around the world, with more than a third of people affected by NTDs living in Africa. While about one-sixth of the world’s population suffers from at least one NTD, more attention is often brought to other diseases, such as HIV/AIDS and malaria. While these other diseases require a high level of attention, NTDs need prioritization too. The effects of NTDs can last for decades if proper care is not sought out as many have the ability to bring on permanent blindness and disfigurement. It is of the utmost importance that NTDs are addressed and one such organization putting in the work is the END Fund.

The END Fund

The END Fund is a nonprofit organization that seeks to protect the lives of people at risk of NTDs. It delivers treatments by working with local partners, understanding that these groups have regional expertise and know the needs of their area best.

The END Fund helps its partners design programs so that they can expand their capacity to collect important data regarding NTDs. Further, the END Fund provides technical support and monitors progress so its partners can fight disease in the most effective way possible.

It also collaborates with non-governmental organizations and seeks to involve all stakeholders in order to improve the lives of those at risk of contracting NTDs. The END Fund is active across many countries in sub-Saharan Africa as well as India and Afghanistan. It has programs in Nigeria, Ethiopia, the Democratic Republic of the Congo, Somalia and others.

NTDs in Nigeria

The country with the greatest prevalence of NTDs in Africa is Nigeria. With a population of 195 million people, five of the most common NTDs are present: intestinal worms, lymphatic filariasis, river blindness, schistosomiasis and trachoma. These diseases can cause severe pain that inhibits people from going about their daily lives. Children miss out on their education and adults miss out on economic opportunities. NTDs can cause the already impoverished to sink even deeper into poverty.

In 2013, the END Fund arrived in Nigeria. Two years later, it partnered with Helen Keller International to support local partners, the Amen Foundation and Mission to Save the Helpless (MITOSATH). It has since helped build the capacity of these groups so that they can respond to the issue of NTDs even stronger. It engaged with local leaders across many levels to make people aware of the treatment plans that are available. Among traditional groups, leaders took medication in front of many people to show that it was safe.

The End Fund’s Impact

In 2019 alone, the END Fund was able to treat 121 million people. The END Fund also trained 2.7 million healthcare workers between 2012 and 2019. Its workers have performed almost 31,000 surgeries during that same time period, with the treatments valued at more than $1 billion.

NTDs pose a great threat to people in developing countries. The END Fund has been able to accomplish a lot through its collaborative projects in Nigeria and across other countries. The END Fund will continue to work toward its vision of ensuring that people at risk of NTDs can live healthy lives.

– Evan Driscoll
Photo: Flickr

countries that have eliminated trachoma

Neglected tropical diseases (NTDs) affect more than 1.4 billion people in 149 countries. These diseases flourish in areas of the world where there is a lack of basic sanitation, which means that the global poor have the highest risk of contracting them. These diseases are preventable and treatable, but due to a lack of resources and aid, millions of people still suffer from these diseases that can cause them to be disfigured, disabled and may even result in death.

However, with the help of several different organizations and national campaigns, many countries have successfully eliminated some NTDs, including trachoma, which is the leading cause of blindness in the world. Trachoma is a bacterial eye infection that affects the eyes and eyelids, causing the eyelashes to turn inward toward the eye leaving patients blind.

Here are three countries that have eliminated trachoma.

3 Countries That Have Eliminated Trachoma

  • Ghana – In 2018, Ghana became the first country in West Africa to eliminate blinding trachoma. Three groups were instrumental in this effort: FHI 360 – a nonprofit human development organization; END in Africa Project (financed by USAID) and Ghana Health Service’s NTD program. Working together, the three organizations eliminated blinding trachoma over an eight-year period. From 2010 to 2018, the END in Africa Project supported the global distribution of more than 464 million NTD Program treatments for trachoma and other diseases. They also mapped disease distribution, treated at-risk populations and monitored treatment impact while also documenting successes along the road to eliminating this terrible disease. FHI 360 provided technical and financial assistance for trachoma post-treatment surveillance, which will help with further prevention of the disease. The program’s long surveillance and treatment of patients is a testament to its dedication and commitment to ending NTDs.
  • Laos – In 2017, Laos became the fifth endemic country in the world to eliminate blinding trachoma as a public health problem. Blinding trachoma was especially common among young children. The United States government had been supporting Laos since 2012 through several USAID projects, such as END in Asia and ENVISION. These projects assisted the Ministry of Health in collecting reliable data on the status of trachoma, which helped determine the correct approach to eradicate the disease. Laos was able to place ophthalmologists at national, provincial and district levels to detect and operate on cases of patients with the disease. The projects also trained primary health care workers to screen patients for trachoma, and they gave patients with less severe conditions the antibiotic eye treatments they needed. Nongovernmental organizations also helped train health volunteers in villages on ways to prevent trachoma. Education ministries invited volunteers to come to their schools and educate their students on facial cleanliness and showed how the infection spread from person to person. Laos achieved amazing success with its partners, working to not only diagnose and treat the disease but also to educate people on how to prevent trachoma.
  • Mexico – Mexico became the first country in the Americas and the third country in the world to officially eliminate trachoma in April 2017. In 2004, the Secretary of Health of the state of Chiapas formed a group of health professionals called Trachoma Brigades to implement SAFE, the strategy recommended by the World Health Organization to eliminate the disease. In their fight against this disease, Mexico provided surgery for people at imminent risk of blindness, administered antibiotics in affected communities to reduce infection in children as well as to stop transmission, promoted personal hygiene and improved environmental conditions. The SAFE strategy’s 4 interventions have been especially successful in the state of Chiapas. Trachoma was endemic in 246 communities in the state and affected over 146,000 citizens. Trachoma Brigades, alongside national, state and community efforts and international partners, eradicated this disease. Trachoma Brigades visited communities several times a year to conduct surveys, eye examinations, identify cases, administer antibiotics, educate children about proper hygiene and perform surgeries.

These three countries worked for years to eradicate this trachoma and improve their citizens’ quality of life. The combined efforts of multiple organizations and governments brought medication, surgeries and public education to these countries toward achieving this goal. In addition to Ghana, Laos and Mexico, countries such as Cambodia, Togo, The Marshall Islands, Oman and Morocco have also made progress against this disease.

It is a U.S. foreign policy objective to support the treatment, control and elimination of Neglected Tropical Diseases (NTDs). The World Health Organization recognizes 17 NTDs which currently afflict 1.4 billion people around the globe. Urge Congress to support the End Neglected Tropical Diseases Act to advance U.S. foreign policy interests and safeguard national security.

Email Congress to End NTDs

Jannette Aguirre
Photo: WHO

Fighting Neglected Tropical Diseases
Neglected tropical diseases (NTDs) are a group of diseases such as Dengue fever, rabies, hookworm and sleeping sickness that collectively affect more than one billion people around the globe. These diseases are crippling, but very often preventable and treatable. The world stands to gain a great deal from even moderate investment into fighting neglected tropical diseases.

Impact of NTDs

Neglected tropical diseases are widespread in sub-Saharan Africa, Asia and South America. They disproportionately affect the world’s poor and make it even harder for these people to climb out of poverty.

These diseases collectively kill hundreds of thousands of people each year and they significantly harm hundreds of millions more. NTDs can lead to sickness, deformities and even blindness. Infected children are also at risk of malnutrition and stunted growth.

These symptoms cause more than personal suffering; they also threaten the long-term development of entire communities. Adults afflicted by these diseases are often unable to work or care for their families and may become socially isolated. Affected children are often unable to regularly attend school to learn the skills they need to help themselves and their communities.

Taken together, the effects of neglected tropical diseases add up to billions of dollars in lost productivity. Those losses are hard to absorb for these already-impoverished areas.

Effectiveness of Treatments

The good news is that fighting neglected tropical diseases is easier, cheaper and more efficient than dealing with many other widespread health issues. These diseases are preventable and some, like river blindness, are treatable with currently available drugs.

Since several of these diseases are often concentrated in a single area, effective treatment of one often helps with others as well. Several of the most effective drugs are also available for free as donations from their developers. It is likely that half a billion people suffering from these diseases could be treated for less than $400 million.

With this in mind, there is a very real chance that the impact of neglected tropical diseases could be severely reduced within a generation. The World Health Organization even has a goal to completely eradicate two or more by 2020. To achieve this goal, though, it is likely that the international community will have to make a greater commitment to cooperate in fighting neglected tropical diseases.

U.S. Response to Fighting Neglected Tropical Diseases

In recent years, U.S. efforts to support researching and treating neglected tropical diseases have amounted to little more than treading water. Congress has had to renew support for existing research centers on a yearly basis since long-term authorization ended in 2009. This may be changing soon, however.

In November, the End Neglected Tropical Diseases Act was sent out of committee to be considered by the full House of Representatives. While it is still in a relatively early stage, the bill has already been cosponsored by representatives from both parties.  

If implemented, the bill would protect current research funding and keep Congress more directly informed about neglected tropical diseases. It would also shift U.S. policy into directly supporting the international effort against them. Specifically, U.S. representatives at the U.N. and World Bank would be instructed to promote researching, monitoring and fighting neglected tropical diseases.

While the bill does not allocate a great deal of money for the problem (the CBO estimates that the bill will cost only $14 million over five years), the End Neglected Tropical Diseases Act would be the first step in years toward more directly involving the U.S. in this crucial global health issue. With continued U.S. and international efforts, these diseases may no longer be so neglected.

– Josh Henreckson
Photo: Flickr

According to information released by the World Health Organization in 2015, the world has made major progress on reducing tropical diseases. Sixty percent of the 1.3 billion people who suffer from Neglected Tropical Diseases (NTDs) received some form of treatment, and NTDs all over the world are decreasingly significantly, with some close to eradication.

To this effect, Dr. Margaret Chan, Director-General of the World Health Organization, stated, “Over the past 10 years, millions of people have been rescued from disability and poverty, thanks to one of the most effective global partnerships in modern public health.”

In 2015, reported cases of sleeping sickness were lower than ever in recorded history. There were only 3,000 total cases of sleeping sickness, an 89 percent drop from the year 2000.

In the same year, there were only about 25 cases of guinea worm disease, down from 3.5 million in 1986. Guinea worm disease is a parasitic worm that is ingested via contaminated water and can live inside the host for up to a year. The disease causes extreme pain, nausea, fever and vomiting.

The world’s leading cause of infectious blindness, trachoma, was eradicated as a public health problem in Mexico, Morocco and Oman. More than 56 million people worldwide received antibiotics for trachoma.

Other noteworthy items from the report on progress on reducing tropical diseases include that 556 million people were treated for elephantiasis, 114 million people received treatment for river blindness and, overall, one billion people were treated for NTDs in 2015.

The World Health Organization credits the progress on reducing tropical diseases to political support, donations of medicines and living condition improvements worldwide. This past month, pharmaceutical companies, government representatives and charity organizations met for a summit in Geneva to further the progression of the fight against NTDs, and $812 million was pledged towards the goal of complete eradication.

However, there is still plenty of progress to be made. This same report attributes further gains as connected to the Sustainable Development Goals, noting that there are still 2.4 billion people that do not have access to basic sanitation facilities and that more than 600 million people get their drinking water from inadequate sources.

Dustin Jayroe

Photo: Flickr