By Kelly Bridges (Colleges ’16), Senior Associate
Global Water 2020
March 19, 2020
2020 has been dubbed by many in global health as the Year of Neglected Tropical Diseases, or NTDs. Ringing in this momentous year, the global community celebrated the first-ever World NTD Day on January 30th, with nearly 100 events hosted online and in 35 countries across Africa, Asia, the Americas, and Europe. At the World Health Assembly in May, Member States will consider a Resolution on NTDs, reaffirming their commitment to disease control, elimination and eradication. Accompanying this resolution, the World Health Organization (WHO) is preparing a roadmap to guide countries, as well as donors, non-governmental organizations, academia and other stakeholders, toward the ultimate goal of eliminating and controlling NTDs by 2030 so that 90% fewer people require interventions against NTDs. Partners in the fight against NTDs will also convene in Kigali in June and Kathmandu in September to announce political, financial and in-kind commitments in support of the new roadmap, as well as exchange best practices and present research findings.
So, what are NTDs and why is the world rallying around this global health challenge in 2020?
NTDs are a grouping of 20 viral, bacterial, protozoan and helminth infections found in 149 countries. These diseases affect over 1 billion people, largely those that are marginalized and living in extreme poverty. Even in the United States, it is estimated that 12 million Americans—predominantly in Alabama, Texas, Louisiana, Mississippi and Florida—are living with at least one NTD, prompting Senator Cory Booker of New Jersey to introduce a domestic bill, the Study, Treat, Observe, and Prevent Neglected Diseases of Poverty Act, in the Senate last October.
These diseases are incredibly painful, debilitating and, in some cases, lethal. For instance, trachoma—the leading preventable cause of blindness globally—is transmitted by flies and can result in irreversible blindness if left untreated. Repeated bacterial infections cause the eyelashes to invert so that they scratch and scar the cornea of the eyes. Approximately, 142 million people are at risk of contracting this disease, especially those living in conditions with inadequate water, sanitation and hygiene (WASH), as the flies breed where feces is not safely managed and disposed of, and—without water and soap—face washing to break transmission is impossible.
Beyond trachoma, access to safe, reliable and affordable WASH facilities, along with practicing proper behaviors, is important for 16 of the 20 NTDs across the continuum of prevention, treatment and care. Intestinal worms like roundworm, hookworm, and whipworm—which impact 1.5 billion people or nearly one-fourth of the global population—can cause chronic malnutrition and stunting in children, affecting their ability to perform well later in life academically and professionally due to impaired cognition. However, with treated water alone, the chance of being infected with these soil-transmitted helminths drops by 54%. Schistosomiasis—another disease caused by parasitic worms when coming in contact with infected waters—can be prevented by ending open defecation and urination, avoiding contact with bodies of water, promoting personal hygiene, and improving water supply and sanitation.
Other diseases also require WASH facilities and services for treatment, management and care. Lymphatic filariasis, caused by parasitic roundworms living within the lymph system, can produce painful swelling of the arms, legs, breasts or genitals. Annual losses from this debilitating disease can be as high as $1 billion, but is ultimately preventable with improved sanitation, the draining of mosquito breeding sites, and mass drug administration of preventative chemotherapies. In looking at treatment and morbidity management of lymphatic filariasis, WASH is needed in hospitals and clinics to safely carry out surgical procedures that remove excess fluids in affected limbs, and water and soap are needed at home and elsewhere to hygienically clean limbs and skin as to lower the occurrence of acute inflammatory episodes.
While significant progress has been made toward ending the plight of NTDs since WHO launched its first roadmap in 2012, much more is required to beat NTDs once and for all. With the conclusion of the 2012-2020 roadmap this year, WHO and global partners are taking this opportunity for introspection to see what is needed to sustain progress to 2030 and beyond. It has become abundantly clear that greater cross-sectoral collaboration with WASH and other sectors, such as education and nutrition, is needed to carry us across the finish line.
In the draft 2030 roadmap, made publicly available last month, there is now—for the first time ever—a global cross-cutting target for WASH that by 2030, all NTD endemic areas must have universal access to WASH services. WHO is also updating its Global Strategy on WASH and NTDs for release later this year, with implementation supported by the first-ever step-by-step guide to WASH and NTD collaboration. Even back home, Congress passed the End Neglected Tropical Diseases Act in mid-December, which demands the US Agency for International Development work in a more coordinated fashion across programs related to NTDs and WASH, among other areas.
2020 is not simply the Year of NTDs. Arguably, it is the Year of NTDs and WASH. If we are to stop and alleviate the suffering of the more than 1 billion people affected by NTDs, these two seemingly disparate communities must come together. In this final decade to 2030, there is no other way but through collaboration to sustainably achieve the ambitious goals outlined in the soon-to-be launched roadmap. Without a doubt, 2020 is starting on the right foot.
Kelly Bridges is a Senior Associate at Global Water 2020, a DC-based advocacy and facilitation initiative working to solve critical challenges in the global water, sanitation and hygiene (WASH) sector. Kelly works across the organization’s portfolio, leading efforts to integrate WASH and neglected tropical disease investments, policies and programs. Kelly graduated from the University of Pennsylvania (C’16) with a BA in Science, Technology and Society and a concentration in Energy, Environment and Technology; after which, she went on to pursue her MSc in Water Science, Policy and Management at the University of Oxford.