Last year, one of seven inhabitants of the planet was treated for at least one of the 20 neglected tropical diseases listed by the WHO. This achievement paves the way to a more ambitious goal: that of universal health coverage, as emphasised in the fifth progress report of the London Declaration, published by Uniting to Combat NTDs that every year evaluates progress and challenges in ten NTDs: Chagas disease, Guinea worm, sleeping sickness, leprosy, lymphatic filariasis, onchocerciasis , schistosomiasis, helminthiases, trachoma and visceral leishmaniosis. According to the authors, having overcome the obstacles faced by the populations affected by these diseases, such as lack of resources, remoteness or limitations resulting from the disease itself, shows that there are no insurmountable challenges to achieving high-quality universal health coverage.
The report highlights the leading role of lymphatic filariasis control and mass drug administration (or preventive chemotherapy) strategies in the progress made in fighting these ten diseases, since the number of affected people has fallen from 2,000 million in 2011 to 1,500 million in 2016. In addition, as already emphasises by the summit on NTDs that took place in April in Geneva, donors, pharmaceutical industries, NGO coalitions and researchers have played a key role in drawing attention to these diseases. This is for example the case of the Global Chagas Coalition (funded by ISGlobal, DNDi, Mundo Sano, Baylor College and CEADES) that has allowed uniting more stakeholders and raising awareness of the disease to draw attention and promote knowledge sharing.
Advances in the fight against Chagas Disease
The report underlines progress made in vector control in the endemic countries, 9 of which have been declared free of vector-mediated transmission, and in all countries except one, screening of blood transfusions is mandatory. However, access to diagnosis and treatment remains a big challenge since it only reaches 1% of the population in need, despite NGO efforts that have managed to double the number of diagnosed and treated persons in at least ten of the affected countries.
The registration of benznidazole (one of the two available treatments) in USA and Mexico, as well as the free donation of the paediatric treatment by Mundo Sano Foundation, are reasons to hope for further advances in disease control. According to the report, much remains to be done in terms of research at all levels, particularly in biomarkers to reliably evaluate treatment efficacy and in the development of new treatment schedules and diagnostic methods.
Other diseases that have seen a drastic reduction in cases have been African trypanosomiasis (or sleeping sickness) of which only around 2,100 cases remain; or Guinea worm disease, with only 26 cases reported in 2017 - a spectacular decrease if one considers that only 30 years ago 3 million people were affected by the disease.
The London Declaration
In 2012, a group of health and development organisations, donors and pharmaceutical industries signed the London Declaration on Neglected Tropical Diseases, with the aim of supporting and accelerating the elimination and eradication of ten of these diseases between 2020 and 2030, through massive drug administration strategies, as in lymphatic filariasis, or through increased innovation and disease control, as in Chagas disease.