Neglected Tropical Diseases

FY2017 Funding Recommendation:  
$125 million

 

Funding History

       Enacted   

       President's FY2017 Request   

       InterAction's FY2017 Recommendation


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Justification

 Key Facts

  • Over 800 million children are impacted by NTDs leading to blindness, deformities, and malnutrition.

  • NTDs kill as many as 400,000 people every year.

  • Of the 336 new drugs approved for all diseases in 2000-2011, only four (1%) were for neglected diseases; none were for NTDs.

  • As a result of U.S. government funding for NTDs and other global support 92.5 million people are no longer at risk for lymphatic filariasis or elephantiasis and 45.5 million people are no longer at risk for blinding trachoma *

*Indicator calculated by the population estimated to live in areas confirmed for disease prevalence below thresholds established by the World Health Organization. According to USAID’s 2014 NTD Database, managed by ENVISION.

Neglected Tropical Diseases (NTDs) are a group of 17 infectious diseases and conditions afflicting more than 1 billion of the world’s poorest people and threatening the health of millions more. NTDs are responsible for 400,000 deaths each year. NTDs cause widespread physical disability and consequently billions of dollars in lost productivity. One of the most common NTDs, trachoma, is the second leading cause of preventable blindness globally.

The NTD program administered by USAID has made important and substantial contributions to the global fight to control and eliminate seven of the most common NTDs by 2020, providing direct funding support, technical assistance, and training to 25 national NTD programs, while also informing the global policy dialogue on NTDs. Since its start in 2006, USAID’s program has leveraged more than $8.8 billion in donated medicines. USAID has supported the distribution of 1.3 billion safe and effective NTD treatments to more than 560 million people in Africa, Asia and Latin America.1

While many of the most common NTDs have treatments that are safe, easy to use, and effective, treatment options for the NTDs with the highest death rates, including human African trypanosomiasis (sleeping sickness), visceral leishmaniosis, and Chagas disease, are extremely limited. New investments are urgently needed to support research and development for new tools, including diagnostics, drugs, and vaccines for all NTDs. Since 2014, the USAID NTD Program has been investing in research and development to ensure that promising new breakthrough medicines for filarial diseases can be rapidly evaluated, registered, and made available to patients.

We recommend a funding level of $125 million for FY2017 to maximize the benefits of increased drug donations received from pharmaceutical companies; ensure that all countries supported by USAID’s program can reach national scale and maintain the great progress towards 2020 control and elimination targets; and continue to invest in research and development for new tools – including diagnostics, drugs, and vaccines – for all NTDs to ensure that new discoveries make it through the pipeline and become available to people who need them most.

 


1 As of June 2015. Source: USAID

Success Story

Haiti’s Journey to Elimination of Lymphatic Filariasis: It’s Almost Over

Neglected tropical diseases (NTDs) affect more than one billion people globally. In 1997, the World Health Organization classified lymphatic filariasis (LF), as eradicable, due to advances in diagnostic and treatment options. WHO then launched the Global Programme to Eliminate Lymphatic Filariasis, with the goal of eliminating LF as a public health problem by 2020.

Haiti is one of four countries in the Americas where LF is endemic. It is a country that faces many challenges, including high rates of infant and maternal mortality and poverty. Moreover, Haiti is still recovering from the massive 2010 earthquake that killed more than 160,000 people and displaced over 1.5 million.

In this challenging context, the National Program to Eliminate Lymphatic Filariasis (NPELF), part of the Haiti Ministry of Public Health and Population (MSPP), has achieved remarkable gains, with financial support from USAID through the ENVISION project. ENVISION is led by RTI International and implemented by IMA World Health in Haiti. Other implementing partners include the University of Notre Dame and l’Hôpital St. Croix.

Since the start of mass drug administration (MDA) for LF in 2000 and soil transmitted helminths in 2004, over 35,000 community drug distributors and community leaders have been trained and mobilized to carry out MDA. The drugs, Diethylcarbamazine and Albendazole, help stop the spread of infection and can lead to the elimination of LF when at least five rounds of annual MDA are carried out with at least 65% population epidemiological coverage.

By 2014, 48 of Haiti’s 140 communes were eligible to conduct transmission assessment surveys (TAS) to determine whether they could stop treating the population. Passing a TAS in a given area is an incredible milestone toward elimination, since it means that infection has been reduced to levels where transmission is assumed to be no longer sustainable and recurrence is unlikely to occur.

With strong buy-in and support from MSPP and the National Laboratory, 26 dedicated MSPP and partners’ lab technicians were trained to conduct TAS. From November 2014 through June 2015, the NPELF and implementing partners carried out TAS, a logistically complex, two to three-week survey, in hundreds of schools and communities testing over 16,000 children using the immunochromatographic card test (ICT), an approved rapid diagnostic for LF. In 46 of these communes, the number of ICT-positive cases was below the critical cutoff, meaning these communes passed the TAS and no longer need treatment. 

From 2016-2019, an additional 94 communes will be ready for TAS. If they all pass TAS by 2019, there may be no communes left needing treatment, and Haiti will be on track to achieve its 2020 LF elimination goal. Haiti’s story is an inspiring example for other national LF programs, and elimination in Haiti would be a significant contribution in the global effort to eliminate the disease. Haiti’s achievements demonstrate how USAID’s ENVISION project helps strengthen national NTD programs to rapidly and effectively scale-up in some of the most challenging environments. 

Photo: IMA World Health

 

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