Treating NTDs:

Current efforts focus primarily on mass drug distribution for the control or elimination of seven of the most prevalent neglected diseases - trachoma (eye infections), soil-transmitted helminths (hookworm, ascaris, trichuris), onchocerciasis (river blindness), schistosomiasis (snail fever) and lymphatic filariasis (elephantiasis). Some of these diseases can be treated with a single donated or inexpensive drug, while others require a combination of drugs. There are four drugs required to treat all seven neglected diseases and they are donated through a designated program set up by the pharmaceutical manufacturers.

Mass Drug Administration 2006

Drug Donations

The pharmaceutical donations make NTD control efforts feasible by reducing programmatic costs and enhancing sustainability at the country level.  As can be seen above, the majority of the drugs are donated; only three need to be purchased (for only a few pennies each).  

Since 2000, Merck reported the approval of over 120 million treatments of Mectizan and albendazole, while the International Trachoma Initiative reports administering 41 million doses of Zithromax. The drug donations themselves are valued at over US $1 billion, and represent the largest drug donation in history.

The details of the donation programs are outlined in the table below.

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The PUSH Fund

The PUSH Fund has been established to fill the funding gap.  Praziquantel, Diethyl Carbamazine and Albendazole (for STHs), the only drugs that are not donated, which will be covered by this PUSH Fund.                                               

Overall Benefits of Rapid Impact Package

• Inexpensive, safe and simple dose
• Easy to implement
• Streamlines efforts to control NTDs
• Decreases medicine delivery costs
• Promotes global heath partnerships
  
• Pro-poor  and non-discriminatory
• Improves worker productivity
• Increases school attendance
• Contributes to the fight against poverty

 Cost Savings of Rapid Impact Package

Armed with four drugs, three of which are donated, the major initiatives in Africa could integrate control of seven major neglected tropical diseases (NTDs) targeting over 90% of the disease burden. This health package (combination of drugs) would make a rapid impact on the morbidity, blindness, and skin disease at an estimated minimal cost of about US $0.50 per person per year. At this relatively low cost, the benefits of an  NTD control program are enormous, with a positive impact on the health, growth, physical performance, educational performance, cognitive function, and future wage earnings of children. Adults may also benefit from improved productivity due to treatment.

 Compare Annual Cost to HIV, Malaria and TB

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 Compare to Deworming a Dog for a year

Challenges to Integration

While integrated NTD control holds great promise for positively impacting the lives of millions of the world’s poorest, there are several challenges anticipated in the near and long term. Such challenges include, but are not exclusive to:

• Additional costs required for the monitoring of drug use and the development of new tools for neglected disease control, as well the promotion of related research activities
• In some areas, certain drugs may prove to not be very effective, especially when used in single dose
• The possibility of emerging resistance, which has shown to be common for intestinal worms that infect livestock
• Obstacles encountered in integrating different vertical control programs, which include reconciling disparities between programs, such as the identification of common target groups
• Potential political hurdles in persuading each non-governmental organization or public-private partnership working in Africa to cooperate on disease control efforts to fully integrate activities
• Challenges may be encountered in the scaling up of integrated programs. Scale-up will require committed support for baseline mapping of prevalence of individual neglected diseases, scientifically vetted treatment protocols, and appropriate alignment of these efforts with regional and national heath policies
• At risk populations are difficult to reach due to living in remote areas or not attending school
• National level health systems strengthening for NTD management will need to be built for long term sustainability

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