Address of the WHO Regional Director for Africa, Dr Matshidiso Moeti: WHO’s fight against Neglected Tropical Diseases

Submitted by on Thu, 26/10/2017 - 07:12

Honorable ministers

Dear partners

Ladies and gentlemen

It really gives me very great pleasure to be here today to celebrate with you the 30th anniversary of the Mectizan Donation Programme, which has done so much to change both the geographic and health landscape in affected African countries.

We were able to honour this game-changing commitment of Merck at the recent Regional Committee of the African Region with African Ministers of Health, partners in the fight against Neglected Tropical Diseases, and others. This was indeed a joyous occasion.

Ladies and gentlemen, Africa bears about half the global burden of NTDs, and the highest global burden of disease for Buruli ulcer, human African trypanosomiasis, and onchocerciasis.

WHO is committed to fighting NTDs which afflict the 1 billion poorest people in the world who often live in remote areas or slums, with little access to healthcare.

These diseases perpetuate the vicious cycle of poverty and disease, cause disability, disfigurement and stigma, and have detrimental effects on child development, school attendance, agriculture and economic productivity.

In the African Region, the Regional Strategy on NTDs (2013-2020) guides Member States towards implementing the global roadmap for eradication of Guinea worm disease and yaws; elimination of lymphatic filariasis, onchocerciasis, human African trypanosomiasis, leprosy and trachoma; and control of Buruli ulcer, leishmaniasis and soil transmitted helmithiasis.

MSD’s donation of Mectizan was pivotal to the success of the African Programme on Onchocerciasis Control (APOC).

By the time the APOC programme closed according to plan in 2015, the donation of Mectizan together with the innovative strategy known as Community Directed Treatment with Ivermectin (CDTI), were protecting over 110 million people annually in 19 countries, preventing over 40,000 cases of blindness each year between 1995 -2015.

The Mectizan Donation Program and the CDTI strategy became a model for successful preventive chemotherapy programmes in the fight against NTDs, and opened the door to massive pharmaco-philanthropy, with Africa as the major beneficiary.

The partnership between endemic countries, civil society, the private sector and WHO was a key factor for the success of the programme.

Thanks to generous donations of NTD drugs by the pharmaceutical industry - and the commitment of the African governments and their partners - we have the effective means to fight the five PC-NTDs: lymphatic filariasis (or LF), onchocerciasis, schistosomiasis, soil transmitted helminthiasis and trachoma.

Of these diseases, lymphatic filariasis is racing fastest towards the finish line. I’m very pleased to inform you that in 2017, Togo became the first country in Africa to achieve elimination of transmission of LF.

This success highlights what can be accomplished in the Region with sufficient resources that are used efficiently and, most importantly, if we work together in a coordinated, constructive manner. 

Through the Mectizan Donation Programme,  we can now shift the goal from control of onchocerciasis to elimination, a really ambitious achievement.

I have made NTDs a priority for WHO in the African Region, and so in May 2016, we launched the Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN), to accelerate elimination the 5 PC-NTDs from Africa.

ESPEN is a small, lean structure, nested in our Regional Office in Brazzaville, which brings together endemic African nations and the international NTD community.

ESPEN puts power in the hands of African countries and their national programmes, providing the technical advice, capacity building and financial support they need  to address key challenges and enable the full use of medicines donations.

Three main pillars support its work:

Country ownership, with strong emphasis on long term sustainability and strengthening of health systems;

A data driven approach for evidence-based action, and sharing of data with all our stakeholders to accelerate progress  towards elimination;

A trustworthy partnership with Health Ministries and all partners where we are collectively accountable for what we agree to do and achieve together.

After one year, ESPEN has already shown impressive results, due largely to this multi-sectorial, inclusive approach and a range of strategies to guide actions.

In the past year, with $15 million in start-up funds, ESPEN has

recovered 132 million tablets through supply chain analysis in seven countries;

produced the African Region’s first baseline endemicity atlas of the 5 PC-NTDs, and

launched a new NTD portal,  enabling countries to share their subnational maps and data, which is empowering health ministries and stakeholders to make informed decisions to control and eliminate NTDs.

Ladies and gentlemen: NTDs and the sustainable development agenda are inextricably linked. Simply put, we will not attain the SDGs in Africa if we don’t overcome NTDs.  

Tackling NTDs makes economic and development sense. Our efforts will help advance all the SDGs, from reducing poverty and malnutrition to improving water and sanitation, gender equality and education.

Progress made by NTD programmes has led to the development of capacities and experience that may provide valuable lessons for SDG actions in countries and potentially drive progress towards Universal Health Coverage, which is about providing equitable access to health care with minimal financial barriers.

For instance, NTD programmes are grounded in equity, reaching people in need of health services wherever they are – leaving no one behind. 

These programmes have embraced multisectoral collaboration for years, working with governments, the private sector, international nongovernmental organizations and civil society, among others.

Engaging with the private sector has ensured the availability of medicines which is a key component to achieving UHC.

Over the past year, ESPEN reached 30 million people that had never been treated before through direct support to mass drug administration (MDA) in 15 countries.

MDA is a massive logistical exercise, requiring careful planning and coordination with countries for the drugs to reach their destinations in time for successful, large-scale treatment campaigns. Other health programmes may be able to draw lessons from this.

Community directed MDA campaigns reduce demands on national capacities and resources, and alleviate the financial burden on communities at risk, in addition to keeping them well, able to generate an income and contribute to economic growth.

A final example of NTD programmes’ alignment with the SDGs is that of onchocerciasis control which led to reclamation of vast tracts of land along rivers for agriculture, contributing to achieving food security, improved nutrition and sustainable agriculture.

Now, the Mectizan Donation Programme and ESPEN are helping to strengthen health systems and attain Universal Health Coverage through essential health interventions for NTDs.

In turn, UHC and strengthened health systems will serve the millions of people who require medical attention following an NTD infection – ranging from medicines to surgery.

Within SDG Goal 3, NTDs have been given a specific target –“by 2030, end the epidemics of AIDS, TB, malaria and NTDs…” - reflecting their importance in terms of their global prevalence and their social, economic and developmental consequences.  

Preventive chemotherapy is being proposed as a tracer intervention for monitoring equity in progress towards achieving UHC.

However, PC as an intervention is currently only reaching 59% of the population in need in Africa.

ESPEN urgently needs support and commitment to reach the 600 million most vulnerable, disadvantaged people in Africa, to control and eliminate the five targeted NTDs by 2020.

I’d like to use this opportunity to extend an invitation to you all to partner with us as we move towards elimination by 2020.  I’m quite determined that we will get there, with your solid partnership.

Finally, let me say how very grateful we are to MSD for its renewed commitment to continue the donation of Mectizan until Onchocerciasis and LF are eliminated in every endemic community. I’m very pleased to celebrate this milestone event with you.