COVID-19 and Neglected Tropical Diseases: why we must fight them in tandem

By Dr Mwelecele Ntuli Malecela, Director of the Department of Control of Neglected Tropical Diseases, WHO.

It starts with a child bathing in a stream to escape scorching temperatures. Silently, beneath the water, larvae that have emerged from a tiny snail burrow into their leg before entering the bloodstream. Over the next few weeks, the larvae turn into adult worms which mate and produce hundreds of eggs every day. This is schistosomiasis, also known as bilharzia – a neglected tropical disease (NTD) affecting more than 200 million people in sub-Saharan Africa, many of whom are children who have acquired infection just by playing or washing in contaminated water.

People across the world have become attuned to the fight for public health on a global scale in 2020. Never before has there been this amount of discussion about vaccines, treatments and prevention of disease. This year’s World Health Summit – held virtually from Berlin and which I had the honour to address earlier this week – had a strong focus on preparedness and resilience in the age of COVID-19, and the importance of global cooperation. Yet while the world rightly fights coronavirus, we must not forget about another widely prevalent and devastating subset of infections: the neglected tropical diseases (NTDs).

What are Neglected Tropical Diseases (NTDs)?

NTDs are a diverse group of 20 infectious diseases that are prevalent in tropical and subtropical conditions of some 149 countries worldwide. They affect more than 1.5 billion people, and cause an estimated 500,000 annual deaths globally.

Despite these shocking figures, they are termed ‘neglected’ because they continue to receive little attention.

During the World Health Summit, I spoke of the need to change how we think about NTDs. They not only compromise people’s health, keep children out of school and cause disfigurement and mental distress that disproportionately affects and stigmatises women. NTDs do not just affect health – they also hamper the economic growth and productivity and impede education. The good news is that most NTDs are easy to treat and can be prevented. The moral responsibility now lies with us to invest in their treatment and prevention and help the poor and marginalized communities who are mostly affected.

In fact, investing in treatment and prevention of NTDs not only helps alleviate suffering against these diseases, but also prevents other diseases that share the same origins: namely, poor sanitation and inadequate access to clean water. This investment would lead to better sanitation and access to clean, safe water that will help prevent NTDs and minimise other serious threats across the African continent, including COVID-19.

Eliminating NTDs while meeting COVID-19 Challenges

As a community, we are continuing our mission to eliminate NTDs, while ensuring that the challenges of COVID-19 are met. Investing in NTDs is one of the most cost-effective buys in public health, with treatment for the top 5 NTDs costing less than $0.50 per person, yet it is instrumental to improving development and equality, and lifting up communities.

The lessons that we have learned from NTDs can also be applied to other public health threats, like COVID-19 which is now pervasive across the world. This is also the case in Africa, with almost 1.5 million cases and over 35,000 deaths reported by the African Centre for Disease Control and Prevention. Many of those affected by NTDs also live in poverty without adequate access to water, hand sanitizer and masks, all of which are non-pharmaceutical public health interventions recommended to reduce their risk of contracting COVID-19. With so much at stake, it is now more important than ever to focus on investing in NTDs to prevent more deaths from COVID-19. To look at it from another angle, an investment in public health measures to combat COVID-19 is also an investment in the fight against NTDs.

The World Health Organization is set to launch its 2021-2030 Global NTD Roadmap, setting out important milestones and targets in our ongoing endeavour to eliminate and eradicate these diseases. These milestones will be even more important and will also benefit the work the global health community is undertaking against COVID-19.

The new NTD roadmap will provide the direction needed to ensure that the global health community does not take its foot off the pedal when it comes to the fight against NTDs. A lot remains to be done to ensure that those who require interventions against NTDs receive them. I urge countries, donors, political leaders and citizens to not lose sight of these low-cost, high-impact interventions.

We must ensure that NTDs and those who suffer from them do not find themselves neglected even further while the fight against COVID-19 rages on. The livelihood of 600 million African people depends on us all.

This article was originally published by Health Policy