Commitment to NTD control has increased in recent years, including periodic deworming campaigns with safe, cheap drugs.
International commitment to NTD control
Recent years have witnessed an unprecedented commitment to the control of neglected tropical diseases, with a specific emphasis on the integration of mass drug administration (MDA) programmes. The main commitments include:
In January 2012, the World Health Organization published a roadmap for implementation detailing its vision for control, elimination and eradication of NTDs, including a series of global, regional and country goals to be reached by 2020.
- On the same month, global health organizations, donors and pharmaceutical industry leaders endorsed the London Declaration on Neglected Tropical Diseases.
- NTD endemic countries have developed multi-year integrated NTD plans and have begun to allocate funds to NTD control.
- In January 2013, WHO published its second report on NTDs, which outlined the progress made towards the 2020 goals.
- In May 2013, the World Health Assembly adopted a comprehensive resolution on all 17 neglected tropical diseases (WHA66.12)
Worms can be effectively controlled by periodic chemotherapy (deworming) with safe, cheap and single-dose drugs. Treatment should ideally be implemented alongside improvements in sanitation and health education. Deworming can improve children's growth and benefit their learning by increasing primary school attendance. Even though re-infection may occur after treatment, the risk of developing chronic or severe disease is greatly diminished and even reversed when treatment is initiated in childhood.
For STH and schistosomiasis, the World Health Organization (WHO) identifies three key groups for mass treatment: school-aged children, pre-school children and pregnant women. In communities where infection is common, all individuals at risk of infection should be offered treatment.
School-aged children typically have the highest intensity of worm infection of any age group, with significant consequences for their health and development. However, much of this morbidity can be rapidly reversed by treatment. School-aged children are therefore key targets for mass treatment, or deworming.
The most cost-effective way to deliver deworming regularly to such children is through schools. These offer a readily available, extensive and sustained infrastructure with a skilled workforce that is in close contact with the community.
Community directed treatment
Treatment for LF and onchocerciasis is typically implemented through community structures, using community drug distributors. The success of the African Programme for Onchocerciasis Control (APOC), the first NTD programme to benefit from a substantial drug donation, has been attributed largely to its public private partnership model, and the use of community volunteers to deliver treatments. The same approach is successfully used by LF control programmes.