Give us a brief introduction about ‘END7 campaign.
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Dr Neeraj Mistry
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END7 campaign is an awareness campaign seeking to eliminate the seven most common neglected tropical diseases (NTDs) by 2020. NTDs are parasitic and bacterial infections transmitted through mosquitoes or flies and contaminated water or soil. The seven most common NTDs – lymphatic filariasis (elephantiasis), river blindness (onchocerciasis), snail fever (schistosomiasis), trachoma, hookworm, whipworm (trichuriasis) and roundworm (ascaraisis) – account for 90 per cent of the global NTD burden. NTDs afflict one in six people worldwide, including half a billion children who are living in marginalised communities on less than $1.25 a day. NTDs cause blindness, swelling, pain, and stigmatisation, trapping people in a cycle of poverty and disease.
END7, which is run by the Global Network for Neglected Tropical Diseases (Global Network), an initiative of the Sabin Vaccine Institute, uses the power of social media and compelling digital communications to build awareness for NTDs among the general public and encourage people to take action. END7 also calls upon global political and philanthropic leaders, as well as national governments in endemic countries, to make the modest funding commitments to help cut the transmission cycle of NTDs.
The END7 campaign seeks to raise the profile of NTDs with the public and key decision makers so that people can be reached in dire need of treatment and spur sustainable economic growth. The momentum and funds generated by END7 supporters thus far has enabled to reach an expansive network of individuals, directly provide treatments to communities, and encourage donor and endemic countries to invest in NTDs.
END7 is the first global public awareness campaign seeking to eliminate NTDs. Tell us about its on-going activities?
By 2020, it is being anticipated that the next major milestone in public health will be the control and elimination of the seven most common NTDs impacting more than one billion of the world’s poorest people. END7 contributes to seven active project countries worldwide and anticipates expansion to additional countries by the end of the year. In India and around the world, we are working closely with our implementing partners to bring existing NTD control programmes to scale, integrate NTD control with other global health interventions such as water, sanitation and hygiene (WASH) efforts; nutrient supplement programmes; bed net distribution; and maternal and child health care. Our advocacy work relies on innovative digital and social media strategies; corporate, celebrity, and public-private partnerships; and mass-level viewer ship of our online content to reach and captivate diverse audiences. For instance, in March 2013, END7 released a hard-hitting video, “How to Shock a Celebrity”, which included six celebrities from around the world and captured the attention of hundreds of thousands of people globally and compelled them to donate to the NTD cause.
In India what strategies do you have for END7 campaign?
In India, END7 seeks to raise the visibility of NTDS by educating the general public about the need to participate in national NTD control programmes and encouraging government officials to scale up their NTD programmes. END7 will rely on celebrity ambassadors, corporate and public-private partnerships, and other promotional activities to educate local communities about the effectiveness and importance of NTD preventive treatments, raise funds to deliver medicine to the most remote communities and strengthen political commitment. We are also looking for India’s leadership to demonstrate models by which NTD programmes can truly go to scale. That scale-up model is what we’d like to share with other countries scaling up themselves.
How successful is the END7 campaign in India?
The END7 campaign in India will elevate NTDs by raising funds and building awareness on how their control and elimination. One of the most cost-effective public health interventions in existence today, it will help meet national and global development targets. By building up awareness, END7 will help promote the social uptake and endurance of government programmes. Investing in the health and well-being of the most marginalised communities in India through ultra low-cost interventions can help create more expansive economic growth; improve maternal and child health; and increase school attendance.
How grave is NTD’s situation in India?
Nearly 35 per cent of the global population infected with NTDs resides in India. Currently, India accounts for 27 per cent of the world’s soil-transmitted helminth burden, with over 240 million Indian children in need of deworming medicine. India also accounts for 40 per cent of the global burden for lymphatic filariasis.
Which diseases fall under the NTD category? In India which diseases are likely to grow aggressively and why?
The most prevalent NTDs in India are soil-transmitted helminths (STH) and lymphatic filariasis (LF). Other NTDs are also endemic in parts of India, including trachoma, kala azar (also known as visceral leishmaniasis), leprosy, rabies and dengue. India has already eliminated two NTDs, guinea worm and yaws. To address soil-transmitted helminths and lymphatic filariasis, India is managing comprehensive, state-by-state programmes. The national lymphatic filariasis elimination programme is the largest in the world, reaching approximately 300 million people each year with preventive treatment. India has also just launched two of the world’s largest integrated de-worming initiatives, aiming to protect 220 million school-age children and 120 million adolescents each year from soil-transmitted helminths. To support India’s efforts to expand existing programmes and make the case for investment in NTDs, the Global Network and END7 is focused on building awareness, mobilising resources, and working with government, non-governmental organisations, corporate and celebrity partners.
You were the Vice president of the Global Business Coalition (GBC) on HIV/AIDS, tuberculosis and malaria. Give some insight on handling the situation in the Indian subcontinent?
During my tenure at the Global Business Coalition (GBC) on HIV/AIDs, tuberculosis and malaria, I worked with corporations, multi-lateral and bilateral agencies, and diverse sectors to increase public health investments and public-private partnerships (PPP) to help stimulate improvement in the health and socio-economic status of people worldwide. I saw the power of bringing different groups and individuals together to achieve common development goals and ensure sustainable progress, and I have since sought to apply a similar approach in my work at the global network.
In India, I believe that it is critical for diverse sectors, government, organisations, and individuals the pharma industry, ministries of health, business leaders and celebrities for instance to make the cost-effective investment of building awareness about NTDs, mobilising resources to ensure that preventive treatment reaches the most marginalised communities, and ultimately ensuring the control and elimination of NTDs by 2020. With the Indian government’s leadership, support from the private sector, and on-going advocacy work, I believe that India will be in a position to achieve new milestones in the control and elimination of NTDs.
The Government of India has taken up an initiative to fight against NTDs. What suggestions would you like to give to the government?
At the Global network, we believe that India’s leadership and success will be central to achieving global and regional goals to control and eliminate the most common NTDs by 2020. By tackling NTDs, India will help achieve more inclusive and expansive economic growth for its citizens, which in turn will positively impact the global economy. Finally, the government’s successful efforts can only go so far without engaging the general public to comply with drug treatment programmes and take advantage of the availability of medicines that are distributed in many cases for free to communities.
This will require greater engagement and social marketing at the community levels to demonstrate the importance of everyone taking these medicines.
Which public private partnerships have been formed in India to eliminate NTD’s from India?
GSK is donating albendazole for lymphatic filariasis and soil-transmitted helminth control in India, as well as other countries, through the WHO. The deep commitment of non-governmental organisations such as Deworm the World and foundations such as the Michael and Susan Dell Foundation have also supported school-based deworming programmes to protect millions of Indian children against soil-transmitted helminth infections. A faith-based organisation called the Church’s Auxiliary for Social Action (CASA) has also supported NTD education efforts and has helped teach people living with chronic lymphatic filariasis infection how to alleviate suffering and prevent disability. By engaging with different individuals, organisations, and Indian government bodies to drum up interest in and commitment to investing in NTDs in India, END7 intends to expand innovative public-private partnerships that will accelerate the pace of improving the health of the Indian people.
Since July 2010 you have been associated with the Global Network for NTDs. Tell us about your endeavours against NTDs in India?
In India, the Global Network advocates for Indian government officials to continue making investments in NTDs that will lead to the improved health, well-being and productivity of its citizens. The Global Network works closely with the WHO, international and Indian non-governmental organisations, such as Deworm the World, and officials and technical experts overseeing the NTD programmes of the Ministry of Health and Family Welfare (MoHFW). In 2011, the Global Network collaborated with Deworm the World and Indian government officials to implement a school-based deworming programme in the state of Bihar. The programme successfully provided deworming treatment for 17 million school-age children in over 67,000 schools in one of the world’s largest school-based programmes ever conducted. In 2012, Rajasthan carried out a deworming programme targeting 16 million children from 90,000 government schools and 70,000 community health centres to reduce the effects of anaemia and malnutrition that soil-transmitted helminth infections have on children. Rajasthan’s reach was impressive and the huge collaboration that helped make the deworming successful: Rajasthan’s Departments of Education, Health and Women and Child Development; Deworm the World, Michael and Susan Dell Foundation and UNICEF. The Global Network’s advocacy work encourages India to scale up treatment programmes, expand data mapping to better understand the current burden of NTDs across the country and continue the momentum of previous successes in the elimination of certain NTDs. The Global Network believes that India is in a position to elevate NTDs and build awareness on how their control and elimination will enable its citizens to lead healthy, productive lives.
The Indian government is targeting that by 2020 the nation will become free from NTDs. Do you think a set deadline can be met?
We believe that India can meet the 2020 deadline. India is at the tipping point of achieving NTD control and elimination goals. It already runs some of the largest national NTD programmes in the world and is poised to scale up programmes, close the treatment gap and continue expanding momentum. By increasing its commitment to invest in and build awareness on NTDs, India will be able to make great progress. Fortunately, we also have the necessary treatment available, thanks to donations from many pharmaceutical companies. Still, it will be critical for the Indian government to ensure that the investments of the last decade in the fight against NTDs continue to last through renewed commitment and innovation during the last mile of achieving elimination. To support the Indian government’s efforts to scale up treatment, educate the public, and reach marginalised communities, END7 will work to build awareness and help sustain government programmes. We are committed to leading NTD advocacy efforts in India and globally for the control and elimination of these diseases and we are optimistic that India and other countries around the world can meet this deadline.
Why has less research been carried out in this field? How can we encourage the institutes and companies to work enthusiastically in these areas?
It is only over the last decade that NTDs have started receiving increased global recognition, but scientists, doctors, governments, and other institutions have already produced substantial important research on the impact and reach of NTDs throughout the world.
The case for investing in NTDs is a simple one: NTD treatment is one of the most cost-effective public health interventions in existence today. For just 50 cents, we can treat and protect one person per year against the seven most common NTDs. Tackling NTDs also provides a return on investment for nearly every major development goal. By treating NTDs, which cause tremendous pain and suffering and keep people out of work and school, countries can help spur increases in school attendance, improve worker productivity, enhance earning potential and lead to an overall improvement in well-being.
How serious is this issue in Asia Pacific and which are the countries are seriously affected from this endemic?
Asia and the Pacific account for almost two-thirds of the world’s population at risk for lymphatic filariasis and half of the world’s children at risk for soil transmitted helminths. India, Indonesia, Philippines, Bangladesh, China, and Myanmar have the highest burden in Asia, and account for almost 60 per cent of the global burden (see chart). Many endemic countries are making tremendous strides, including Sri Lanka, Cambodia, Laos, and Vietnam. Countries such as Japan and South Korea were formerly endemic for these diseases and have successfully controlled and eliminated them.
(Figure 1: Proportion of Global Burden of NTDs by Country)
What is your agenda for this year and how closely are you working with the Indian government to achieve this?
END7 works with an extensive network of partners around the world to make certain that we’re on pace to control and eliminate the seven most common NTDs by 2020. Each of our partnerships contributes a unique skill and area of expertise that when working together, enables the national and state NTD programmes to deliver effective programmes and achieves results.
What is your message for the pharma industry?
The fight against NTDs requires diverse sectors that can each contribute particular skills and competencies. The pharma industry has already demonstrated that it is an instrumental partner in the global effort to control and eliminate NTDs by 2020. Notably, in the largest partnership to date, the London Declaration on NTDs, 13 pharma companies committed to donating 14 billion doses of pills by the end of the decade, and because of their generous donations, it costs only 50 cents to treat and protect one person per year against the seven most common NTDs. We encourage the pharma industry to continue their deep commitment to alleviate the suffering caused by NTDs by also carrying out new research and development initiatives that will help us stay ahead of how our existing effective treatments evolve. What’s important to remember is that no one sector alone can achieve the control and elimination of NTDs, but rather we must all unite through close coordination and collaboration to realise our 2020 goal. In addition to pharma donations and R&D programmes, global partners, including endemic countries, must also work together to enhance strategies for implementing effective supply chain logistics, treatment distribution, and monitoring and evaluation programmes. Community engagement and awareness is also critical to ensure that people understand the benefits of NTD treatment, which will help generate demand and support for countries like India to maximise their commitments to control and eliminate NTDs.
