World NTD Day 2022: Time to End the Neglect
Sunday, 30 January marked the third annual World Neglected Tropical Diseases Day. WHO and Uniting to Combat NTDs hosted virtual events which highlighted the importance of drawing attention to these neglected diseases. At the WHO's event on 26 January, 2022, Stanley Kutcher, a Canadian Senator highlighted that we “already have the tools needed to achieve success.” Whilst it is true we have the tools, the resources and political will to seriously impact the diseases has been sadly lacking. Rabies is a perfect example of a disease that is 100% preventable and treatable yet tens of thousands die every year. The cost of eliminating rabies in the canine population is significantly less than the estimated USD 8.6 billion rabies in currently costing in treatment and loss of life.
A tidal shift in our thinking about global health is what is required if we are to truly tackle the existence of NTDs. Members of the Oshun team, Sarah Beeching and Katy Cronin, have recently co-authored a paper on the importance of a ‘One Health’ approach towards zoonotic disease: an approach which understands the health of human to be inextricably linked with that of animals and the environment. For rabies elimination the only way to entirely end human deaths, is through mass dog vaccination alongside education in animal welfare and integrated bite case management for health professionals plus access to post exposure prophylactics. On the environmental side, rapid urbanisation has led to inadequate waste disposal, which in turn increases the likelihood of rabies by attracting scavenging dogs.
Speakers from the NTD day event hosted by Uniting to Combat NTDs, on 27 January, 2022, highlighted the ways in which NTDs perpetuate inequalities. The Nigerian Minister of Health, Hon. Dr Osagie Ehanire, was clear that “NTDs lead to poverty, stigma, social exclusion”. The President of Tanzania, H.E. Samia Suluhu Hassan highlighted that in her country nearly half of the population requires treatment for NTDs, placing a huge economic burden on those affected.
Though Covid highlighted the potentially devastating impact of zoonotic diseases, it has also created significant gaps in the fight to combat NTDs. In 2018, there were 1 billion people around the world being treated for at least one NTD, a trend which continued until 2019. However, in the article, ‘Rabies and the pandemic: lessons for One Health’ (2021), the authors highlight the challenges which Covid compounded in the fight against NTDs. In 25% of countries, staff previously working on rabies surveillance were reassigned to Covid response, while in Ghana and many other countries resources for rabies education was withdrawn in 2020. Disease monitoring and community outreach have proved crucial in the fight against NTDs, and it is vital that we mobilise resources to continue efforts. Today, rabies causes an estimated 59,000 deaths annually and yet we have the tools available to ensure that no-one should die. The WHO NTD 2030 Roadmap and companion document, 'Ending the neglect to attain the sustainable development goals. One health: approach for action against neglected tropical diseases 2021-2030' will further focus attention on the goal to end deaths from dog-mediated rabies by 2030.