By Sola Ogundipe
NIGERIA continues to suffer Africa’s biggest burden of Neglected Tropical Diseases, NTDs, otherwise known as diseases of poverty, despite improving treatment coverage of the diseases between 2015 and 2017.
According to a new table ranking, Nigeria improved its average score for treatment against the five most common NTDs (calculated via a statistical tool called the geometric mean, which is commonly used in social sciences) between 2015 and 2017 from 15 to 60.
In the league table drawn up from the coverage results, Nigeria ranked 23rd out of 49 countries endemic for NTDs.
With this development, Nigeria moved from the World Health Organisation, WHO, category of “not on track” to “making progress but more work needs to be done”.
The league table ranks the countries according to their performance in reaching everyone in need with the necessary treatment, across the five most common NTDs in Africa that are amenable to mass treatment. The countries treating the highest proportion of those in need across all five diseases rank highest in the table.
An Index score is calculated based on the average of treatment coverage across the five most common NTDs sometimes known as the “preventable chemotherapy” diseases, that can be treated by mass drug administration.
The NTDs are known as ‘diseases of poverty’ because they thrive in communities without clean water and with inadequate sewerage systems.
They trap people in a cycle of extreme difficulties including not being able to go to school or work.
The five most common NTDs amenable to mass treatment are: blinding trachoma; intestinal worms; the mosquito-borne filariasis (elephantiasis); snail-borne bilharzia; and river blindness.
All five NTDs can be prevented or treated with medicines that are donated to endemic countries by pharmaceutical companies.
“We have the largest burden of NTDs in Africa because we have the largest population on the continent – nearly 200 million people,” said Nigeria’s National Coordinator of NTDs in the Federal Ministry of Health, Dr Chukwuma Anyaike.
“We have achieved 100 percent mapping of the five preventable chemotherapy NTDs throughout the country, which is the first step towards elimination”, Dr Anyaike added.
“But we do not have 100 percent geographic treatment coverage in terms of mass drug administration”, the National Coordinator continued.
“Lymphatic filariasis (elephantiasis) is a particularly difficult challenge for us because it is endemic in large parts of the country – in fact in 583 of the 774 Local Government Areas.
“Out of the 583 endemic Local Government Areas”, Anyaike concluded “we have coverage gaps in 37 of them. We are looking for partners and funders to help fill the gaps in coverage of this disease”.
NTDs rarely make headline news because they tend to afflict the poorest and most marginalised communities. The diseases were once prevalent throughout the world, including in western countries.
However, they are now almost exclusively endemic in developing nations, causing disability and stigma and even death.
In 2015, world leaders adopted the sustainable development goals in which NTDs were specifically targetted.
Over the same period, the proportion of people receiving treatment has risen. In Sub-Sahara Africa alone, there were 630 million people in need of treatment for at least one NTD in 2015.
By 2017 this fell to 605 million – a drop of 25 million in just three years, showing that treatments for NTDs are effective.
The SDG target for NTDs, is to reduce the number of people in need of treatment by 90 percent by the end of 2030.
In 2015 the proportion of the 630 million people in need of treatment in Sub Sahara Africa who received it, was just over half, or 51 percent. By 2017 this proportion had risen – 68 percent of the 605 million people in need were getting the drugs they required.
The success is due, in large part, to the commitment and leadership of the WHO Regional Director for Africa, Dr Rebecca Matshidiso Moeti, who set up a dedicated project in the regional office called the Expanded Special Project for the Elimination of Neglected Tropical Diseases (ESPEN) which has been working with countries, providing technical and implementation support.