Activities of the DNTDs

++ World Health Summit 2021 with a discussion on digitalisation and NTDs

Berlin, 26.10.2021 "Neglected tropical diseases are not neglected by the German Government" declared Paul Zubeil of the Federal Ministry of Health at the World Health Summit Workshop "New Impulses from the WHO-NTD-Roadmap 2030, Digitalization as Opportunity for Improving Health Management Systems". He listed numerous activities of the Ministry of Health, the Ministry of Research and the Ministry of Economic Cooperation and Development in the context of NTD control. He also stressed that more data should be collected on the gender-related impact of NTDs in the future. An overview of how and which digital tools can improve programme work to combat NTDs at different stages, from education to treatment and follow-up/examination of patients, was given by Dr Babar Qureshi from CBM. Carolin Gunesh from DAHW described specifically the work with the digital app Audio Pedia , which is used especially in the field of education. She underlined how important it is to adapt the programmes to the respective conditions on site. As NTD patients are usually among the poorest of the poor. Often, they lack simple things like electricity or are sometimes unable to read and write. The importance of digital systems for data, especially in the supply chain, was emphasised by Dr Sultani Hadley Matendechero of the Kenya National Public Health Institute. Such a tool is currently being tested in a pilot project in Kenya and will be expanded if successful. Dr Pauline Mwinzi, WHO-ESPEN (Expanded Special Project for Elimination of Neglected Tropical Diseases) described how the ESPEN collect tool collects real time data and makes it publicly available via the ESPEN portal. She emphasised that this data is key to success in the fight against NTDs.

The discussion was moderated by Dr. Dr. Carsten Köhler, University of Tübingen and Prof. Dr. Achim Hörauf, IMMIP Bonn. For the sixth time, the German Network against Neglected Tropical Diseases organised a session at the World Health Summit.

++ Joint event of Friends of the Global Fund Europe and the DNTDs

Berlin, 04.05.2021 - In the run-up to the Kigali Summit on Malaria and NTDs and on the occasion of World Malaria Day, Friends of the Global Fund Europe together with the German Network against Neglected Tropical Diseases organised a joint discussion event.

Heidemarie Wieczorek-Zeul, former Minister for Economic Cooperation and Development, Vice-President of Friends of the Global Fund Europe welcomed the opportunity of the Kigali Summit in June to discuss integrated solutions to combat infectious diseases. Financial commitment and political will are needed to fight these diseases. But at the beginning of everything is attention. That is why an event like this is important.

Olivia Ngou, Impact Santé Afrique and network CS4ME (Civil Society for Malaria Elimination), described the work of community health services in the fight against malaria and NTDs. The scope of work was becoming more and more ambitious, from diagnosis to treatment. Unfortunately, the staff are often not t integrated into the state structures of the public health services.

For Prof. Dr. Achim Hörauf, spokesperson of the DNTDs, Director of the Institute for Medical Microbiology, Immunology and Parasitology at the University Hospital of Bonn, new programmes of digitalisation offer the possibility to tackle NTDs and malaria control faster and more effectively together. Also, the just-released UN Aids 5-year plan (2021-2026) points to the links between HIV and female genital schistosomiasis (FGS) and proposes treatment in integrated health services.

Dianne Stewart, Donor Relations Department, GFATM supported the thesis that in the future the integrated, one-health approach would lead the way. The Global Fund is on the way to achieving this.

Birgit Pickel, Head of Division at the Federal Ministry for Economic Cooperation and Development, underlined the importance of integrating the One Health approach in the Global Fund against HIV/AIDS, TB and Malaria and how closely it is linked to the fight against neglected tropical diseases. In the future, intersectoral approaches must be taken into account, and her ministry is increasingly involved in the area of WASH. But also, the cooperation of human and veterinary medicine, with the finance ministers and the representatives of civil society are groundbreaking pioneering.

Dr Claude Oeuvray, Program Lead: Malaria Integrated Health Solution at Merck Group took a look at the use of different drugs that can be used in the fight against neglected tropical diseases and malaria. With ivermectin, an insect bite becomes a lethal risk for the malaria mosquito. At the same time, the drug is used in the treatment of neglected tropical diseases such as river blindness and elephantiasis (lymphatic filariasis).

Dr. Aimable Mbituyumuremyi, Rwanda Biomedical Center, Ministry of Health described that in his country, control strategies are coordinated in the national plans. This leads to savings in financial resources for vector control and in the deployment of personnel.

A short survey showed that a small majority of participants think that Momentum Covid offers an opportunity to improve health systems in middle- and low-income countries. A vote that was echoed by the speakers.

Discussion on Malaria and NTDs in the run-up to the Kigali Summit

++ Government of Rhineland-Palatinate for more awareness in the fight against neglected tropical diseases

 

Berlin/Mainz - 29.04.2021. At a joint event organised by the Rwanda Department of the Rhineland-Palatinate State Government and the DNTDs on the occasion of the Kigali Summit on Malaria and NTDs in June 2021, NTDs were the focus of discussions.

Prof. Dr. Achim Hörauf, speaker of the DNTDs, Director of the Institute for Medical Microbiology, Immunology and Parasitology at the University Hospital Bonn (IMMIP) explained some disease patterns of NTDs and placed the Kigali Summit in the context of the numerous activities in the field of global health policy.

Uta Elisabeth Düll, a doctor in Rwanda, spoke about the great efforts of the Rwandan government to maintain the NTD programmes despite the COVID-19 pandemic. She reported on the well-coordinated health infrastructure at different levels - through community health workers, health posts and district hospitals. A health insurance scheme for everyone, she said, provides the population with good health care.

"The state government of Rhineland-Palatinate has been supporting a country partnership with Rwanda for more than 40 years, which focuses on schools, hospitals and water supply," said Carola Stein, Head of Division for the partner country Rwanda in the Rhineland-Palatinate Ministry of the Interior and Sport. The partnership approach is important. The exchange is not a one-way street. Rwanda is ahead of Germany in the implementation of the Sustainable Development Goals 2030, for example, and one can learn from this.

Johannes Waltz, Head of Merck Schistosomiasis Elimination, Program and Global Schistosomiasis Alliance (GSA) affirmed Rwanda's pioneering role in the fight against neglected tropical diseases, especially schistosomiasis. The prospect of elimination is realistic, he said. Therefore, Merck has agreed on additional drug donations with the Rwandan government in order to get closer to the goal. However, integrated use is important, i.e. education, prevention, WASH and hygiene measures must be combined with the use of medicines.

Burkard Kömm, Managing Director, DAHW Deutsche Lepra- und Tuberkulosehilfe e.V. (German Leprosy and Tuberculosis Relief Association), described the trauma suffered by many women and men who have schistosomiasis, leprosy or elephantiasis. Often superstition and ignorance lead to the exclusion of the sick and traditional healers are then the first port of call. DAHW therefore has programmes with social workers to find these people and to convince them to accept help from modern medicine.

Ottmar von Holtz, Member of the German Parliament, member of the Parliamentary Advisory Council against Neglected Tropical Diseases and for the Strengthening of Health Systems underlined the possibilities of the parliamentarians to raise the issue of neglected tropical diseases in different committees such as the Subcommittee on Health in German parliament. He promised they will continue to put pressure on the federal government to further promote the fight against NTDs.

There were also numerous questions from the audience. Among other things, the announced cuts by the British government were intensively discussed. It is planned to reduce public development funding from 0.7 per cent to 0.5 per cent. The effects would also be dramatic for programmes of neglected tropical diseases, because millions of donated medicines would no longer reach the sick people on the ground.

+ + GHHG - Working Group Week 2021

Berlin, 24.3.2021 - Malaria and neglected tropical diseases can be tackled together, the participants of the webinar “Integrated and cross-sectoral interventions: Example Neglected Tropical Diseases and Malaria” which took place within the Actionweek of the Global Health Hub Germany. International experts had met in the run-up to the Kigali Summit on Malaria and NTDs, scheduled for June, to find out how both diseases - NTDs and malaria - can be tackled together and how this can lead to a paradigm shift in health policy.

 Dr Mwelecele Ntuli Malecela, Director, Department of Control of Neglected Tropical Diseases, World Health Organization (WHO) advocated for reformulating the global health architecture and breaking down vertical health financing and allowing endemic countries more flexibility in spending as part of their greater responsibility for programmes. Dr Aimable Mbituyumuremyi, Division Manager for Malaria and NTD Programmes, Government of Rwanda explained that in his country both diseases, which represent the greatest burden of disease, were already being worked on together in one division in the Ministry of Health. He described the coordination and collaboration of the different levels of work at government, district and community levels. Richard Allan, CEO, MENTOR Initiative explained that poor populations could often benefit from joint control structures and activities of malaria and NTDs. He said that community health workers, who should be further trained and equipped with innovative digital tools, can make better diagnoses and share important data, are crucial in the fight against both diseases.  Dr Daniel Eibach, Senior Health Officer One Health, from the German Federal Ministry for Economic Cooperation and Development (BMZ) underlined Germany's efforts to integrate the One Health approach in the fight against NTDs and made the case that despite all the necessary interventions in the COVID-19 epidemic, neither malaria nor NTDs should be forgotten. Dr Lutz Hegemann, Group Head, Corporate Affairs and Global Health, Novartis Institutes for BioMedical Research pointed out that pharmaceutical companies continue to support partnerships to fight both diseases. A request from the audience underlined the importance of incorporating local knowledge and decolonising innovation. The event was moderated by Dr. Dr. Carsten Köhler, Director of the Competence Centre Tropical Medicine Baden-Württemberg, Institute for Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital, Eberhard-Karls-University Tübingen and Prof. Dr. Achim Hörauf, Director of the Institute for Med. Microbiology, Immunology and Parasitology at the University Hospital Bonn, speaker of the DNTD and coordinator of the GHHG working group.

++ Kick off the week of action against neglected tropical diseases

Berlin, 25.01.2021 - To kick off the week of action against neglected tropical diseases, the German network under the patronage of Georg Kippels MdB, organised a webtalk on Chagas disease.

Thomas Jacobs, group leader at the Bernhard-Nocht-Institute for Tropical Medicine Hamburg (BNITM), regretted that the fight against Chagas disease was not receiving any attention. Much more resources - from research to access to medicines - were needed to contain the disease. In Europe in particular, the issue is ignored, even though the disease is spreading rapidly through migration. In Spain, it is estimated that between 48,000 and 90,000 people are infected. In Hamburg alone, where his institute is active, it is estimated that 200 to 1000 people are affected.  

Dr Simone Kann, Chagas expert from the Medical Mission Institute in Würzburg, described the activities in Colombia, how important hygiene concepts, the fight against local intermediate hosts but also prevention among the rural population are. The insidious thing about Chagas disease is that it is often not visible for many years. The Mission Medical Institute has therefore developed a PCR-test that can be used to measure the pathogen load.

Ulrich Madeja, Head of NTD Program at Bayer pointed out the important cooperation of drug manufacturers with WHO, especially in the context of developing and implementing a regional action plan with partners under the leadership of WHO/PAHO. He stressed that most Chaga-sufferers do not have access to health systems. It is a disease of the poor.

Eric Chatelain, Head of Drug Discovery, DNDi stressed the importance of working with good studies that show the effectiveness of drugs. It is also important to develop new drugs that are better tolerated.

Prof Achim Hörauf, DNTDs spokesperson and Director of the Institute for Medical Microbiology, Immunology and Parasitology at the University Hospital in Bonn, summarised that one must be realistic and assume that the pathogens cannot be eradicated. The Corona virus has made it very clear how dynamic infectious diseases are. He therefore pleaded once again that national and international funds in this area should not be reduced, but rather increased, if we want to be prepared to combat infectious diseases in the coming decades. He emphasised that the fight against Chagas disease can only be successful if poverty is combated.

Background

Two thirds of all new infectious diseases originate from animals. 60-70% of all new infectious diseases occurring in humans originate from animals: Chagas disease also has a zoonotic reservoir. It is one of the 20 neglected tropical diseases that the World Health Organisation (WHO) has put on its list with the aim of eliminating them. There is no vaccination against Chagas disease. According to WHO estimates, about 6 to 7 million people are infected worldwide, with the majority living in Latin America (about 4.6 million), followed by the USA with over 300,000 and Europe with about 80,000 infected people.

The risk of infection with neglected tropical diseases increases in Europe, particularly through the transmission of parasites from latently infected mothers to their unborn children or through blood supplies contaminated with Chagas pathogens.

One problem in fighting Chagas disease is that the infectious disease is usually not diagnosed in time because the symptoms are very unspecific at the beginning (symptoms like a cold).  Without diagnosis or treatment, however, Chagas can lead to serious health complications, such as heart disease, some of which result in death.

Background on German activities in the field of Chagas

At the Bernhard-Nocht-Institute for Tropical Medicine in Hamburg, researchers are working on a study to find out more about the disease in Germany. They are dedicated to screening, research, prevention and education about Chagas disease. As part of this study, people of Latin American origin living in Germany will be informed about the disease. If necessary, the study participants can receive free diagnosis and treatment at the BNITM. The project also advocates for a change in the prevention policy of this disease for Latin American people.

 

The Medical Mission Institute Würzburg runs a large project against Chaga disease in rural areas of Colombia. The programme follows the "One Health Approach" and consists of three pillars: the medical part (disease screening, observed therapy, therapy success and patient follow-up), the surveillance part (screening for the transmitting insects, spray campaigns, programme initiations) and the education part (about Chagas, infectious diseases, hygiene, etc.). In addition, co-infections and other newly spreading infectious diseases (e.g. gastrointestinal infections, leishmaniasis, etc.) are also addressed. The overall system in which the disease develops and spreads is considered. It is about the connections between agriculture, veterinary medicine, human medicine and nutrition.

The German pharmaceutical company Bayer, for example, has been supporting the WHO in its fight against Chagas disease since 2004, with 1 million free tablets of Lampit (nifurtimox) per year and an additional 300,000 € per year for logistics and distribution.

The Institute of Medical Microbiology, Immunology and Parasitology at the University of Bonn is working with the Drugs for Neglected Disease Initiative (DNDi, Geneva) to develop the drug fexinidazole against Chagas disease, which was already approved for sleeping sickness in 2018.