Activities of the DNTDs

Berlin, 21 January 2021 - WHO will present the new Roadmap  on NTDs 2030, which was adopted by the World Health Assembly at the end of last year, to the public. The new thing about this roadmap in particular is the integrative, multi-sectoral approach and the emphasis on the responsibility of countries where the neglected tropical diseases are endemic.

Prof. Dr. KH Martin Kollmann, founding and honorary member of the DNTDs, expert on neglected tropical diseases at the Christoffel Blind Mission (CBM) and CBM ophthalmologist explains what changes the new WHO NTD Roadmap entails. He has lived in Kenya with his family since 1994.

1^st QUESTION: The new WHO NTD Roadmap is being presented to a broad public worldwide, what is new?

Prof. Dr. KH Martin Kollmann: “First of all, the new WHO-NTD Roadmap 2030 builds on the successes of an extraordinary multi-actor partnership. With the experience of decades of collaboration, e.g., in river blindness and trachoma control, this coalition of country programmes, implementing partners, research institutions, the pharmaceutical sector and communities affected by the burden of disease set common goals in 2012 with the "London Declaration" on the road to global control and elimination of NTDs.

As a result, by 2020, 42 countries have already eliminated one or more of the 20 tropical diseases defined by the WHO as neglected tropical diseases (NTDs). These impressive advances have been helped not least by substantial and long-standing drug donations from research-based pharmaceutical companies, as well as innovative approaches by civil society aid organisations. However, many interventions in the past have focused mainly on individual diseases and have paid too little attention to interactions, overlapping disease burdens and joint intervention options. It has already been shown that NTD-interventions also have systemic effects, such as the administration of antibiotics in trachoma treatment, which also have an effect against other infections and can thus reduce disease-related mortality overall, especially among children.

Integrated into the UN Sustainable Development Goals (SDGs), the WHO is now making a remarkable course correction with the new Roadmap 2030. This paradigm shift aims to better coordinate and bring together established and new NTD-partnerships to achieve the ambitious goals.

The emphasis on community-centred approaches is rightly central to this: people affected by NTDs must be systematically and from the outset actively and inclusively involved in the planning, implementation and evaluation of programmes.

This goes hand in hand with a shift in focus towards more holistic and intersectoral programmes. For example, the WHO-Roadmap explicitly highlights the importance of deepening collaboration with the WASH sector, as well as the need to strengthen One-Health-approaches.”

2^nd QUESTION: What are the roles of old and new partners in implementing the strategy?

Prof. Dr. KH Martin Kollmann: “The new NTD-Roadmap 2030 builds on past successes and existing partnerships. These include, for example, disease-specific coalitions with their technical and programmatic expertise, as well as various drug donation programmes supported by the pharmaceutical sector.

But we need to step up our efforts in many areas if we are to achieve our ambitious goals of stopping all 20 NTDs. We need more drug donations and need to expand distribution structures and accompanying health interventions. And we need increased research and development efforts for additional innovative diagnostics and active ingredients.

Furthermore, to implement the new NTD-Roadmap 2030, it is essential to involve new partners, for example from the WASH (water, sanitation and hygiene) and One-Health-sectors with the important interfaces between people, animals and their shared environment. But we should also deepen partnerships with other health actors, such as the HIV/AIDS, tuberculosis and malaria communities. The links between NTDs, stigma and mental health are also obvious. Systematic treatment is also needed for other diseases caused or exacerbated by NTDs, such as female genital bilharzia, which massively increases the risk of HIV infection for affected women and girls.”

3^rd QUESTION: What are the major challenges in the next ten years?

Prof. Dr KH Martin Kollmann: “Crucial to success by 2030 will be how to achieve greater efficiency and sustainability by effectively bringing together what have often been separate, side-by-side programmes; how to create congruence and strengthen local resources by systematically integrating NTD-programmes into general health and development systems; and how to meet the expected "last mile" challenges.

This includes, in particular, finding local answers for countries and regions particularly shaken by poverty and crises, shouldering the increased costs with decreasing numbers of cases, overcoming the presumably decreasing willingness of national governments and international donors to invest with increasing success, and mastering possible problems such as the development of resistance.”

Foto: ©CBM/argum/Einberger

Berlin – 26.10.2020 The DNTDs workshop at the first virtual World Health Summit 2020 focused on the COVID 19 crisis and the effects on the measures to eradicate neglected tropical diseases. Dr. Mwele Malecela, WHO, Director of Department of Control of Neglected Tropical Diseases noted that the COVID-19 pandemic has dramatically impacted advances in the eradication of neglected tropical diseases (NTDs). Implementation of NTD programs has been suspended following the initial WHO recommendations, but a differentiated decision-making framework for resumption of mass treatment and other NTD interventions is now in place. This means that the annual mass drug administration cycles have been interrupted, no monitoring and evaluation has been carried out, little to no operational research was implemented, work is slowly resuming. Dr. Johannes Waltz from Merck pointed out that if COVID-19 NTD interventions are disrupted for a longer period of time, the probability is high that the exposure to NTDs will increase again and long-term efforts will be lost. Dr. Irene Ayakaka from DAHW described for the East African region how the NTD community has adapted programs and guidelines, faced the challenges of the COVID-19 pandemic and continued on the path to eradicate NTDs. Makoy Yibi Logara, the NTD program coordinator for the country of South Sudan, emphasized that NTD programs offer unique platforms that reach all communities in their target areas, thus ensuring prevention and treatment, even for those who often do not have access to health care benefit the fight against COVID-19. Constanze Bönig then pointed out, how NTD control programs can be combined with the One Health approach and that the German government is building a new "One Health" focus in the Federal Ministry for Economic Cooperation and Development. Prof. Dr. Achim Hörauf, spokesman for the DNTD and director of the Institute for Medical Microbiology, Immunology and Parasitology at the Bonn University Hospital and Dr. Dr. Carsten Köhler, Director of the Competence Center Tropical Medicine Baden-Württemberg, Institute for Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital, Eberhard-Karls-Universität Tübingen moderated the event.

More information is available here.