Tropical and subtropical parts of the world are home to a range of communicable diseases known as neglected tropical diseases. They are designated as “neglected” because prevention and control efforts have been minimal or nonexistent for several decades. The World Health Organization directs their identification and management.
DISEASES
These twenty conditions disproportionately affect poor populations, women, and children. The majority of those affected by them reside in rural regions with overcrowded dwellings and inadequate water and toilet facilities. It is believed that more than one billion individuals are afflicted globally.
Onchocerciasis, schistosomiasis, lymphatic filariasis, soil-transmitted helminth infections, and trachoma are examples of neglected tropical diseases. Dengue fever, leptospirosis, trypanosomiasis, leishmaniasis, Buruli ulcer, leprosy, and snakebite envenoming are also included.
More than 170,000 people die annually from these diseases, fewer than the 627,000 deaths expected from malaria in 2020. However, the diseases can result in ugliness, stigmatization, malnutrition, and cognitive difficulties, resulting in a variety of social, economic, and psychological costs for people affected.
Nigeria bears an especially tremendous strain. A fifth of the African population afflicted by neglected tropical illnesses resides in Nigeria. An estimated 100 million people in the United States are at risk for at least one of the diseases, and several million people are affected with many diseases.
As an epidemiologist who has studied some of these diseases and provided technical support for control initiatives for the past 21 years, I can state that Nigeria has made progress in managing them. Two states have eradicated onchocerciasis and the country has eradicated Guinea-worm disease. But it can still do more.
Other diseases continue to be prevalent in Nigeria. A National Steering Committee for Neglected Tropical Diseases oversees control efforts. Additionally, there are control units at the federal, state, and municipal levels of government. As partners, local and international donors assist. There have been advancements in illness mapping, master plan creation, and intervention delivery.
GLOBAL EFFORTS
The World Health Organization divides disease control activities into two categories: prevention and management.
Preventive control involves the administration of drugs that are effective, safe, and affordable. Onchocerciasis, schistosomiasis, lymphatic filariasis, soil-transmitted helminths, and trachoma can be prevented in this manner. It is the most prevalent in sub-Saharan Africa.
The case-by-case management of diseases for which adequate instruments for large-scale application are unavailable.
Pharmaceutical corporations, donors, endemic nations, and non-governmental organizations signed the London Declaration on Neglected Tropical Diseases in 2012. They promised to controlling, eliminating, or eradicating ten top diseases by 2020.
World Neglected Tropical Diseases Day will be observed annually on January 30 beginning in 2020.
Through research grants, the numerous worldwide programs have increased the capacity of African scientists and developed awareness and financing partnerships to accomplish the WHO 2030 eradication goals in Africa.
NIGERIA
The foundation of the Nigerian Institute for Trypanosomiasis Research in Kaduna in 1947 marked the beginning of concentrated efforts to combat human and animal trypanosomiasis (sleeping sickness and nagana) in Nigeria. In 1988, large-scale attempts to combat human onchocerciasis (river blindness) were initiated. In 1997, when proof of treatment efficacy became available, the National Lymphatic Filariasis Elimination Programme was launched.
Through donor programs, assistance for the acquisition, delivery, and distribution of medications surged throughout the 1990s. The Federal Ministry of Health established control units, and all 36 states were charged with implementing control actions using recommended medications.
To reach the marginalized communities that carry the greatest burden of chronic diseases, volunteers give medication door-to-door in their neighborhood. When drug distribution occurs in schools, teachers also play a similar role.
SUPPORT AND MEDICATION FOR THESE ILLNESSES
These interventions are funded by the government budget, bilateral aid, and direct development partner funding. Pharmaceutical corporations give medicines, and the WHO coordinates their distribution.
The treatment statistics for human onchocerciasis and lymphatic filariasis (elephantiasis) from 2014 to 2021 demonstrated an increase in the number of patients treated and the attainment of 65 percent WHO treatment coverage. For schistosomiasis (bilharzia) and soil-transmitted helminthiasis (intestinal worms), Nigeria has not achieved the WHO-recommended 75% coverage.
This indicates that progress is being made in the control and eradication of certain illnesses.
During the 2020 and 2021 COVID pandemic, coverage was at its lowest point.
Two states have stopped the transmission of onchocerciasis: Plateau and Nasarawa. The abolition of 61 local governments is imminent in 2021. This indicates that the sickness has been contained.
Also on the decline is lymphatic filariasis, although only 37 local government areas are close to elimination. The disease is present in 520 of Nigeria’s 774 local governments.
Schistosomiasis treatment coverage has fallen short of the WHO goal. This is largely due to poor medicine availability and the difficulties associated with treating children in and out of school. In 2022, the WHO issued revised control and eradication guidelines. The road map aims to eliminate schistosomiasis as a global public health problem. To stop the transmission of schistosomiasis in impacted areas, the revised guidelines also urged the deployment of other interventions, including the supply of water, sanitation, and hygiene education (WASH), behavioral health education, and snail control.
Out of 147 local government areas targeted for treatment of soil-transmitted helminthiasis, 117 have achieved greater than 75 percent treatment coverage.
Nigeria has made significant progress in reducing the prevalence of trachoma.
THE WAY AHEAD
The prevention of neglected tropical diseases is dependent on widespread drug administration. This demands significant monetary and human resources. Moreover, effective community participation is essential. However, public knowledge of these diseases and the measures to control them is limited.
The lack of medications, inadequate financial assistance, and inadequate material logistics for treatment campaigns hinder control and elimination attempts. Insufficient political will, the absence of an NGO partner in some areas, and apathy among medication dealers and health personnel due to a lack of incentives are further obstacles. During the pandemic, these obstacles grew worse.
Government and partners at all levels should increase financing for activity control. Citizens should also be educated through advocacy to support control efforts in their communities. It is crucial that Nigeria enacts legislation to direct and intensify control efforts. Otherwise, the country would be left behind by 2030, when the rest of sub-Saharan Africa will have managed or eliminated these diseases.
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