Multisectoral interventions needed to fight against neglected tropical diseases
The neglected tropical diseases (NTDs) refer to a group of 20 diseases that are preventable and treatable yet have placed a heavy burden on about 1.7 billion people worldwide.
Recently, the World Health Organisation (WHO) classified mycetoma, scabies and snakebite envenoming as NTDs. According to the WHO, Africa alone bears about 40 per cent of the global burden posed by the NTDs as the diseases are endemic in 47 African countries, with about 36 co-endemic cases in some of the affected African countries including Ghana.
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The NTDs are incapacitating and stigmatising so every year, they kill over 200,000 people globally. As part of the incapacitation of the affected population, the NTDs lead to physical and intellectual impairment and for that matter poverty.
This is because people who contract these diseases are unable to work, either due to stigma or lack of strength to do so.
NTD Situation
In Ghana, the NTDs permeate the 16 administrative regions and they constitute a serious public health concern for the country. Over the years, Ghana has been battling NTDs including but not limited to Lymphatic Filariasis, Onchocerciasis, Schistosomiasis, Soil Transmitted Helminthiasis (i.e., Ascaris, Hookworm, and Whipworm), Rabies, Trachoma, Buruli Ulcer, Yaws, Guinea Worm, Leprosy, Leishmaniasis and Human African Trypanosomiasis (HAT).
Apart from Ghana, the NTDs are found in many other countries in Africa, Asia and Latin America. The NTDs are usually endemic in tropical areas where potable water is highly inaccessible or where there are no safe ways of disposing human waste.
Multisectoral
A sustained and strategic fight against the NTDs calls for a multisectoral approach to control disease vectors such as mosquitoes, ticks, black flies, tsetse flies, fleas, etc. and simultaneously improve potable water supply, sanitation and environmental hygiene.
For example, while the health sector is focusing on preventive and curative approaches to fighting the NTDs, the Ministry of Defence must use helicopters for mass spraying of vectors.
Again, while the water sector extends potable water to various communities, especially those in rural and hard-to-reach areas, the metropolitan, municipal and district assemblies (MMDAs) must also see to environmental hygiene in communities under their control.
Accordingly, I dare submit that the health sector alone cannot and should not be left to fight against the NTDs. Other sectors must be involved.
After all, Ghana’s eradication of the guinea worm disease was achieved through effective multisectoral interventions.
This is why Ghana’s development agenda must cut across various sectors and communities. Also, the beneficiary communities must be involved in any effective fight against the NTDs.
Recommendations
The WHO recommends five major interventions necessary to fight the NTDs and these include:
1. Preventive Chemotherapy and Transmission control (PCT): An approach that focuses on safe and efficacious medication availability necessary to achieve a large-scale preventive chemotherapy.
2. Innovative and intensified Disease Management (IDM): This involves the use of primary healthcare disease control methods with the ultimate aim of eliminating the NTDs. Many healthcare management experts consider the IDM intervention as a cost-effective NTD control approach.
3. Vector Ecology and Management (VEM): As indicated earlier, an effective fight against the NTDs calls for a targeted control of the vectors that transmit the pathogens.
4. Safe Water, Sanitation and Hygiene (WASH): The WHO strongly recommends access to safe water, adequate sanitation and hygiene in various communities as a major intervention in the fight against the NTDs. Sadly, recent empirical data suggests that about 40 per cent of the world’s population and close to 47 per cent of schools lack hand-washing facilities at home and on school premises respectively. It was also found that 16 per cent of healthcare facilities have no functioning toilets or hand-washing facilities at points of care where patients are treated. In Ghana, most of the public health facilities charge patients for the use of washrooms.
5. Veterinary Public Health Services (VPHS): Arguably, human health is linked to animal health and the environment, hence good health for animals means good health for humans. For example, most NTDs such as rabies are zoonotic diseases that are transmitted from animals to humans.
Fighting NTD
Under the guidance of the WHO, the Ghana Health Service (GHS) commendably put in place from 2016 to 2020 a master plan for fighting the NTDs. At the expiration of the said master plan, the GHS introduced another one (2020-2025 plan) on Tuesday, August 24, 2021 to enable Ghana to meet the 2030 global deadline of eradicating the NTDs.
This master plan calls for the effective implementation of interventions that must be supported by other sectors of the Ghanaian economy for the prevention, control, elimination and eradication of the 20 NTDs and other disease groups in NTD-endemic countries.
Conclusion
I maintain unhesitatingly that a sustained fight against the NTDs should not be the sole duty of the health sector; other sectors must join this important fight, methinks. I reiterate that the eradication of the NTDs by 2030 calls for multisectoral interventions targeted at these preventable and treatable but neglected diseases that bestow stigma and poverty on humanity.
Religious organisations, chiefs and people, civil society organisations, academic institutions, corporate Ghana, other identifiable groupings and individuals must also join Ghana’s fight against the NTDs. Early detection and treatment of these diseases is key to overcoming them.
With the protagonist MacDuff in us, let us come out from our hideouts in the Burman Woods and move as warriors toward Dunsinane Hill to defeat the antagonist Macbeth in the NTDs, just as William Shakespeare would proffer. Said differently, Portia must save Bassanio from Shylock’s intended pound of flesh now or never.
The writer is a health service administrator. Email: [email protected]