Combating disease also boosts nutrition programs

Eradicating hunger and combating disease are at the heart of overseas development policy. And they are linked in several ways.

To us, they are unsavory but usually harmless exotic species. However, according to WHO, in developing countries they cause more disease in school-age children than any other pathogen. We're talking here about intestinal worms. It is estimated that more than 1 billion people, including many children, are infected with intestinal roundworm, hookworm and whipworm alone. Simply walking barefoot in contaminated soil is enough to become infected because the larvae can penetrate human skin. Playing with friends by the riverside takes on quite a different meaning - it is not a harmless pleasure. Areas of damp ground or standing water are teeming with worm larvae.

Frequently, such a worm infestation leads to diarrhea and anemia, compounding the consequences of malnutrition, thus leading to impaired growth and reduced performance in school and employment. A woman giving birth might suffer bleeding, harmless in itself but potentially fatal if the woman is anemic due to a worm infestation. In the long term, people are locked into poverty through intestinal worm diseases. WHO recommends the administration of a drug treatment once or twice a year to all children aged between one and 15 years living in areas where there is a high prevalence of intestinal worms.

It is often the local health centers that help the villagers get rid of the parasites. In the Protestant district hospital in Koyom in Chad with its network of 32 health centers, the German charity "Bread for the World" has been able to ensure that even people in isolated regions receive basic medical care. Twice a year the volunteers visit the village, set up tables for the crates of deworming medicine. In the days leading up to this, they have announced the event by megaphone. Hundreds of fathers, mothers and children gather in the shade of trees and wait their turn. This gives the volunteers a great opportunity to spread the word, "Wash your hands before eating! Wash fruit and vegetables in purified water!"

Usually, "deworming" rapidly improves the child's health and developmental state. Simply treating each child without waiting for a worm infestation diagnosis is a feasible and common-sense approach, because the drugs are well tolerated. They benefit those who are infected while not harming those who are not infected. Up to now, about 35 % of schoolchildren in affected areas have been treated. The goal is to reach 75 % by 2020.

This recommendation is being implemented by the program Children Without Worms. The program partners are the pharmaceutical companies Janssen and GlaxoSmithKline. Together, they provide about 600 million tablets every year.

Yet, tablets are not enough to bring an end to intestinal worm infections. So, Children Without Worms is following a holistic approach by not only providing access to clean water but also improving sanitation and providing hygiene education.

Medicines to fight poverty-associated tropical diseases

1987

River blindness

Start of the WHO program for patients suffering from river blindness; MSD is donating the medicine

1992

Leishmaniasis

Support of the Leishmaniasis Control Program of the WHO by Gilead Sciences who started donating a medicine in 2011

Leprosy

Start of the WHO program for free treatments; Novartis has been donating the medicines (since 2000)

 

1995

African sleeping sickness

Start of the WHO programs against sleeping sickness; Sanofi (since 2001) and Bayer (since 2002) are donating the medicines, since 2009 also for a new combination therapy

1998

Trachoma

Start of the "International Trachoma Initiative"; Pfizer is donating the medicine

2000

Elephantiasis, lymphatic filariasis

Start of the "Global Alliance to Eliminate Lymphatic Filariasis"; the medicines are donated by GlaxoSmithKline, MSD, Eisai and Sanofi

2003

DNDi

Foundation of the "Drugs for Neglected Diseases Initiative" (DNDi), a product development partnership to develop new medicines, above all, for the treatment of poverty-
associated tropical diseases. Numerous pharmaceutical companies have since been involved in the research and development.

2004

Chagas disease

Start of the WHO treatment programs; Bayer is donating the medicine

2006

Soil-transmitted worms

Start of the Initiative "Children Without Worms"; Janssen and GlaxoSmithKline are donating the medicines

2007

Bilharzia

Start of the WHO program fighting this disease; Merck is donating the medicine

Liver fluke disease
(Fascioliasis)

Start of the WHO program fighting fascioliasis; Novartis is donating the medicine

2010

Lung fluke disease
(Paragonimiasis)

Start of the WHO program fighting paragonimiasis; Novartis is donating the medicine

2011

WIPO Re:Search

Foundation of WIPO Re:Search. This organization promotes, among other things, the exchange of research findings, technologies and licenses between companies and research institutes on poverty-
associated tropical diseases.

2012

London Declaration

Governments, organizations and companies agree to increase their mutual collaboration to fight ten poverty-associated tropical diseases; the companies involved are Abbott (now AbbVie), AstraZeneca, Bayer, Becton Dickinson, Bristol-Myers Squibb, Eisai, Gilead Sciences, GlaxoSmithKline, Janssen (Johnson & Johnson), Merck, MSD, Novartis, Pfizer and Sanofi

2015

Record

With drugs for more than 1.5 billion treatments a new annual record for donated medicines to treat poverty-associated tropical diseases has been reached.

2020

Milestone

By then, ten poverty-
associated tropical diseases are to be regionally eliminated or their incidence reduced. The fight against such diseases will, however, continue.

You can also download the above timeline as a PDF poster.


For the German Association of Research-Based Pharmaceutical Companies, this is an example of how combating poverty-related tropical diseases also benefits other development goals, for instance better nutrition. "If schoolchildren are dewormed, then their food fills them up instead of feeding their intestinal parasites", according to Harald Zimmer, Head of International Affairs at vfa and board member of the German Network combating Neglected Tropical Diseases (GNTDs). He goes on to cite more links, "Farmers can extend their fields right up to the river bank again when they no longer need to be scared of being infected by river blindness." WHO reports that it has already been possible to safely regain 25 million hectares of land for agriculture through combating river blindness in West Africa. This area is equivalent to the size of the former West Germany.

Yet it is still rare for health programs and activities for rural development and food security to be linked up. In the worst case scenario, a disjointed approach can even lead to a dangerous conflict of goals; in the past, when irrigation channels were installed to improve the harvest, this often led to the spread of another disease: bilharziasis. With good planning, however, this can be dealt with through suitable design of channels, by explaining to the residents the routes of infection and the preventive measures to be taken, and also by ensuring that control programs can be rolled out rapidly in the affected region, if need be.

Integrated programs and collaboration by the stakeholders can simultaneously eliminate the nutrition and health problems of the poor, thus creating even more opportunity for them to overcome poverty.