Africa’s social entrepreneurs must take up fight against NTDs

Francis Kokutse is a journalist based in Accra and writes for Associated Press (AP), University World News, as well as Science and Development.Net. He was a Staff Writer of African Concord and Africa Economic Digest in London, UK.

With over $777 million pledges made by countries and global donors to help defeat Neglected Tropical Diseases (NTDs), African social entrepreneurs must take up the challenge, using the availability of these funds to fight  the scourge that has caused pain to many people on the continent. No one, but Africans can help fight these menaces.

They can follow the example of the  World Shoe factory in Akosombo – Ghana, which is  poised to take part in this global effort by producing shoes to fight hookworm. The company joined the bandwagon of industries contributing in the fight to eradicate NTDs with the establishment of their factory to provide cheap shoes to fight contracting diseases by walking barefoot, and make   money at the same time.

Two of the NTDs that World Shoe has targeted are hookworm, which is contracted  by walking barefoot on soil contaminated by faeces, and  podoconiosis, or endemic non-filarial elephantiasis, which is also  caused by exposure of the bare feet to irritant alkaline clay soil.

Early symptoms of podoconiosis include a burning sensation and itching on the back of the feet. Skin thickening is accompanied by papillomatous growths around the sides of the feet and the heel. Reversible foot and lower leg oedema (swelling) become fixed and gradually progress up the leg.

Other NTDs include, Buruli ulcer, Chagas disease dengue and chikungunya, dracunculiasis; echinococcosis; foodborne trematodiases; human African trypanosomiasis, and  leishmaniasis; leprosy.

Giving an insight to the NTDS, Thoko Elphick-Pooley, the  executive director of Uniting to Combat NTDs, said these diseases are a group of preventable and treatable diseases that affect about 1.65 billion people around the world, often living in remote communities. NTDs cause immeasurable suffering, they debilitate, disfigure and can be fatal. In addition, they can  create cycles of poverty and cost developing nations billions of dollars every year.

She said they are  referred to as ‘neglected’ as they generally affect people who are underserved and marginalised, and whose political influence may be limited. “This means that NTDs are often a forgotten priority in global development and health financing,” Elphick-Pooley added.

Although NTDs are specifically mentioned in the Sustainable Development Goal (SDG) target 3.3, alongside HIV/AIDS, tuberculosis, and malaria, they do not benefit from the same level of prioritisation and resourcing.

Thoko Elphick-Pooley says the burden of NTDs is felt strongly in the African continent, adding that, “the region accounts for over a third of people requiring treatment for NTDs globally. These diseases have a profound effect on people’s lives; they cause immeasurable suffering, prevent adults from being able to work, and children from being able to go to school. They rob the continent of its vital human capital.

In addition, NTDs also have a significant economic impact on households through costs of treatment and care, as well as lost productivity. They create barriers to education, employment, and economic growth as well as stigmatisation which leads to exclusion from society.

So far, 50  countries have eliminated at least one NTD including 21 in Africa, with Togo the first country globally to eliminate four NTDs in 2022. Domestic and international commitment to control, elimination and eradication has accelerated progress against NTDs, demonstrating that it is possible to reach some of the world’s poorest and most remote communities through creative, low-cost programmes.

The problem so far is though the  political will to tackle NTDs across Africa exists and African governments are leading the way,  Elphick-Pooley said,  “sustainable  financing for tackling NTDs is critical if we are to control and eliminate NTDs, and help to build resilience against the health impacts of climate change.”

For this reason she said, it is gratifying  that,  African leaders, including Tanzania and Sierra Leone, African philanthropists – such as Higherlife Foundation – and global donors pledged over $777 million towards tackling NTDs at the 2023 Reaching the Last Mile Forum held under the patronage of His Highness Sheikh Mohamed bin Zayed Al Nahyan, President of the UAE, and in collaboration with the Bill & Melinda Gates Foundation at COP28.

It is against this background that more African social entrepreneurs need to rally  to find a way of tapping into this global pledge to put up facilities that will help fight these diseases. It should not be a situation where entrepreneurs access these funds and end up doing nothing because that will be the worst crime against the continent.

Africa is indeed waiting to see how the continent will be helped because there is also the growing fear that there is a link between NTDs and climate change  and this relates to people and their livelihoods.

“NTDs typically affect poor people who have limited access to basic services. Major weather events such as floods, droughts, wildfires, and heat waves are having devastating impacts, eroding the little these communities have and pushing them deeper into poverty, whilst also spreading these preventable, infectious diseases further as we start to witness the spread and shift of NTDs into areas they have never been seen in before,” Elphick-Pooley said.

She said climate change makes it harder to control and eliminate NTDs, and limits the capacity of health services to effectively respond to disease, adding that, “this undermines Universal Health Coverage (UHC) and disrupts health systems, widening health inequalities and threatening to undo these monumental achievements in global health.”

So, social entrepreneurs who may want to provide solutions to the eradication of NTDs can look into integrating climate resilience into health systems. In addition, there is also  an urgent need for immediate action to safeguard previous global health gains in this rapidly evolving climate landscape.

“We need to work together to make sure the health impacts of climate change are visible to decision makers in order to unlock vital action and funding. Whilst the problem is significant, it has been great to see health – and NTDs – feature on the agenda at COP28 this year. This is welcomed and much needed – the climate crisis is among the greatest health challenges facing the world today,” Elphick-Pooley added.

Social entrepreneurs can look at the use of unmanned  ground vehicle systems to monitor sewers for Aedes mosquitos and to carry out the eradication of Dengue fever. Elphick-Pooley admits that Dengue is the fastest spreading infectious disease in the world, adding that the  disease represents a ‘pandemic threat.’ There are over five million dengue cases reported each year and rates of the disease have risen eight-fold since 2000.

Already a major health problem across the world, chief scientists believe dengue fever will become an increasing threat in the southern United States, southern Europe, and new parts of Africa this decade.

Elphick-Pooley said solution in prevention and treatment of dengue fever are multi-faceted, explaining that, experts like Jeremy Farrar, WHO’s chief scientist, have said  public health funds must be spent in the right areas, including on the best way to control the mosquito and  therefore called on proper prevention including triaging plans for hospitals, as well as scientific innovation alongside other key factors, such as urban planning, to reduce mosquito breeding sites near or in houses. If this work includes community-level initiatives, it can lead to sustainable behaviour change that results in real and positive impact on health outcomes.

She said there are large-scale, affordable methods being developed to reduce the dengue “reservoirs” in endemic communities (for example, the work of the World Mosquito Programme). It is for this reason that African social entrepreneurs can help the continent by Investing in this in the tropics to substantially reduce the pandemic potential in today’s travelling world.