The Kigali Declaration on Neglected Tropical Diseases is a global health project that aims to mobilise political and financial resources for the control and eradication of infectious diseases, the so-called neglected tropical diseases due to different parasitic infections. [1] Launched by the Uniting to Combat Neglected Tropical Diseases on 27 January 2022, it was the culmination and join commitment declared at the Kigali Summit on Malaria and Neglected Tropical Diseases (NTDs) hosted by the Government of Rwanda at its capital city Kigali on 23 June 2022.
The declaration was launched as a support for the World Health Organization's 2021–30 road map for NTDs and the target of Sustainable Development Goal 3 to end NTD epidemics; and as a follow-up project of the London Declaration on Neglected Tropical Diseases. [2] Supported by WHO, governments of the Commonwealth of Nations pledged the endorsement, along with commitments from pharmaceutical companies including GSK plc, Novartis, Pfizer, Sightsavers and the Wellcome Trust. [3]
The World Health Organization classified 20 major diseases as neglected tropical diseases (NTD), while finer classifications consider several additional conditions. [4] The diseases collectively had affected almost 2 billion people worldwide every year, causing about 200,000 deaths and almost 50 disability adjusted life years annually. In 2012, WHO published its first NTD road map for 2012–2020. [5] [6] NTDs are not deadly diseases, and are often ignored, described as "diseases of poverty and inequality"; [7] but are responsible for large-scale economic problems, health issues, and educational backwardness. [8] For achieving the goals of the road map, the London Declaration on Neglected Tropical Diseases, spearheaded by the Bill & Melinda Gates Foundation, was launched on 30 January 2012. The project was supported by major pharmaceutical companies, in addition to governments and organisations. [9] [10]
As the London Declaration terminated, there were considerable successes in disease control. Although no disease was eradicated globally, many of the target infections were eliminated in several countries, with 42 countries having eliminated at least one disease. [11] One of the biggest successes was the control of Guinea worm disease (dracunculiasis). The disease was eliminated in 19 of 21 countries; [12] by 2021, only 15 cases were recorded globally. [13] NTDs were still a major health concern, affecting 1.7 billion people worldwide, 35% of who are in Africa. Tanzania, for example, had the highest cases of NTDs; more than 29 million Tanzanians, almost half the population, required treatment for at least one NTD, and 19 million of the children were at risk of intestinal worms. [14]
In November 2020, the 73rd World Health Assembly announced the WHO's 2021–2030 road map for NTDs, to prevent, control, eliminate and eradicate these diseases. [15] The new road map aims to:
As the new road map was announced, there was a need for another complimentary project to continue the London Declaration. [7] In 2021, a new programme called the Kigali Declaration on Neglected Tropical Diseases was prepared by the Government of Rwanda with a support from the Uniting to Combat Neglected Tropical Diseases. It was publicised for responses throughout that year. [16]
The Uniting to Combat Neglected Tropical Diseases launched the Kigali Declaration as a "100% Committed" (the name of the campaign [17] ) political movement on 27 January 2022. [18] Édouard Ngirente, Prime Minister of Rwanda, Muhammadu Buhari, President of Nigeria, Samia Suluhu Hassan, President of Tanzania, and James Marape, Prime Minister of Papua New Guinea, were present at the announcement and endorsed the project. On the occasion, Mark Suzman, CEO of the Bill & Melinda Gates Foundation, said:
The partnership between the private and public sectors on NTDs, exemplified by the London Declaration, has led to one of the great public health successes of the past decade. The sheer scale of the accomplishment – one billion people reached with treatments each year for the past five years – means that hundreds of millions fewer people are at risk compared to 2012. The Bill & Melinda Gates Foundation is pleased to join many of our long-standing partners in welcoming the new, country-led Kigali Declaration to build on this incredible progress. Funding for NTDs is an investment in health equity–with a focus on integrating NTDs into strengthened health systems, the Kigali Declaration promises a chance at a healthier life for people affected by these debilitating diseases. [19]
The declaration was publicly announced by the WHO on the third World NTD Day on 30 January 2022. Gautam Biswas, acting Director, WHO Department of Control of Neglected Tropical Diseases, stated: "Progress achieved over the last decade is the result of the excellent public-private partnership with countries endemic for NTDs and the unfaltering support of partners who endorsed the London Declaration in 2012. It is exciting to see political will gearing up around the Kigali Declaration to achieve the new road map targets for 2030." [20]
The African Union and the Uniting to Combat NTDs signed a memorandum for the declaration on 29 March 2022. [21] They agreed that the declaration would be launched as a global project at the Kigali Summit on Malaria and NTDs, to be held alongside the 26th Commonwealth Heads of Government meeting in Rwanda. [3] [8] The declaration was officially launched by Paul Kagame, President of the Republic of Rwanda, [22] at the Kigali Summit on 23 June 2022. [2] Kagame stated:
Ensuring that all African countries mobilise the domestic financial resources required for quality health care is a priority for the African Union and our partners. If there is one thing the pandemic has taught us, it is that together, through coordinated and collaborative action, we can achieve much more. [23]
It was endorsed with commitments from donor governments, endemic country governments, pharmaceutical companies, organisations, with US$1.5 billion in financial commitments and 18 billion donated tablets. [22] The commitment immediately rose to US$1.5 billion and 18 billion medications from pharmaceutical companies. [23]
The declaration aims to create the "world's largest public-private partnership" [1] to reduce the number of infection by 90% and eliminate at least one NTD in 100 countries by 2030, as stated in the WHO road map. [7] Specific eradication targets are Guinea worm disease and yaws that were almost eradicated under the London Declaration project. [2] It also aims to "ensure that people affected by NTDs – particularly women and girls, persons with disabilities, and minority and underrepresented groups – are at the center of NTD programs and decision-making processes." This is because women and girls are prone to infections as their daily chores involve washing and visiting parasite-infested water bodies. [14]
The main statement runs:
Building on the progress of the London Declaration on Neglected Tropical Diseases (NTDs) and putting individuals and communities at the centre of the NTD response, we, the signatories of this declaration, come together to commit to ending NTDs. We acknowledge that NTDs are diseases of poverty and inequity. By tackling NTDs we will reduce poverty, address inequity, strengthen health systems, increase human capital and build resilient communities, bringing us closer to achieving universal health coverage and the SDGs. This declaration is for and in service of the 1.7 billion people who continue to suffer from NTDs. [24]
Lions Clubs International, is an international service organization, currently headquartered in Oak Brook, IL, USA. As of January 2020, it had over 46,000 local clubs and more than 1.4 million members in more than 200 countries and geographic areas around the world.
Tropical diseases are diseases that are prevalent in or unique to tropical and subtropical regions. The diseases are less prevalent in temperate climates, due in part to the occurrence of a cold season, which controls the insect population by forcing hibernation. However, many were present in northern Europe and northern America in the 17th and 18th centuries before modern understanding of disease causation. The initial impetus for tropical medicine was to protect the health of colonial settlers, notably in India under the British Raj. Insects such as mosquitoes and flies are by far the most common disease carrier, or vector. These insects may carry a parasite, bacterium or virus that is infectious to humans and animals. Most often disease is transmitted by an insect bite, which causes transmission of the infectious agent through subcutaneous blood exchange. Vaccines are not available for most of the diseases listed here, and many do not have cures.
Lepra (Leprosy Relief Association) is a UK-based international charity established in 1924, working to diagnose, treat, and rehabilitate people with leprosy. Lepra currently works in India, Bangladesh, and Zimbabwe.
An advance market commitment (AMC) is a promise to buy or subsidise a product if it is successfully developed. AMCs are typically offered by governments or private foundations to encourage the development of vaccines or treatments. In exchange, pharmaceutical companies commit to providing a certain number of doses at a fixed price. This funding mechanism is used when the cost of research and development is too high to be worthwhile for the private sector without a guarantee of a certain quantity of purchases.
Global health is the health of the populations in the worldwide context; it has been defined as "the area of study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide". Problems that transcend national borders or have a global political and economic impact are often emphasized. Thus, global health is about worldwide health improvement, reduction of disparities, and protection against global threats that disregard national borders, including the most common causes of human death and years of life lost from a global perspective.
Neglected tropical diseases (NTDs) are a diverse group of tropical infections that are common in low-income populations in developing regions of Africa, Asia, and the Americas. They are caused by a variety of pathogens, such as viruses, bacteria, protozoa, and parasitic worms (helminths). These diseases are contrasted with the "big three" infectious diseases, which generally receive greater treatment and research funding. In sub-Saharan Africa, the effect of neglected tropical diseases as a group is comparable to that of malaria and tuberculosis. NTD co-infection can also make HIV/AIDS and tuberculosis more deadly.
The Global Network for Neglected Tropical Diseases is an advocacy initiative of the Sabin Vaccine Institute dedicated to raising the awareness, political will, and funding necessary to control and eliminate the most common Neglected Tropical Diseases (NTDs)—a group of disabling, disfiguring, and deadly diseases affecting more than 1.4 billion people worldwide living on less than $1.25 a day.
The eradication of infectious diseases is the reduction of the prevalence of an infectious disease in the global host population to zero.
The Children's Investment Fund Foundation (UK) (CIFF) is an independent philanthropic organisation with offices in Addis Ababa, Beijing, London, Nairobi and New Delhi. It is a registered charity in England and Wales and in 2021 disbursed $468 million and committed $772 million in charitable investments. With assets of GBP £5.2 billion (USD $6.6 billion), it is the 5th largest global development philanthropy in the world based on annual disbursements. According to OECD published data, it is the world's second largest private funder of reproductive health and environmental protection globally and the largest philanthropy that focuses specifically on improving children's lives. In 2021, CIFF pledged $500 million towards gender equality over five years as part of the generation equality forum.
The Task Force for Global Health is an international, nonprofit organization that works to improve health of people most in need, primarily in developing countries. Founded in 1984 by global health pioneer Dr. William Foege, The Task Force consists of eight programs focused on neglected tropical diseases, vaccines, field epidemiology, public health informatics, and health workforce development. Those programs include the African Health Workforce Project, the Center for Vaccine Equity, Children Without Worms, International Trachoma Initiative, Mectizan Donation Program, Neglected Tropical Diseases Support Center, Public Health Informatics Institute, and TEPHINET. The Task Force works in partnership with ministries of health and hundreds of organizations, including major pharmaceutical companies that donate billions of dollars annually in essential medicines. Major funders include the Bill & Melinda Gates Foundation, CDC, WHO, Robert Wood Johnson Foundation, de Beaumont Foundation, United States Agency for International Development, Sightsavers, Pfizer, Merck & Co., Johnson & Johnson, and GlaxoSmithKline. The Task Force is affiliated with Emory University, headquartered in Decatur, Georgia, a town in metro Atlanta, and has regional offices in Guatemala and Ethiopia. The Task Force currently supports work in 154 countries.
The London Declaration on Neglected Tropical Diseases was a collaborative disease eradication programme launched on 30 January 2012 in London. It was inspired by the World Health Organization roadmap to eradicate or prevent transmission for neglected tropical diseases by the year 2020. Officials from WHO, the World Bank, the Bill & Melinda Gates Foundation, the world's 13 leading pharmaceutical companies, and government representatives from US, UK, United Arab Emirates, Bangladesh, Brazil, Mozambique and Tanzania participated in a joint meeting at the Royal College of Physicians to launch this project. The meeting was spearheaded by Margaret Chan, Director-General of WHO, and Bill Gates, Co-Chair of the Bill & Melinda Gates Foundation.
Children Without Worms (CWW) is a program of the Task Force for Global Health and envisions a world in which all at-risk people, specifically targeting children, are healthy and free of worm infections (helminthiases) so they can develop to their full potential. To accomplish the vision of a worm-free world, CWW works closely with the World Health Organization, national Ministries of Health, nongovernmental organizations and private-public coalitions such as Uniting to Combat NTDs. It acts as an intermediary for the pharmaceutical company Johnson and Johnson in distributing the latter's mebendazole for mass deworming of children to reduce or end soil-transmitted helminthiasis.
Mundo Sano, or Fundación Mundo Sano, is a scientific, nongovernmental foundation in Argentina working for the prevention and control of communicable diseases such as dengue fever, Chagas disease, malaria, leishmaniasis and soil-transmitted helminthiasis. Its main objective is to facilitate equal access to health and welfare among people who are vulnerable to these otherwise avoidable diseases, mainly by promoting strategic policies for the improvement of the quality of life of affected communities.
The Global Health Innovative Technology Fund, headquartered in Japan, is an international public-private partnership between the Government of Japan, 16 pharmaceutical and diagnostics companies, the Bill & Melinda Gates Foundation, the Wellcome Trust and United Nations Development Programme. It funds scientific research and development for anti-infectives and diagnostics for diseases that primarily affect the developing world. Bill Gates has noted that "GHIT draws on the immense innovation capacity of Japan’s pharmaceutical companies, universities and research institutions to accelerate the creation of new vaccines, drugs and diagnostic tools for global health." Margaret Chan, former Director-General of the World Health Organization, said: "The GHIT Fund has stepped in to provide that incentive in a pioneering model of partnership that brings Japanese innovation, investment and leadership to the global fight against infectious disease."
This is a timeline of deworming, and specifically mass deworming.
Eradication of dracunculiasis is an ongoing program. Dracunculiasis, or Guinea worm disease, is an infection by the Guinea worm. In 1986, there were an estimated 3.5 million cases of Guinea worm in 20 endemic nations in Asia and Africa. Ghana alone reported 180 000 cases in 1989. The number of cases has since been reduced by more than 99.999 % to 13 in 2023 in five remaining endemic states: South Sudan, Chad, Mali, Ethiopia and Angola.
Neglected tropical diseases in India are a group of bacterial, parasitic, viral, and fungal infections that are common in low income countries but receive little funding to address them. Neglected tropical diseases are common in India.
World NTD Day or World NTD Day is an awareness day for addressing neglected tropical diseases (NTDs). It is held on January 30 annually.
Chinyere Ukaga is a professor of public health parasitology in the department of Animal and Environmental Biology, Imo State University, Owerri.
The END Fund is a private non-profit organisation dedicated to combating the five most common neglected tropical diseases (NTDs) that cause up to 90% of the NTD burden in Sub-Saharan Africa.
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