Celebrating the role of research to control major diseases
Eliminating visceral leishmaniasis and river blindness were just two examples profiled during the World Health Assembly (WHA) and the celebration of the role of research in controlling serious diseases that affect people living in poor countries. It was 40 years ago at this annual event that government representatives of Member States agreed to create a programme like TDR.
A panel presentation held 23 May drew a standing-room only crowd to review how community programmes are controlling river blindness and malaria, and collaborations among WHO, TDR and the government of Bangladesh are helping that country to eliminate visceral leishmaniasis.
Eliminating visceral leishmaniasis
It was at the World Health Assembly in 2005 that the countries of Bangladesh, India and Nepal signed a Memorandum of Understanding to eliminate visceral leishmaniasis by 2015.
The situation in 2005 was not positive. There were 20 000 cases of VL a year, diagnosis could only be made in one centre in the country’s capital, there was only one drug treatment, no measures for controlling the mosquito that transmitted the parasite, few trained physicians and nurses, and little research on the disease.
"Research helped us adapt policies and practices, and we should be able to achieve elimination of visceral leishmaniasis by the end of 2015."
Dr Be-Nazir Ahmed, Director of the Disease Control and Directorate General of Health Services in Bangladesh
Making progress would require strong collaborations and commitments, explained Be-Nazir Ahmed, Director of the Disease Control and Directorate General of Health Services in Bangladesh. The national and regional governments, WHO at both the global and country level, and TDR worked hand in hand to address the challenges.
The work covered 5 key areas:
- Validating a rapid diagnostic test
- Testing new drugs and drug regimens
- Studying better ways to control the mosquitos that transmit the dengue parasite through insecticide spraying and treated bednets
- Identifying ways to identify cases in remote areas
- Developing a monitoring and evaluation toolkit
“This collaboration was essential, and it worked,” said Dr Ahmed. The number of cases dropped from 9400 in 2006 to under 1500 by 2013. “Research helped us adapt policies and practices,” he added, “and we should be able to achieve elimination by the end of 2015.”
Tackling onchocerciasis through communities
The power of remote, rural communities to manage their major diseases has been studied at TDR for many years. One of the strongest results to come from this work is in the area of delivering an annual treatment to manage onchocerciasis.
“I am here to tell you a story of a young, pregnant girl, and how she motivated me to better understand the problems of this terrible disease,” related Dr Uche Amazigo, the former director of the African Programme for Onchocerciasis Control (APOC), to the panel audience.
Dr Amazigo began her career with pioneering research on the social consequences of onchocerciasis (river blindness) for adolescent girls and women. Her early work supported by TDR identified the impact of severe skin disfigurement and itching from river blindness.
"I am here to tell you a story of a young, pregnant girl, and how she motivated me to better understand the problems of this terrible disease".
Dr Uche Amazigo, former director of the African Programme for Onchocerciasis Control (APOC)
Dr Amazigo is a long-time collaborator with TDR, receiving her first fellowship in 1978. At the panel, she talked about both the value of research, and the support from TDR that was critical to her career. “TDR transformed my life into something more than I could have imagined,” she said.
Dr Amazigo went on to help set up APOC, which was created to mass distribute an annual drug treatment, eventually becoming its director. While there, she worked with TDR on research to improve the distribution of ivermectin, the drug to manage the disease. The system she described is now a model of community-based care that in is providing treatment to 98 million people in 24 sub Saharan African countries, and has also been found to increase malaria diagnosis and treatment.
World Health Assembly acknowledgement
WHO Director-General Margaret Chan called attention to TDR in her speech at the annual Assembly, citing the work “to find the barriers to access, including costs, in impoverished settings and break them down.”
On 22 May, a former TDR grantee received a Jacques Parisot Foundation Fellowship at the WHA. The grant will allow Dr Htin Zaw Soe from Myanmar to further develop innovative environmentally-friendly repellents to prevent bites of the mosquito that transmits dengue fever. Dr Soe received TDR funding in 2010 to develop the concept with experts from Mexico and India. See more information in this news item.
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