Can you simply neglect one billion people?

The WHO published their interim report on its strategy against Neglected Tropical Diseases (NTDs) in April. FAIRMED Managing Director René Stäheli explains why the integrated WHO approach comes as confirmation of the work done by FAIRMED, how we should value the commitment of Bill Gates and why drugs are only part of the fight against NTDs.

René Stäheli, director of FAIRMED, is happy with the direction FAIRMED is going.

FAIRMED on the spot: the WHO published the fourth report in the spring of 2017 - an interim report on progress made with the NTD roadmap and the strategy for what needs to be achieved in the fight against Neglected Tropical Diseases by 2020. Where are we with this?

René Stäheli: On the one hand, the report highlights successes in the fight against NTDs: sleeping sickness has been reduced by around 90 percent over the last 15 years, Guinea worm has almost been eradicated and cases of Buruli ulcer have fallen by about 60 percent - FAIRMED having made a significant contribution in Cameroon. But the report also reveals even bigger challenges on the way to achieving set targets.

What are the challenges?

First of all, we need to defend and monitor the ground we have already gained - so that we can react right away if a disease starts advancing again. But the search for new drugs needs to continue in case the current ones lose their effect – and awareness of NTDs needs to play a much bigger part in public health. Warring countries with collapsed health systems are a major challenge.

Does the report reveal any surprises?

Put it this way: the WHO is making itself very clear about the integration of NTDs in health systems, measures implemented across every sector, contributions to sustainable development goals and global health coverage. And it is very gratifying to see that the WHO is clearly admitting that millions of people will suffer the consequences of an NTD – even after the goals on the Roadmap have been achieved. People who suffer the consequences of NTDs will not be able to work or only in a limited way, regardless of whether the diseases causing such consequences are eradicated or not. This is completely in line with the approach applied by FAIRMED.

So the WHO is actually supporting the way in which FAIRMED works in its report?

Yes, the WHO has copied us! (laughs). We feel that the fourth NTD Report confirms that we are on the right track with our integrated cross-sector approach. We have learned that you can’t just pick a single disease and treat it. The health of the people in our project regions depends on many different factors, and they can only be addressed effectively by taking their interdependencies into account. An obvious example is the treatment of bilharzia with drugs.

… soon after people have been treated for bilharzia they get it again because they keep fetching their water from the river.

Exactly! Drinking and waste water, controlling vectors, education, nutrition and many other factors have a part to play alongside a functioning health system. In a nutshell, everything with an influence on human health needs to be taken into account– treating an individual disease with drugs is only a tiny piece of the puzzle.

How can organisations fighting against NTDs like FAIRMED employ this integrated approach?

We work with local people to establish the major factors affecting their health. This is how we run our projects – we combine the expertise of local people, organisations and authorities with our own experience and scientifically proven results. This delivers solutions adapted to local conditions that will be taken up by everyone.

FAIRMED helped found the Swiss Alliance against Tropical Diseases at the NTD Summit in Geneva. Is the same trend appearing in this alliance as identified in the WHO report – namely an integrated and networked approach to NTDs?

Totally. It’s really amazing how many organisations in such a small country as Switzerland are involved in the fight against NTDs: various development organisations, universities and pharma companies. Whether we work out in the field or in the lab, we all share the same concern – bringing an awareness of the burden of STDs to a wider public. There might only be a few thousand people affected by NTDs, but a billion people….

…so now even Bill Gates is campaigning against NTDs.

The fact that Bill Gates - with all his high status and wealth - is also campaigning against  NTDs is very helpful to our cause.