The fight against neglected tropical diseases: A mixed picture in Africa

Every year, the Network Uniting to Combat NTDs compiles an index that measures the success of 49 African countries in their efforts to combat Neglected Tropical Diseases (NTDs). The index highlights a somewhat unusual trend: poorer countries such as Swaziland and Malawi are at the top of the rankings, while richer countries, including Botswana and South Africa, are stuck in the lower third.

According to the WHO, countries that treat more than 75 percent of people at risk are on track to defeat a disease.

In concrete terms, the figures refer to the five most widely used NTDs for which mass treatments are available: trachoma, intestinal worms, elephantiasis, schistosomiasis and river blindness. These diseases affect 1.6 billion people worldwide, of which more than 600 million are in Africa.

The index compares the number of people that require treatment against the number receiving treatment, which provides a ‘coverage’ for each disease in percentages from 1 to 100. From the five coverage values for each country, statistical instruments are used to calculate an overall figure.

If this value is above 75, the index deems the country to be “on track” in the fight against NTDs. This is because – according to the World Health Organization (WHO) – countries that treat more than 75 percent of at-risk people are ultimately able to defeat the diseases.

Alternative priorities
At this time, 15 countries in Africa are exceeding the target of 75 percent. The unexpected twist: at the top of the list are Swaziland and Malawi – countries with a low gross domestic product. Richer countries such as South Africa, Equatorial Guinea, Gabon and Botswana, on the other hand, are all in the lower third of the index.

Dr. Mwelecele Ntuli Malecela, Director of NTD Control at the WHO, suggests that richer countries lag behind because they may not see NTDs as a priority or a threat to national health. “In South Africa, for example, HIV/AIDS has long been the recipient of far greater attention,” she writes.