September 27,2013

Calling All Collaborators to Eliminate Intestinal Worms in Children

Panel on STH at the opening of UN General Assembly's 68th session

Cross-posted from End the Neglect. By Deborah Elson.

“What we want to do is produce quality of life for the people.” – H.E. John A. Kufuor, President of the Republic of Ghana (2001-2009) and Global Network NTD Special Envoy

We have been anxiously awaiting the United Nations General Assembly’s (UNGA) sixty-eighth kick-off session, “The Post-2015 Development Agenda: Setting the Stage.” Neglected Tropical Diseases (NTDs) have impeded critical breakthroughs in development efforts for too long – plaguing one in six people globally, including half a billion children. While we have the medicine, which costs just 50 cents per person per year, we must garner greater attention, collaboration and political will to see the end of horrible suffering in the world’s most neglected communities.

We are certainly hopeful.

It was fitting that in the height of UNGA meetings, the Global Network, Johnson & Johnson, Children Without Worms, The Task Force for Global Health and the World Health Organization (WHO) co-hosted a conversation to identify innovative ways we can eliminate soil-transmitted helminth (STH) infections – one of the key diseases undercutting many Millennium Development Goals (MDGs).

“Business as usual” simply wouldn’t do! So, our event, “Innovate & Integrate: Multi-sectoral Approaches for Eliminating Intestinal Worms in Children,” set out to explore how and why organizations in the fields of NTDs; water, sanitation, and hygiene (WASH); nutrition; maternal and child health; and education can collaborate on this issue to ensure lasting advancements.

Bill Lin, director of Worldwide Corporate Contributions at Johnson & Johnson, opened with his experience growing up in a rural area outside of Hong Kong. Forever imprinted on him was the constant chanting of “wash your hands” and “don’t put your hands in your mouth.” “You [couldn’t] get clean water just by flipping a faucet.” Bill explained.

Bleak living conditions then and now have caused the perpetual transmission of intestinal worms. Therefore, we must not only distribute medicines to control STH infections but also work with partners to stop them from spreading. “There is a clear need for the education [and] health sectors to work together” to encourage behavioral changes.

Dr. Richard Besser, chief health and medical editor at ABC News then asked tough questions to our panelists: H.E. John A. Kufur, former president of the Republic of Ghana (2001-2009); Dr. Lorenzo Savioli, director of the Department of NTDs at WHO; and Ms. Kathy Spahn, President and CEO of Helen Keller International (HKI).

Recognizing that we were talking about “a disease that isn’t killing a lot of people” during a “busy week in New York,” Dr. Besser asked Dr. Savioli, “why does [STH] deserve attention?”

Optimistically, Dr. Lorenzo responded, “We can do something about it. We are eradicating guinea worm, we have the drugs to treat intestinal helminths … we can really interrupt transmission. We can make a difference with the tools we have in our hands.”

President Kufuor chimed in, “our goal is to seek solutions.” Speaking from his experiences in making NTD and WASH advancements as President of Ghana, including tremendous strides in the effort to eliminate guinea worm, President Kufuor noted that behavior change was critical, including “show[ing]  [people] how to boil water.” President Kufuor also stressed that the successes he oversaw were due to implementing policies that educated the public and provided infrastructure, and knowing when to “seek international help.”

Dr. Besser then asked Kathy, “Why does HKI think this is an important problem to tackle?”

Kathy answered that STH infections are “incredibly disabling” and threaten worker productivity, children’s attendance in school and the ability of children to achieve. We’re “really talking about the posterity of the country unless these diseases are tackled,” Kathy said.

Dr. Besser then asked President Kufuor about the widespread impact of intestinal worms. President Kufuor stated, “Worms prevent kids from getting full benefits. … The economy isn’t well when people have worms. … We tackle the problem from the source.”

President Kufuor also touched on a devastating consequence of STH infections: the impact on pregnant women and their babies: “Even with mothers, if they do not look after themselves well with what they eat, what they drink, then the fetus will not mature the way it should.”

Addressing the economic impact, Dr. Besser asked Dr. Savioli, “What evidence is there that these type of control efforts make a difference?” Dr. Savioli recognized that there is huge economic growth occurring in Africa, and that “those countries doing best in the African continent with NTDs are the ones that are doing better economically.”

Asking Kathy about whether it’s “idealistic to think that you can accomplish cross-sector integration,” Dr. Besser said, “Can it happen?” To which Kathy responded, “Nothing can happen unless you work cross-sectorally.”

Wrapping up the interviews, Dr. Besser asked, “If the MDGs don’t list NTDs, what does that mean?”

Dr. Savioli noted, “We need to put pressure to make sure that happens” and that, thanks to “a unique relationship between international organizations, NGOs, endemic states and the private sector,” we have a “historically unique” opportunity “in the history of public health.”

Kathy shared that we need to go beyond the drugs, giving the example of HKI’s partnership with Johnson & Johnson to develop curriculums in education – hand washing, face washing – in Cambodia to realize tremendous successes.

It’s no wonder that after the interviews and audience Q&A, Dr. Besser said, he has “about 50 more questions [he] would love to ask” and that we’re “fortunate to have such different perspectives on this problem.” STH is different in that the solution is known, and that “it’s a problem of will and resources to implement the solution,” Dr. Besser concluded.

In his closing remarks, Dr. Savioli stated, “We have the scientific evidence that when you treat people regularly, the morbidity goes down.” However, “countries have to be at the center of it” because “countries that have done well have performed better” in economic, health and other development markers.

“You deprive the country if you don’t do it,” Kathy closed.

Thanks to all for such an engaging, thought-provoking event! We look forward to seeing how cross-sectoral collaboration can make a difference in STH control and elimination in children.

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