Why British leadership remains critical to ending neglected tropical diseases” Ellen Agler, CEO of the END Fund

Since the dawn of medicine, the UK has been a pioneer and world leader in preventative medicines like vaccines, antibiotics and neglected tropical disease (NTD) treatments. It started with Lady Mary Wortley Montagu’s introduction to deliberately inoculating people with a mild case of disease in the eighteenth century, and was followed decades later by Edward Jenner’s creation of the first smallpox vaccine. The field of tropical medicine was created by Scottish parasitologist Sir Patrick Manson in the nineteenth century. Manson discovered that an insect (e.g. a mosquito) can serve as an intermediate host for a developing parasite, radically advancing the knowledge of tropical diseases including malaria, and NTDs like lymphatic filariasis, schistosomiasis, leprosy, and loa loa. The recent reduction to the United Kingdom’s foreign aid budget forces some difficult decisions that could jeopardize this illustrious history. My hope is that one of those decisions is to honor the legacy of the U.K.’s historic commitment to NTDs. A cut to NTD program funding would be a setback for millions of people around the world, at a time when the possibility of seeing an end to these diseases is so tangible.

NTDs are a group of diseases that sometimes kill people but more often destroy their quality of life through malnutrition, disfigurement, blindness, and other severe ailments. These diseases affect 1.7 billion people worldwide, most of whom live in areas with limited resources such as poor access to clean water and sanitation. Infected children often cannot attend school; adults struggle to work and this affects their earning potential. As the CEO of the END Fund, a philanthropic organisation focused on ending the five most prevalent NTDs, I can say with certainty that NTDs perpetuate a cycle of poverty, sickness and suffering; they rob millions of men, women and children of the opportunity to reach their full potential.

In the past 40 years—and at an accelerating pace—more progress has been made against NTDs than any other time in human history and leadership from the U.K. has been at the heart of this progress. This surge is the result of several factors, including effective drugs (donated by pharmaceutical companies) and the unflagging work of organisations to distribute these drugs and help implement disease interventions. The number of people at risk of NTDs has been reduced by 600 million people in the last decade alone, and 42 countries have eliminated at least one NTD. We are so close to seeing a world free of the burden caused by NTDs. The new World Health Organization (WHO) 2030 NTD Roadmap ratified last November charts an ambitious path to NTD elimination over the next decade. 

A reduction in aid would jeopardize progress when the finish line is just on the horizon. Currently the U.K.’s foreign aid commitment for NTDs is about £220 million to 2022, a mere 0.6% of the aid budget per annum. On the granular level, the cost to treat or prevent the five most prevalent NTDs is less than 50 pence per person per year, on average. Each pound invested in NTD treatment in endemic countries yields £19 – £30 worth of economic benefit, which unlocks the door to health and future prosperity. A recent study by the Economist Intelligence Unit (EIU) found that meeting parasitic worm infection elimination targets for four African countries (Ethiopia, Rwanda, Zimbabwe, and Kenya) would yield £3.7 billion in productivity gains by 2040.  The U.K.’s ability to strengthen the local economy of so many nations is one of the major reasons why the commitment to NTDs should not be reduced. The recent emphasis on initiatives such as the U.K. – Africa trade will yield greater benefit if the global economy is strengthened.

Many British entities, some of which are listed below, have and continue to contribute to the field of NTDs: 

● British non-governmental organisations are leading the fight against NTDs: the Schistosomiasis Control Initiative Foundation, Sightsavers, Leprosy Mission (which Diana, Princess of Wales worked with since 1989), Mentor Initiative, LEPRA, Uniting to Combat NTDs, and others. 

● Many of the most impactful British philanthropies are invested in the fight to end NTDs: Children’s Investment Fund Foundation, Power of Nutrition, Virgin Unite, and Wellcome Trust. 

● The oldest and most esteemed schools of tropical medicine are British: London School of Hygiene & Tropical Medicines, Imperial College London, Liverpool School of Tropical Medicine. 

● British institutions, such as the Natural History Museum and the Wellcome Trust, provide crucial support and resources for NTD research. 

● The Queen Elizabeth Diamond Jubilee Trust’s Trachoma Initiative provided 26.6 million antibiotic eye treatments and 104,020 sightsaving operations. 

● British pharmaceutical GlaxoSmithKline has donated over 10 billion tablets of albendazole to protect over 900 million people from intestinal worms and lymphatic filariasis. Owing to the U.K.’s long tradition of altruism, contributions to this field have never slackened. It is, therefore, critical that British leadership stays the course in this movement to end NTDs over the coming decade. A funding reduction would be a devastating chapter in the U.K.’s proud history as a global leader that has been a bedrock of funding, a font of knowledge and a reliable source of action. Even in a world wracked by COVID-19, to divert funds from NTDs will be to lose critical progress and relinquish leadership status. It will bring a premature conclusion to what is due to seal the great British success story of ending NTDs in this decade. That is why I call on the UK government to maintain NTD funding. 

Source: African Media Agency (AMA) and END Fund