Tanzania set to streamline policy on neglected diseases

Geneva. For the first time in Tanzania, neglected tropical diseases (NTDs) will now be recognised in the National Health policy, which will enable the government to put in place a sufficient budget meant to control the public health menace, The Citizen has learnt.

Currently, programmes to control NTDs, such as schistosomiasis, trachoma, lymphatic filariasis, onchocerciasiasis and soil-transmitted worms are largely funded by donors, according to Prof Yunus Mgaya, Director General of the National Institute for Medical Research (NIMR).

Prof Mgaya told The Citizen on the sidelines of last week’s summit on NTDs in Geneva that the ongoing process to fully recognise NTDs in the national health policy could not have come at a better time than now when people afflicted by the diseases need to be freed from cycles of poverty and disease.

“When the control of NTDs is embedded in the National Health Policy, this comes along with more options for tackling the illnesses. You see, the control of NTDs requires integrated efforts—ranging from the government, global financiers and the local communities,’’ said Prof Mgaya, who was representing Health minister Ummy Mwalimu at the Summit.

“Having a good policy will make the local authorities to put the control of the diseases in their priorities too,’’ he added. He further underscored the need to extricate people from poverty as the surest way to eliminate NTDs according to the vision highlighted in Sustainable Development Goals (SDGs).

Over the past few years, there has been a growing momentum in the fight against these debilitating diseases among stakeholders in Africa and the world at large.

In 2012, an ambitious plan to control, eliminate or eradicate 10 neglected diseases was endorsed by a coalition of representatives from various sectors—it was the London Declaration on Neglected Tropical Diseases.

According to WHO Africa Regional Director, Dr Matshidiso Moeti, two dozen African countries pledged to strengthen their commitment to NTDs under the Addis Ababa Commitment on NTDs in 2014. And in 2015, the Sustainable Development Goals made clear that tackling NTDs was essential to helping communities break free of poverty.

“By and large, NTDs are not killer diseases. Instead, over years and decades, they sap people’s strength, destroy their quality of life and eat away their savings. For many people who suffer from them, chronic fatigue, bad vision and persistent discomfort seem to be routine parts of life,” says Dr Moeti,

Goal number one, among the 17 SDGs, ending poverty in all its forms everywhere is priority for socio-economic development. One of the targets is to tackle poverty in all age groups and how it affects people’s education, health, nutrition, and security.

“Further gains in the fight against neglected tropical diseases will depend on wider progress towards the Sustainable Development Goals,” stresses Dr Dirk Engels, Director of the Department of Control of Neglected Tropical Diseases. “Meeting global targets for water and sanitation will be key,’’ he added.

During the recent global NTD summit in Geneva which ended last weekend, leaders in public health, governments and donors pledged over Sh1.7 trillion ($812 million) to prevent NTDs in nearly a billion people each year across the world.

Within a year, that’s when it is expected that the committed funds would trickle down to the Tanzania said the NTD Programme Manager at the Ministry of Health, Community Development, Gender, Elderly and Children, Dr Upendo Mwingira.

However, for the country to qualify for the assistance, she said, local plans, implementable policies and better research on the true burden of the NTDs in Tanzania is a prerequisite.

“There has to be more investment in mapping the diseases, locating the more afflicted parts of the country and doing more research on which diseases have been fully tackled and those that are not yet. And this is the focus of the government now,’’ she said.

In 2009, the country adopted the World Health Organisation (WHO) initiative to integrate all the implementation of activities for NTD control but a series of efforts have been ongoing to try and accord more priority to the diseases, despite financial and capacity hurdles faced by the government.

“The coming of the national health policy, which is still being drafted, is part of the inclusive efforts against the NTDs,” says the NTD Programme Manager at the Ministry of Health, Community Development, Gender, Elderly and Children, Dr Upendo Mwingira.

That’s why, she said, the country launched its National NTD Master Plan for 2012-2017, a more robust and centralised plan through which all NTD efforts would be coordinated.

She told The Citizen in an interview in Geneva that the NTDs are now part of the third Health Sector Strategic Plan (HSSPIII) which started in 2009, but also they have been included in the fourth plan of 2016 which ends in 2021.

Tanzania is endemic for all five of the most common NTDs, with a large part of the population at risk for co-infection of two or more, says a report issued by End Fund—an NGO dealing with NTDs in Tanzania.

However, the country is considered one of the priority countries for trachoma elimination, reports indicate. Trachoma was initially said to be endemic in 50 districts but according to Dr Mwingira, the number of districts affected has gone down to about 30 or less.

Currently, the districts with a high prevalence of blinding trachoma—the largest infectious disease causing blindness in the world—and the large number of people requiring surgery for trichiasis are in the rural Maasai communities in the North East.

It is caused by a bacterium called chlamydia trachomatis and it affects both children and adults. It is estimated that 12.5 million people live at risk of the disease in Tanzania, according to data released by End Fund, an NGO dealing with NTDs.

Lymphatic filariasis is also endemic throughout the country with an estimated 45 million people living in high risk areas for the disease, data further reveals.