31 January 2018

Africa: The Middle-Class Can Help End Neglected Tropical Diseases

Photo: Anthony Morland/IRIN
Trachoma screening in Nigeria (file photo).
analysis

At the 30th African Union Summit, Heads of State and Governments endorsed the new African Leaders Malaria Alliance scorecard which includes indicators on neglected tropical diseases (NTDs). This is important because for the first time, in one consolidated scorecard, it will be possible to track progress and investment opportunities for ending the suffering of children, women and men that are affected by NTDs.

NTDs are a group of preventable and treatable diseases that affect 1.5 billion people - 600 million of whom live in Africa. They are so widespread that half of Africa’s population is affected, from urban spaces to hard-to-reach parts of the continent. NTDs disfigure and disable people, keep our children out of school, and prevent many able-parents from working while caring for them. NTDs erode progress in health and economic investment. According to a study from Erasmus University, if the World Health Organization (WHO) Regional Office for Africa (AFRO) meets its 2020 goals, for the 5 most prevalent NTDs, in Africa, our economies will generate US$ 52 billion in productivity gains by 2030. We could also save over 100 million disability-adjusted life years. Thus, the consequences are far-reaching in Africa and the rest of the world.

Creating wealth on the continent requires us to end NTDs and close the health gap that limits, stifles, and ends good economic opportunities for too many. We have the figures and know it is possible. The WHO estimates the costs of health sector interventions to end most NTDs are $750 million per year until 2020 and US$ 300 million per year from 2020 to 2030. This cost is not impossible but it means Africa’s middle-class must invest the required resources to help end NTDs for good, even if they and their families are not currently affected by the diseases.

Africa’s middle-class will spend an estimated US$ 1.4 trillion by 2020. What if they put some of that money toward ending the five most common NTDs: lymphatic filariasis, intestinal worms, onchocerciasis (river blindness), trachoma and schistosomiasis? These can be treated for less than US$ 0.50 cents as the delivery cost per person per year. And the good news is that they don’t need to know how to pronounce the names of the diseases to invest to end them.

I will not disagree with those that think that African governments, donors and others have a responsibility to end NTDs, but they cannot do it alone. If we follow the money, they already have contributed significant resources over the past five years. For example, the Democratic Republic of Congo now provides 25 percent of funding for its NTD programs, up from 0 in 2011. Ethiopia has made significant strides in the fight against Trachoma. Sudan, Egypt and Tanzania signaled their willingness to increase domestic financing. But the African middle-class can accelerate progress and become the generation that ended NTDs in Africa, just as they helped to reduce the spread of AIDS on the continent in the previous generation.

For those that doubt that Africa can end NTDs for good, Morocco eliminated trachoma in 2016 and Togo eliminated lymphatic filariasis - elephantiasis - in 2017. They did it by partnering to implement large scale treatment of affected populations. To end the 5 for good, we need all hands on deck and new funding from an untapped source; the middle class.

Millions of people suffer from NTDs but together, we can work to end them and/or disrupt their transmission by 2020. Thanks to the ALMA Scorecard tracking NTDs, organizations like The End Fund are better equipped to disrupt the transmission of diseases that can be eradicated. The data is now reported alongside malaria, maternal and child health to the Head of States and Government. Ultimately, this is the real disruption that Africa needs; ending diseases.

Carl Manlan is an economist and Chief Operating Officer of the Ecobank Foundation. He is a 2016 Aspen New Voices Fellow.

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