Neglected Tropical Diseases Day: India can beat them but that needs bold action

News: Neglected tropical disease day is on January 30 and it reminds that India needs an integrated approach to eliminate NTDs.

What is Neglected Tropical Diseases (NTDs)?

NTDs is an umbrella term that refers to 20 medically diverse, communicable diseases that flourish in impoverished environments, tend to coexist, cause significant mortality.

Why there is need to pay attention to NTDs?

One, NTDs can cause permanent disabilities, impact mental and emotional health. NTDs affect over 1.7 billion people across the world. For instance, Lymphatic Filariasis which is known as haathipaon in hindi or Elephant Feet is the second-leading cause of permanent disability in the world.

It attacks the human lymphatic system and can cause painful swelling of limbs (lymphoedema), genitalia (hydrocele) and disfigurement of breast.

Two, some NTDs are deadly. For instance, Visceral Leishmaniasis known as Kala-Azar or Black Fever. It is transmitted by sandflies.

Three, in case of India, Lymphatic Filariasis is endemic in 328 districts across 21 states / Union territories. Kala-Azar is endemic in 54 districts across four states of India. These diseases affect 650 million and 140 million people in the country, respectively.

What steps have been taken by the government to eliminate NTDs?

One, government has set a target of 100 per cent elimination of Lymphatic Filariasis and Kala-Azar in line with global targets. The government also supports morbidity management and disability prevention for those affected by lymphoedema and hydrocele.

Two, preventive methods like Mass Drug Administration (MDA) rounds are periodically deployed in endemic areas during which anti-filarial medicines are provided free-of-cost to at-risk communities. Vector-control measures like Indoor Residual Spraying are undertaken to prevent sandfly breeding.

Three, State and central governments have introduced wage compensation schemes for those suffering from Kala-Azar and its sequela. Sequela is a condition which is the consequence of a previous disease known as Post-Kala Azar Dermal Leishmaniasis.

Four, India adapted to COVID-19 led disruptions and bounced back. For instance, using bowls to distribute medicines from a safe distance. Over 70 per cent of the districts that had targeted Mass Drug Administration (MDA), distributed anti-filarial medicines to eligible populations.

Dynamic dashboards helped in better planning and implementation. As a result, MDA coverage and compliance have improved and 134 districts have stopped MDA after passing Transmission Assessment Survey (TAS).

This test determines if the prevalence of Lymphatic Filariasis in an evaluation area has decreased with no chance of re-emergence.

Five, even after health system was burdened, India in 2021 witnessed improved case surveillance, case detection and case prevalence rates with respect to Kala-Azar. There is decrease of 35 per cent in all reported case as compared to 2020. Also, 99 per cent of Kala-Azar endemic blocks having achieved the elimination target.

What is the way forward?

First, improving access to quality healthcare, water, sanitation, hygiene, addressing climate change and ensuring gender equity, mental health and well-being should be made core of elimination strategy.

Second, multi-stakeholder and cross-sectoral partnerships and collaboration is required to play a central role in sustaining the momentum gained.

Source: This post is based on the article “Neglected Tropical Diseases Day: India can beat them but that needs bold action” published in Down To Earth on 29^th Jan 2022.