Neglected tropical diseases (NTDs) affect the lives of people who are at the bottom of the pyramid with limited access to health services. The quest to achieve universal health coverage (UHC), leaving no one behind, is incumbent on eliminating NTDs. For long, these diseases have been neglected, but our government has pledged to bring change and ensure that diseases such as Lymphatic Filariasis (Hathi Paon) and Visceral Leishmaniasis (Kala-Azar) are eliminated from India. With a well-designed approach combining technology, research, human capital, innovation, strategic partnerships and financial commitments, we are well placed to fulfil this resolve.
Declared by the World Health Organization (WHO) as the second most common cause of long-term disability after mental illness, Lymphatic Filariasis (LF) is one of the biggest public health challenges that India faces today. The infection, spread by mosquitoes, is manifested in the form of painfully swollen limbs, and if left untreated, can incapacitate individuals during the peak of their productive years. Even today, a large section of the society remains unaware of the disease and the importance of taking preventive medication.
India is the first country in southeast Asia to adopt a game-changing drug regime to prevent LF. The triple drug therapy that administers a single dose of three anti-filarial drugs: Ivermectin, Diethylcarbamazine and Albendazole (IDA), is a radical step towards intensifying LF prevention efforts and the Government of India is committed to scale-up these efforts across the country in 21 of 37 endemic states and UTs. Such progressive interventions are meant to ensure access to essential preventive services for the neglected and the worst affected members of the society.
In line with the government’s will and vision to eliminate this threat, by the end of February 2019, IDA was rolled out in a phased manner across four pilot districts, namely Arwal in Bihar, Simdega in Jharkhand, Nagpur in Maharashtra and Varanasi in Uttar Pradesh. As a result, over 90 lakh beneficiaries have benefited across these four districts and are protected against this completely preventable NTD. By the end of 2019, an additional 4.5 crore people will receive IDA drugs.
The Sustainable Development Goals (SDGs) provide an effective framework for successful elimination of NTDs. SDGs emphasise the interrelated nature of health and development and encourage a broad, multi-dimensional approach that is essential to uproot NTDs. Importantly, the SDG framework ensures that our commitment to leaving no one behind facilitates a mind-set attuned to the needs of the society’s most vulnerable. If we can end NTDs, it will show that we can meet the needs of the most marginalised and address the key factors that drive social, economic and health inequalities.
Prevention of the disease is one part of the LF story, managing the disease is another. The disability associated with the disease vanquishes those affected, both physically and mentally. There is a need to spread awareness that not only is the disease preventable but those affected by it can improve their quality of life. The Accelerated Plan for Elimination of Lymphatic Filariasis (APELF) provides free morbidity management and disability prevention services through kits and corrective surgeries. Our government’s initiatives such as the Swachh Bharat Abhiyan (SBA) are already playing an important role in addressing the source of these vector-borne diseases.
We need to continue to expand our definition of partnership, and explore how NTD programmes can strengthen our health systems and benefit other disease programmes as well.
I appeal to the community leaders and elected representatives to raise awareness through a mass movement in their respective constituencies, and to help improve community compliance of these preventive drugs that are distributed free of cost under APELF. The Government of India is committed to provide adequate resources and is working with the states governments to ensure that these programmes are widely accepted and reach all individuals who are at risk of contracting such diseases.
We are committed, we are focused, and we are ready. The eradication of polio in India is a testimony to the feat that can be achieved once science and society join hands. Now, by accelerating the elimination of LF, India can lead the world towards securing a prosperous and healthy disease-free future.
This article first appeared in the print edition on November 2, 2019 under the title ‘Health Of A Nation’. The writer is Union minister for health and family welfare, science and technology, and earth sciences.