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6 THIRD WHO REPORT ON NEGLECTED TROPICAL DISEASES *** 1.3 Confronting challenges There is an urgent need to address the shortfall in long-term funding for various programmes. In April 2014, NTD partners published Delivering on promises and driving progress, which estimated that an additional US$ 1.4 billion, or US$ 200 million per year, would be needed to meet the 2020 Roadmap targets (5). These requirements include implementation costs for some but not all NTD interventions; they do not include, for example, vector control or the broader preventive chemotherapy agenda, such as post preventive chemotherapy surveillance and morbidity management and disability prevention. They also do not cover innovations, new tools or costs associated with improved strategies to achieve the Roadmap’s targets for 2020, much less the UHC targets for 2030. National control programmes must be strengthened, maintained and mandated with clearly defined responsibilities in order to coordinate essential functions such as situation analysis, strategic planning, budgeting, prevention, diagnosis, treatment, surveillance, capacity development, timely distribution of medicines and supervision of operations at all levels of the national system. Although significant progress has been made against vector-borne diseases, dengue and chikungunya continue to spread at an alarming pace. Challenges also include the shortage of trained health-care personnel, the absence of integrated vector control programmes and the degree of readiness in some countries to implement WHO-recommended integrated programmes comprehensively. Emerging challenges in Chad and insecurity in Mali and South Sudan have hindered dracunculiasis eradication and may compromise WHO’s target of interrupting transmission of the disease by the end of 2015. Some critical interventions go beyond the scope of health. Unpredictable epidemics such as the current Ebola virus disease crisis in West Africa and their potential to expand can divert resources away from NTDs and adversely affect national control programmes. Long-term political commitment, sustained strengthening of health systems, maintenance of technical capacities, and effective monitoring and evaluation of interventions are crucial to achieving the Roadmap’s targets. More State-level engagement, sustainable and innovative financing and greater coordination are required to bring game-changing treatments and diagnostics to patients. Increased domestic resources, including funding and intersectoral collaboration, must be enhanced to support implementation of programmes to achieve universal coverage against NTDs. 1 The concept of universal coverage against NTDs is more fully developed in Chapter 2. _____________________ 1 Universal coverage against NTDs (in particular) applies the principles of universal health coverage (in general) to an essential package of interventions for low-income and rural populations, and other disadvantaged groups.
*** THE RESOLUTION AND THE ROADMAP − CHAPTER 1 7 1.4 Supporting innovation Many pharmaceutical companies are supporting calls for research and development by opening their compound libraries to outside researchers. Major access agreements have been brokered between companies, by the Drugs for Neglected Diseases initiative and through the World Intellectual Property Organization’s Re:Search consortium. 1 Some product development partnerships are advancing the development of new medicines. According to data from the Global Funding of Innovation for Neglected Diseases, or G-Finder, which surveyed global investments into the research and development of products, 2 in 2007 product development partnerships captured US$ 469 million of funding granted by donors to research organizations (6). While existing tools continue to make a substantial impact on the hundreds of millions of people suffering from or at risk of NTDs and for whom innovative and intensified management is typically required, for many diseases, new medicines, diagnostics and innovative technologies are needed to reach the Roadmap’s 2020 targets. 1.5 Staying the course As NTDs are associated with unsafe water and sanitation, their prevention, control and elimination will depend on overall improvements in health-related projects. There must be increased advocacy for and awareness among policy-makers of development projects that foster successful programme implementation. China provides a good example (Box 1.1). The other side of “low-cost” treatment of NTDs is that it results in “market failures”. Emerging market economies can play a determining role in shedding the “charity” image of NTDs by doing more to produce new diagnostic tools, shake-up market dynamics, promote investment in research and advocate the development of new medicines. Lesson should be learnt from high-profile diseases that have attracted global attention through strong advocacy – and the lion’s share of global funding. _____________________ 1 http://www.wipo.int/research/en/ 2 http://g-finder.policycures.org/gfinder_report/
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*** ANNEXES 189 Annex 5. Medicines
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*** ANNEXES 191 WHO REGIONAL OFFICE
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