1A9bnbK

Recommendations

Info

34 THIRD WHO REPORT ON NEGLECTED TROPICAL DISEASES *** (45). Evidence is arguably most complete for visceral leishmaniasis, with studies from multiple countries showing that even when diagnosis and medicines are provided free of charge, between 25% and 75% of households of sufferers experience some type of financial catastrophe (46–50). At least a few countries have made progress to address this issue. In Nepal, for example, in addition to free diagnosis and treatment, visceral leishmaniasis patients receive cash transfers contingent on completion of treatment, to cover transport and nutrition costs (51). Additional evidence on the productivity losses associated with NTDs is presented in Chapter 4. Although some NTDs may already be covered within UHC under inpatient and outpatient service coverage, universal coverage against NTDs requires vigilance that prevention not be neglected within UHC. NTD programmes should demonstrate how progressive (pro-poor) they are in terms of coverage. Income is difficult to measure in low-income settings, and especially difficult to measure in the rural and often informal settings where most NTDs occur. Nonetheless, widely accepted alternatives exist. Reporting routine data broken down by socioeconomic status – including groups based on the ownership of assets, or the education level of the head of the household – would help in identifying remaining barriers to coverage (52). Special attention will need to be paid to the diseases of populations so poor that they cannot access even the loans needed to pay for a proper diagnosis – populations so poor that they do not even have the option of incurring financial catastrophe and debt. The inclusion of an equity focus in policy-making will become more and more important the closer countries get to achieving the targets of the Roadmap. Such a focus will help justify sustained efforts in the remaining number of NTD hot spots where unit costs begin to increase just as the scale of operation begins to decrease. Ultimately, it will be up to countries to define the balance between equity and cost–effectiveness trade-offs in UHC priority-setting (53). It is clear, however, that more work can be done by the NTD community to ensure that UHC priority-setting and subsequent monitoring of progress do not neglect the neglected simply for lack of relevant data and tools.
*** INVESTING TOWARDS UNIVERSAL COVERAGE AGAINST NTDS − CHAPTER 2 35 2.6 Financing universal coverage against NTDs This section provides a broad overview of some of the sources and mechanisms of financing for universal coverage against NTDs in the era of the SDGs (post-2015). It emphasizes the primacy of domestic investment in ensuring that the essential package of health interventions for the poor is not dependent on charity. It invites the NTD community to familiarize itself and engage with sector-wide health financing tools and mechanisms, including newer entries such as “innovative financing” mechanisms. 2.6.1 The role of foreign donors and community volunteers in progress made to 2015 The report of the Uniting to Combat NTDs coalition documents the important role that aid has played, and will continue to play, in the efforts to control NTDs (34). As part of its commitment to the London Declaration, the pharmaceutical industry donated 2.5 billion NTD treatments in 2012–2013. The United States Agency for International Development and the United Kingdom Government have been the “stalwarts of NTD funding among traditional donor nations”, with support to at least 49 countries. Cash and in-kind aid are estimated in the coalition’s report at about US$ 200–300 million a year in 2013 and 2014, excluding the donations of the pharmaceutical industry. More difficult to quantify is the contribution of community volunteers. In the past, preventive chemotherapy has relied in large part on “an army of volunteers, or community drug distributors (CDDs), to distribute preventative drug packages through community and school-based platforms” (54). Volunteers have also been credited with an important role in the early detection and treatment of NTD cases (55). The limits of their charity have not gone untested, however. In at least one setting, it was found that the presence of community-based HIV and tuberculosis programmes providing financial incentives discouraged many CDDs from volunteering for free (56). Relative to other major health programmes, NTD programmes have received one of the largest shares of the pharmaceutical industry’s donations (57). And yet, they are constrained by the smallest number of products on the market and, along with maternal and child health programmes, the smallest number of products in the pipeline. As of 2015, most of these are still in the early stages of development and it will be some time before any of them are on the market. The commitment of foreign donors and community volunteers to NTD control will continue to be important in scaling up access to those products that are available. However, it is unlikely that they can mobilize resources at the scale implied by universal coverage against NTDs. Universal coverage against NTDs will fail if it fails to mobilize domestic investment.
Page 1: INVESTING TO OVERCOME THE GLOBAL IM
Page 4 and 5: ii THIRD WHO REPORT ON NEGLECTED TR
Page 6 and 7: iv THIRD WHO REPORT ON NEGLECTED TR
Page 8: vi THIRD WHO REPORT ON NEGLECTED TR
Page 11 and 12: *** FOREWORD ix FOREWORD BY THE DIR
Page 13 and 14: *** EXECUTIVE SUMMARY xi EXECUTIVE
Page 15 and 16: *** EXECUTIVE SUMMARY xiii for the
Page 17 and 18: *** EXECUTIVE SUMMARY xv Neglected
Page 19 and 20: *** THE RESOLUTION AND THE ROADMAP
Page 29 and 30: *** INVESTING TOWARDS UNIVERSAL COV
Page 49 and 50: ● ● ● ● ● ● ● ● ●
Page 51: *** INVESTING TOWARDS UNIVERSAL COV
Page 63 and 64: *** KEY INTERVENTIONS: SITUATION RE
Page 87 and 88: *** THE DISEASES − CHAPTER 4 69 I
Page 91 and 92: *** THE DISEASES − CHAPTER 4 73 p
Page 93 and 94: *** THE DISEASES − CHAPTER 4 75 4
Page 95 and 96: *** THE DISEASES − CHAPTER 4 77 E
Page 97 and 98: *** THE DISEASES − CHAPTER 4 79 T
Page 99 and 100: *** THE DISEASES − CHAPTER 4 81 1
Page 103 and 104:
*** THE DISEASES − CHAPTER 4 85 A
Page 105 and 106:
*** THE DISEASES − CHAPTER 4 87 F
Page 107 and 108:
*** THE DISEASES − CHAPTER 4 89 4
Page 109 and 110:
*** THE DISEASES − CHAPTER 4 91 F
Page 111 and 112:
*** THE DISEASES − CHAPTER 4 93 I
Page 113 and 114:
*** THE DISEASES − CHAPTER 4 95 4
Page 115 and 116:
*** THE DISEASES − CHAPTER 4 97 I
Page 117 and 118:
*** THE DISEASES − CHAPTER 4 99 M
Page 119 and 120:
*** THE DISEASES − CHAPTER 4 101
Page 121 and 122:
Page 123 and 124:
Page 125 and 126:
Page 127 and 128:
Page 129 and 130:
Page 131 and 132:
Page 133 and 134:
Page 135 and 136:
Page 137 and 138:
Page 139 and 140:
Page 141 and 142:
Page 143 and 144:
Page 145 and 146:
Page 147 and 148:
Page 149 and 150:
Page 151 and 152:
Page 153 and 154:
Page 155 and 156:
Page 157 and 158:
Page 159 and 160:
Page 161 and 162:
Page 163 and 164:
Page 165 and 166:
Page 167 and 168:
Page 169 and 170:
Page 171 and 172:
Page 173 and 174:
Page 175 and 176:
Page 177 and 178:
Page 179 and 180:
Page 181 and 182:
Page 183 and 184:
Page 185 and 186:
Page 187 and 188:
Page 189 and 190:
Page 191 and 192:
Page 193 and 194:
Page 195 and 196:
Page 197 and 198:
*** ANNEXES 179 ANNEXES
Page 199 and 200:
*** ANNEXES 181 Annex 1a (cont’d)
Page 201 and 202:
*** ANNEXES 183 WHA66.12 Recognizin
Page 203 and 204:
*** ANNEXES 185 WHA66.12 3. REQUEST
Page 205 and 206:
*** ANNEXES 187 Annex 3. Classifica
Page 207 and 208:
*** ANNEXES 189 Annex 5. Medicines
Page 209:
*** ANNEXES 191 WHO REGIONAL OFFICE
show all

1A9bnbK

Create successful ePaper yourself

Delete template?

Save as template?