Sustainable Elimination of Poverty-Associated Public Health Problems

Fighting Neglected Tropical Diseases

Young boy leading old blind man - 2 onchocerciasis

Together with the World Health Organization (WHO) and other partners, we are improving public health in some of the most underserved regions of the world by working to eliminate the impact of the most devastating Neglected Tropical Diseases (NTDs) by 2030.

NTDs are preventable and treatable diseases that place a heavy burden on the world’s poorest populations. In fact, with over 1.7 billion people around the world afflicted – including more than a half a billion children – one in six people are infected with NTDs worldwide on average. And despite the huge amount of suffering these diseases inflict, most people around the world are unaware of them.

 

NTDs are widespread in poorer, rural communities, where most people live on less than two dollars per day. These diseases impair physical and cognitive development, contribute to mother and child illness and death, make it difficult to farm or earn a living, and limit productivity in the workplace. As a result, they trap the impoverished in a cycle of poverty and disease. Global NTD programs, coordinated by the WHO in collaboration with private and public sector partners, focus on identifying regions and countries where NTDs are present and work to control or, when possible, eliminate them.

 

In line with our ‘Health for All’ vision and ‘Science for a better life’ purpose, we have been collaborating with the WHO since 2002 in the fight against NTDs. In 2012 we signed the “London Declaration on NTDs” aimed at eliminating the 10 most devastating NTDs by 2020. Though significant progress has been made through public-private partnerships, many of the targets have not yet been achieved. Therefore, we have committed to the WHO NTD Roadmap 2030, endorsed by the World Health Assembly in 2020. This roadmap does not simply replace the 2012 one but advances the NTD agenda with opportunities to stimulate efforts through comprehensive approaches that require multisectoral collaboration. Additionally, new diseases have been added, with 20 NTDs targeted for elimination as a public health problem by 2030.

 

The WHO NTD road map will be supported by the WHO Sustainability Framework for Action. After all, to make sustainability successful, international donors and implementing partners will need to identify and utilize synergies beyond disease-specific programming and consider their potential roles in strengthening health systems. This WHO guiding document will help Member States, stakeholders and partners to align their strategies on identifying sustainable pathways towards the road map 2030 targets. The document is considered to be a living one, to be improved further as we gain experience from the application of these principles in field conditions.

 

We will continue supporting WHO in fighting African sleeping sickness and Chagas disease, and in 2020 we added a new engagement to fight Taeniasis (pork tapeworm infections).

 

 

WHO Infographic

 

 

Addressing the many diseases that afflict the world’s poorest populations, often in remote areas of the world, is not an easy task. It’s a challenge that must be addressed by multiple organizations and stakeholders, both public and private. That is why we partner with the WHO and other organizations to eliminate NTDs through better understanding of disease burdens, socio-cultural contexts and the varied obstacles to healthcare access.

 

We focus our efforts on the NTDs where we can make the most impact based on our expertise, portfolio of products and distribution networks. As the only manufacturer of the treatments Nifurtimox and Suramin, recognized by the WHO as essential medicines, our initial focus has been on fighting the diseases these medicines treat like Chagas disease and African sleeping sickness (HAT). As part of this effort, we have committed to continuing production and donation of these medicines, as long as there is a need, and to providing additional financial support for screening, distribution, education, awareness and surveillance.

African sleeping sickness or Human African Trypanosomiasis (HAT) is a deadly disease transmitted by the tsetse fly that threatens 57 million people in the rural communities of 36 sub-Saharan countries. African sleeping sickness can be fatal and has a long path of suffering, as there is a high risk of handicap if not treated early. While the WHO wide-scale intervention has led to a drop to less than one thousand reported cases in 2018, there are still cases that are not diagnosed and/or reported as a result of several factors including healthcare inaccessibility due to armed conflict in some of the most afflicted areas.

 

 

At Bayer, we’ve continued to donate treatments and resources toward the common goal of fully eradicating African sleeping sickness:

 

  • Since 2002, Bayer has donated Suramin for the treatment of HAT rhodesiense.
  • Since the launch of Nifurtimox-Eflornithine Combination Therapy (NECT 2009), we have donated Nifurtimox for the treatment of the most prevalent form of HAT gambiense. On behalf of the WHO, Médecins Sans Frontières (Doctors Without Borders) is assembling patient treatment kits containing medicines as well as additional tools to facilitate treatments in even the most remote and resource-poor settings.

 

Since 2016, Bayer has provided additional financial support to fight African sleeping sickness in the country with the highest disease burden: the Democratic Republic of the Congo (the location of 95 percent of reported cases). We support the work of mobile intervention teams for case finding and surveillance as well as awareness and education efforts and healthcare personnel (HCP) training.

Chagas disease, or American tryptanosomiasis, is named after the Brazilian physician Carlos Chagas who discovered the disease in 1909. Caused by the parasite Trypanosoma cruzi, it is most commonly spread through contact with the waste of a triatomine bug (or “kissing bug”), a blood-sucking insect. The triatomine bug thrives in poorer housing conditions, such as mud walls or thatched roofs, thus mostly affecting the more impoverished in rural areas. Public health interventions, particularly vector control, have decreased the number of new infections and, in some areas, completely stopped transmission of the parasite by triatomine bugs. However, transmission through blood transfusions, organ donation or from mother-to-child (congenital) can still occur. If left untreated, the disease can cause severe, life-threatening organ damage years after the infection, making early diagnosis and treatment essential to positive outcomes. As a result of massive migration, the disease has become a global threat to health systems in North America and Europe, with 6 to 7 million people worldwide estimated to be infected, and over 75 million at risk of infection.

 

 

Over the past 20 years, we have been supporting the WHO and the Pan American Health Organization in meeting an increasing annual demand of our product Nifurtimox, one of two medicines effective in treating Chagas disease. We also provide the WHO with financial support for logistics, distribution, awareness, training of HCPs and disease surveillance in endemic and non-endemic countries and are working to improve access in countries with the highest disease burdens. In addition, we developed Nifurtimox for treatment of pediatric forms of the disease. First approved in 2020, this new formulation significantly improves weight-adjusted dosing in children under 18.

 

See our video series on Chagas diseases to learn more.

 

Onchocerciasis, also known as river blindness, is an infection caused by a parasitic worm spread by the repeated bite of a blackfly, mostly found in rural agricultural areas in sub-Saharan Africa. Globally it is estimated that about 21 million people are infected, and 205 million are at risk of infection, which can cause skin depigmentation, severe unrelenting itching and, in the most serious cases, blindness. About 14.6 million people have the associated skin disease and over a million have lost their vision worldwide due to this parasite.

 

In 2014, Bayer entered a product development partnership (PDP) with the Drugs for Neglected Diseases initiative (DNDi) to develop a new treatment option: Emodepside. Current drugs only kill the parasite’s larvae and young worms, leaving the adult worms alive and producing offspring. Since adult worms can live up to 15 years in the human body, treatment must be given for up to 15 years. Emodepside, now in Phase II of development, is expected to kill the adult worms, which could significantly shorten the duration of treatment and ultimately cure the disease.

Taenia solium, also called taeniasis/cysticercosis, is an NTD belonging to the sub-group of neglected zoonoses (diseases transmitted from animals to humans) that are highly endemic in many countries of sub-Saharan Africa, South-East Asia and Latin America. The socioeconomic impact of cysticercosis is immense as it affects the health and livelihood of subsistence farming communities by causing neurocysticercosis (an infection of the central nervous system) in humans, reducing the market value of pigs and making pork unsafe to eat.

 

Human infection with T. solium occurs when people eat raw or undercooked infected pork. Risk factors often relate to poor sanitation, including the lack of latrines, unsafe water, poor pig husbandry practices, inadequate meat inspection and lack of knowledge about the parasite that causes it. Neurocysticercosis – a consequence of the T. solium infection – results when parasite larvae embed and form cysts in the brain. This type of infection is the cause of approximately 30 percent of all epilepsy cases in countries where it is endemic.

 

In 2019, we signed a five-year agreement to support WHO's global program combating taeniasis and neurocysticercosis in people exposed to or infected by the pork tapeworm T. solium. Through this agreement, we will help to expand access to essential medicines by donating praziquantel and niclosamide. Additionally, we will provide funding to sustain control and prevention activities in pilot countries and help establish specific mass drug administrations (MDAs) programs in focal disease areas.

I'm proud to be able to think clearly again, thanks to the treatment.
Moses Ayiri
African sleeping sickness patient, Uganda

Photostory: Next Stop Congo – Visit to the WHO’s Program to Control Sleeping Sickness >

 

Quantifiable impact through data

We believe that to measure success we must work with our partners to understand our impact on the lives of individuals living with and at risk of contracting NTDs. We are currently supporting the WHO in building capacities for data processing, analysis, and sharing​ via the WHO’s Information System to Control/Eliminate NTDs (WISCENTD). The WISCENTD will play a major role in helping us steer our NTD strategy by allowing us to monitor progress in achieving the targets for NTDs set in the WHO NTD Roadmap. Additionally, it will provide support to the WHO Member States in their efforts to collect, validate, and analyze data from national surveillance systems.

 

Through our close partnership and collaboration with the WHO’s efforts to eradicate NTDs, we will be able to measurably and credibly demonstrate the impact of our efforts on the communities suffering from NTDs. In addition to working with reliable third-party organizations, we are committed to regularly reporting on the progress being made in reducing the impact of these NTDs on our website.

Currently, the WHO NTD Roadmap 2030 seeks to encourage three fundamental shifts in the approach to tackling NTDs:

 

  1. Increased accountability for impact by using impact indicators instead of process indicators.
  2. Developing programmatic approaches that move away from siloed, disease-specific programs towards cross-cutting perspectives centered around people and community needs.
  3. Establishing greater program ownership on behalf of countries.

 

Monitoring and evaluation were noted as one of the four major gaps in the treatment of multiple diseases. Therefore, in 2020, the WHO NTD Working Group on Monitoring, Evaluation and Research (WG-MER) was established to develop a framework for quantitative and qualitative monitoring and evaluation of the progress made against targets outlined in the WHO NTD Roadmap 2021-2030. It also identified gaps requiring further research. Bayer receives annual reports from the WHO on the number of patients treated with our donated medicines, and progress made by disease area is published by the WHO and discussed during our Annual Partners Meeting.