When I joined the WHO Department of Control of Neglected Tropical Diseases as Director about 18 months ago, one of the daunting challenges was to define the task of bringing together 20 diseases and disease groups into one coherent road map. With incredible support from everyone in my department and colleagues in WHO Regional and Country Offices and with the collaboration of countries and the global community of partners, we undertook a comprehensive consultative process. At WHO, I am happy to say that we did a good deal more listening than talking.
We heard what mattered most to our partners and, crucially, to the countries that work so hard to treat and prevent this diverse set of diseases. The themes that surfaced repeatedly were integration, collaboration and partnership. We heard loudly and clearly that talking about diseases was not as important as talking about patients. We heard that countries wanted to take stronger ownership of their duty of care to patients and programmes and wanted us, as a global NTD community, to support them in that endeavour.
Our listening exercise resulted in a flagship road map, one which has at its core a desire to reach – and surpass – the Sustainable Development Goals and to deliver equitable care for all. There was great excitement and anticipation as we waited in May 2020 for the road map to be endorsed by Member States during the World Health Assembly, thus enabling its official launch on 17 June.
Then came COVID-19 – a pandemic the likes of which none of us has seen. COVID‐19 has affected every country globally and amplified inequity worldwide. Our road map could not be endorsed in May 2020, as more urgent needs surged to the top of the Assembly’s agenda.
Does that mean shelving the road map? No. If anything, postponement only emphasizes its need. Before COVID-19, integration, collaboration and partnership were aspirations in a community defined by vertical, top-down programmes. Now, we see their direct relevance as the only means by which our work can be carried out. The paralysis triggered by the pandemic and the diversion of resources to combat the emergency has affected every aspect of the work we do, every link in the chain.
We understand that there will be fewer resources in the future – and much more work to do. This means that we, as a community, cannot isolate ourselves – even as we respect physical distancing. Our work to overcome NTDs must necessarily be carried out in conjunction with the many other programmes – malaria, TB, immunization, the whole gamut of public health interventions – all of which face a radically changed public health landscape. Failure to collaborate and pool-in resources and efforts will jeopardize the progress we have made over the past decade.
Today, our new road map is more relevant than ever. At its heart, it seeks to promote resilience, health system strengthening, equity and country ownership – none of which can be imposed. These tasks require that we collaborate. I am more certain than ever that these principles will enable us not only to control, eliminate and eradicate specific NTDs, but also to demonstrate through our collective action that health is a basic and universal human right, regardless of social or economic status.
I am proud to be a member of a global NTD community that is committed to working together to ensure that the people who suffer most from these debilitating diseases of poverty are not forgotten. Our collective strength stems from the volunteer, the health worker and the community of innumerable local networks in the field, who deliver the services to people.
It is right to pay tribute to these committed individuals. To them, we owe our deepest gratitude – which should be translated firstly, and at the very least, into a certainty so they can undertake their tasks with the protective care they need.
We may not be able to launch our new road map the way we had planned, but to achieve the much-needed recovery we must focus on basic principles – on patients not their diseases – to enable countries themselves to own and action their NTD programmes. By taking our place in a wider global agenda, we will be rebuilding a better and stronger NTD community.
On 17 June, then, instead of launching the road map, we will be hosting a webinar. We will hear testimonies and discuss the multiple ways in which COVID-19 has disrupted our work and the lives of those we hope to reach through our work – but we will also discuss the road to recovery and focus on how to build back better.
The new road map is based on listening to people’s experiences – as I hope our work will continue to do – to enable us to strengthen existing partnerships, develop new ones and ensure that they are defined by a commitment to equity and equality.
As countries start cautiously to assemble the pieces, we will be best placed to support them by listening to and taking on board what they have to say.
By Dr Mwelecele Ntuli Malecela, Director, WHO Department of Control of Neglected Tropical Diseases