Schistosomiasis: The vision for elimination
Infectious Diseases Schistosomiasis is a disease of poverty. It is far-reaching, posing a threat to over 700 million people, primarily in the world’s most impoverished rural communities.
This water-borne parasite is one of the most devastating NTDs in terms of public health burden and economic impact, but the solutions to control and ultimately eliminate it are known, inexpensive, and within our reach. Despite this, in June 2015 schistosomiasis was the only NTD to score ‘red’ in Uniting to Combat NTDs’ 3rd annual progress report. It is clear that we must take urgent action.
There is a growing momentum behind the achievable goal of elimination. Treatment is very effective, with up to 250 million tablets of Praziquantel a year being donated from 2016. This donation has created a unique window of opportunity to accelerate progress and we must ensure this opportunity is not lost.
The primary vehicle to achieve schistosomiasis elimination is available, effective, and free to those that need them. Therefore, with the medicines available the solution now lies largely in Preventative Chemotherapy, also known as Mass Drug Administration (MDA). Collaborative action between stakeholders at all levels is now urgently needed to mobilise the delivery of hundreds of millions of Praziquantel tablets from warehouses to the remote communities where they are so desperately needed, especially in Sub-Saharan Africa. Combining this with adequate hygiene and sanitation, access to safe water, vector control, and education programmes, we firmly believe that schistosomiasis can be eliminated.
The Global Schistosomiasis Alliance (GSA), founded in December 2014, is made up from a group of leading global health experts, financial donors and key stakeholders in water sanitation who have pledged to work together to reach the targets set by the WHO to eliminate schistosomiasis. This all-inclusive partnership aims to capitalise upon the growing momentum already in evidence towards an ambitious but achievable goal.
In Africa we can take inspiration from recent successes seen in Zanzibar, where the Zanzibar Elimination of Schistosomiasis Transmission project has been making strides towards elimination on the islands of Unguja and Pemba since July 2011. Along with six rounds of MDA the project also includes snail control (spraying infested water bodies with niclosamide to reduce the snail population), and behavioural change with schistosomiasis awareness days in schools and safe urinals and washing areas in communities.
Crucially, the GSA is working to ensure that schistosomiasis is considered a priority by national governments and consequently that the WHO targets of regularly providing preventive treatment to 75 per cent of school-aged children in all endemic countries and eliminating schistosomiasis regionally, in the Americas and Western Pacific, and nationally, in selected African countries, by 2020 can certainly be achieved.