Strength in numbers: neglected tropical diseases and global health advocacy

by Linda Holdbrook, Master of Public Health (MPH) Candidate, Western University

Prior to beginning this practicum placement, I did not know that intestinal worms could even be considered a ‘public health problem’, or that the words “deworming” and “humans” could be used in the same sentence. However, over the last 8 weeks, I’ve learned that for people living in areas where neglected tropical diseases (NTDs) like schistosomiasis and soil-transmitted helminths are endemic, intestinal worms are an all too common reality. So common, in fact, that over 1 billion people in the world are impacted by them (WHO, 2017).

My practicum placement is at the Bruyère Research Institute in Ottawa. I am part of a diverse team of researchers, housed in a unique building with lots of character. My practicum supervisors, Dr. Alison Krentel and Mary Ellen Sellers, have been extremely supportive and encouraging thus far. Dr. Krentel is a global health researcher who specializes in NTDs, and Mary Ellen is a previous alum from the Western MPH program! It’s also great having my classmate Harvir on the same team!

At this point you might be wondering, what exactly is a “neglected tropical disease”, and how can a disease be “neglected”? Briefly, neglected tropical diseases (NTDs) are:

  • A group of 20 communicable diseases (and counting!) that largely affect people living in poverty (schistosomiasis and soil-transmitted helminths are only two of them!).
  • Classified as “neglected” because they are overshadowed by other diseases like malaria, TB, and HIV/AIDS (“the big three”).
  • Diseases that generally cause illness and disability, as opposed to death, making it easier for the international community to “forget” that they exist.

Estimates suggest that 1.6 billion people are affected by NTDs, mainly in Asia and Sub-Saharan Africa (WHO, 2017). In some ways, we can also say that the “neglect” extends beyond the disease, to the affected individuals themselves. Though the term “NTDs” refers to neglected diseases, we are talking about neglected people as well.

MPH students Harvir Sandhu and Linda Holdbrook, along with Alison Krentel and Mary Ellen Sellers from CNNTD, at a Mobilizing Event for the Women Deliver Conference.

My role at Bruyère is to support an advocacy coalition called the Canadian Network for Neglected Tropical Diseases (CNNTD). The CNNTD was formed in 2017 and works to raise awareness amongst policy makers and mobilize Canadian action to end NTDs. The main deliverables I am working on include strengthening the social media presence of the network through Facebook, developing a deworming program, and submitting a proposal to Global Affairs Canada to fund deworming initiatives. Currently, deworming medications exist to treat intestinal worms, but barriers such as gender inequality prevent certain populations from accessing them. The goal of the proposal is to address these barriers and improve health.

One of the first lessons I learned during practicum was that things move pretty quickly around here! Within my first week at Bruyère, I had the opportunity to attend a roundtable event with other global health organizations in Ottawa, to discuss the need to integrate water, sanitation, and hygiene (WASH) into health programming. This experience brought to mind several of our class discussions in the MPH program, especially the Social Determinants of Health course! Another exciting opportunity was being able attend a meeting with the Steering Committee of the CNNTD in Montreal. The purpose of this meeting was to map out the future of the network, develop advocacy strategies, and highlight opportunities for funding. It truly represented the interdisciplinary nature of public health, as professionals from various sectors and organizations were in the room!

More and more, I’m realizing that so much of what we learned in the MPH program is applicable to my practicum placement. I am constantly discovering new insights on concepts covered in class and it has been quite the “full circle” experience to see everything tie together. For example, one morning I had the task of writing a statement for a Member of Parliament. The statement needed to give an overview of NTDs, describe the relationship between NTDs and gender equality, and highlight why Canada should make NTDs a priority for overseas development – all in under 1 minute! This experience allowed me to draw on the framing techniques covered in Health Policy, the influence of gender on health as discussed in Social Determinants, and all of the writing practice from the many policy briefs!

Overall, this practicum has been an amazing experience. Perhaps the most important takeaways I’ve learned, in regard to global health advocacy, is to be persistent when engaging with policy makers, and not to underestimate the power of making connections and building relationships. The saying that there is “strength in numbers” could not be more fitting in this context. We all have a role to play in determining which causes receive adequate attention, and together we can work towards increasing Canada’s leadership in eliminating NTDs. I’m looking forward to what the future will bring, and I am extremely grateful for this learning opportunity!