Neglected Tropical Diseases Remain Neglected by Canada

By Jinisha Panjwani, CNNTD MPH Practicum Student

Neglected Tropical Diseases (NTDs) are a diverse group of 20 conditions that affect more than 1.6 billion people in 149 countries worldwide. NTDs are caused by viruses, helminths, protozoa, or bacteria. Some diseases classified as NTDs include Chagas Disease, Leprosy, Schistosomiasis, Trachoma, Buruli Ulcer and Dengue. NTDs primarily affect individuals living in marginalized and impoverished conditions, who lack access to adequate nutrition, sanitation, clean water and healthcare. These 20 diseases have been coined as neglected because historically they have been under-invested and under-prioritized, in comparison to the ‘Big Three,’ of malaria, tuberculosis and HIV. These three diseases cause greater mortality, whereas NTDs are associated with greater morbidity and lifelong disability. The consequences of an NTD infection can be devastating,  leading to significant physical, cognitive and visual disability.  These disabilities can further lead to job loss, stunted childhood development, discrimination, social exclusion, reduced quality of life and diminished mental health. Thus, NTDs risk trapping individuals already living in disadvantaged conditions in a vicious cycle of poverty. Despite being an important global public health concern and named in Sustainable Development Goal 3.3, NTDs are not prominent  in Canada’s overseas development assistance agenda (ODA).

This past summer the Canadian Network for NTDs conducted a scoping review to quantify and value Canadian investments towards NTDs. This involved a two-pronged approach (1) cataloguing federal investments towards NTD programming and research; (2) meeting with representatives from a select number of NGOs that support NTD programming and advocacy. Through this work, it became evident that many Canadian organizations carry out NTD-related programming such as deworming and water and sanitation activities. However, few identified their work as addressing NTDs and even fewer reported NTD-related outcomes. Similarly, preliminary searches on Global Affairs’ Project Browser revealed that Canada has invested in NTD programming over the past ten years, largely through deworming and nutrition programmes, however, none of these projects were categorized as NTD-related investments. 

How much money has Canada invested in NTD programming and research?

To catalogue the federal investment towards NTD programming and research, we systematically searched Global Affairs Canada’s (GAC) Project Browser and Grand Challenges Canada to identify targeted and integrated NTD interventions and research. These searches demonstrated that GAC has funded ten targeted NTD projects for Leprosy, Dengue, Onchocerciasis, Leishmaniasis and Chagas Diseases over the past ten years. The funding for these tenprojects amounts to approximately $74 million CAD. In addition to this, GAC has also funded sixteen projects that have included the provision of deworming treatments, which are a key intervention for five NTDs: Schistosomiasis, Soil Transmitted Helminths, Onchocerciasis, and Lymphatic Filariasis. However, more information is needed to understand the scope of these projects in relation to NTDs. Grand Challenges Canada, which receives funding from the Government of Canada, has invested $3.5 million CAD in 17 NTD research projects, for diseases like Schistosomiasis, Buruli Ulcer, Dengue Fever, and Human African Trypanosomiasis in Ghana, India, Brazil, Philippines, and Kenya. This scoping review demonstrated that Canada has invested steadily in targeted and integrated NTD programming over the past ten years, despite not quantifying these investments as NTD investments. 

The Landscape of Working in NTDs in Canada

Despite the steady investments that Canada has made in NTD programming, NTDs have not been specifically named in Canada’s ODA. As a result, Canada’s profile and engagement in the global NTD community has been minimal. In addition, Canada does not receive recognition for the investments it has made thus far towards NTD-related SDG Goal 3.3, or contributions towards national NTD indicators. This lack of inclusion of NTDs in Canada’s ODA may also serve as a barrier for Canadian NGOs to become more  involved in NTD programming. In our conversations with Canadian partners, we understood that there was a strong awareness of NTDs and an understanding of the importance of addressing NTDs in global public health. Several of the NGO stakeholders we spoke with indicated a strong interest in pursuing targeted NTD programming or adapting their current programming to include NTDs, if there were opportunities available through the Government of Canada. There seemed to be a general recognition that Canada’s inclusion of NTDs as part of its ODA agenda would align well with the Feminist International Assistance Policy and Canada’s goals to improve the health of women and girls around the world. 

Therefore moving forward, Canada has an opportunity to build on past NTD investments and support NGOs who have a strong interest in pursuing NTD-related programming by increasing investments towards NTDs. These investments can be guided by the NTD Road Map for 2021-2030, released by the World Health Organization and celebrated by Minister Gould on World NTD Day on January 2021 during its launch. The NTD road-map emphasizes the need for a cross-cutting, integrated and coordinated global approach to eliminate NTDs. To effectively beat NTDs, Canada must invest in cross-cutting interventions that include water, sanitation and hygiene, nutrition, vector control, community engagement, health education as well as a gender and equity lens. Ultimately, by investing in NTDs, Canada will help improve the lives of more than a billion people who are impacted by the consequences of NTD infections.