Many Forgotten Diseases, One Integrated Approach

Gates Foundation Pledges $10 Million to Support Carter Center's Integrated Approach to Combat Neglected Diseases in Nigeria

To help combat neglected tropical diseases suffered by millions of people, the Bill & Melinda Gates Foundation has pledged $10 million to fund two groundbreaking Carter Center initiatives in Nigeria. The Carter Center will expand its integrated disease prevention assistance in central Nigeria that currently includes four neglected tropical diseases, and will examine alternative methods to prevent lymphatic filariasis in regions also experiencing the parasitic disease Loa loa.

"We have the ability to combat these ancient scourges, but to succeed we must help make disease prevention and treatment accessible and sustainable," said former U.S. President Jimmy Carter, Carter Center founder. "With the support from partners such as the Gates Foundation, Nigeria and The Carter Center can continue to prove how treating many diseases with one community-based approach can benefit millions of Nigerians and broaden efforts to put an end to the country's cycle of poverty and disease."

Currently the Center's activities in Plateau and Nasarawa states target river blindness, lymphatic filariasis, schistosomiasis, and trachoma, all of which can be controlled or eliminated by safe and effective medicines combined with health education. One of the two new $5 million grants from the Gates Foundation will allow the Center to expand the scope of its activities to add Vitamin A supplementation for young children to the distribution system, as well as pioneer distribution of long-lasting insecticide treated bed nets to prevent both lymphatic filariasis and malaria. The other grant will allow the Center to study the feasibility of eliminating lymphatic filariasis with long-lasting insecticide-treated bed nets in southeastern Nigeria, a geographic area where infection with the parasite Loa loa limits treatment options for lymphatic filariasis.

Over the past two decades, The Carter Center, in partnership with Nigerian health authorities, has created a village-based health care delivery infrastructure to treat multiple diseases simultaneously. By merging resources, health education, and treatment for several diseases into one delivery system, isolated communities become healthier. Thanks to these interventions, children can have the opportunity to grow up no longer fearing the blindness, disfigurement, organ damage, and life-sapping fevers that their parents suffered.

In 1988, the Center first helped establish a village-based prevention and surveillance system when the campaign to eradicate Guinea worm disease began in Nigeria. Building on this infrastructure, the Center helped expand programming to include annual mass drug administration with Mectizan® tablets donated by Merck & Co. Inc. to prevent river blindness in 1996, and later to control schistosomiasis (1999) with praziquantel tablets and eliminate lymphatic filariasis (2000) with Mecitzan® and albendazole. In 2000, The Carter Center began working with state and local health authorities to help build trachoma control programs in Plateau and Nasarawa states. In 2004-2006, using the same established infrastructure, health care workers distributed more than 80,000 insecticide-treated bed nets to prevent lymphatic filariasis and malaria in the region.

During the next four years the Center plans to measure the sustainability, cost-effectiveness, and impact of its disease integration efforts in Plateau and Nasarawa states. By proving that integration is a practical and sustainable solution to providing health care in a developing nation, the project aims to promote expansion of integrated efforts in Nigeria and the region. The Center will work in collaboration with the Nigeria Ministry of Health, Emory University's Rollins School of Public Health, and the Centers for Disease Control and Prevention.

In Africa, more than 500 million people are affected by neglected tropical diseases and many communities are infected with several tropical diseases simultaneously. Globally, more than 2 billion individuals are infected with one or more of the parasites that cause these diseases.

"Imagine a nation like Nigeria, almost half the size of the United States, where a large part of the population is sick from diseases that together can be easily prevented through integrated, village-based health systems," said Dr. Frank O. Richards Jr., technical director for the Center's river blindness, lymphatic filariasis, and schistosomiasis programs. "With just a little outside help, we can witness rural people being empowered to control or eliminate these diseases from their villages, and so make sustainable improvements in their lives and those of their neighbors."

Carter Center Photos: Emily Staub

An integrated disease prevention approach merges resources, health education, and treatment for several diseases into one delivery system, helping isolated communities become healthier. Thanks to these interventions, children can have the opportunity to grow up no longer fearing the blindness, disfigurement, organ damage, and life-sapping fevers that their parents suffered.

One of the new grants will allow the Center to study the feasibility of eliminating lymphatic filariasis with long-lasting insecticide-treated bed nets in southeastern Nigeria, a geographic area where infection with the parasite Loa loa limits treatment options for lymphatic filariasis.

A Nigerian man with lymphatic filariasis demonstrates how to wash his leg to prevent skin infections. The Carter Center promotes leg washing and disinfection techniques to reduce the symptoms caused by the disease.

The Center's Schistosomiasis Control Program assists state ministries of health to distribute the drug praziquantel and provide health education to prevent the disease in villages.

A Nigerian mother washes her daughter's face. Improved hygiene can help prevent trachoma, a bacterial eye infection.

To control river blindness, local health workers visit communities to distribute Mectizan® drug treatments (donated by Merck) annually.

Read about the Center's work in Nigeria>

Bill & Melinda Gates Foundation awards more than $46 million to aid programs fighting against neglected tropical diseases

The new Carter Center grants are part of $46.7 million in grants from Bill & Melinda Gates Foundation to help the fight against neglected tropical diseases. The other organizations which will receive funds are: The Task Force for Child Survival, Atlanta, Georgia ($11.7 million); the International Trachoma Initiative (ITI), New York ($10 million); the Schistosomiasis Control Initiative at Imperial College (London), UK ($10 million); and the World Health Organization, Geneva, Switzerland ($5 million).

The overall goal of the new Gates grants is to develop evidence that controlling selected neglected tropical diseases in an integrated way does have a greater impact on these diseases than present disease-specific strategies. It has been estimated that purchasing and delivering drugs to control five of the neglected tropical diseases could cost as little as $.050 per person per year if existing drug delivery programs were brought together.Read the full news release.