Between 2003 and 2013, the Schistosomiasis Control Initiative (SCI) has delivered over 100 million deworming treatments to people who are infected with tropical worms—and has plans to deliver millions more by 2019. Schistosomiasis primarily infects young children, who contract the intestinal parasites from contaminated water sources. The health consequences The health consequences are serious and debilitating, and include bladder cancer, kidney failure, liver damage, stunting, and learning difficulties. In order to increase projected coverage, SCI needs to raise an initial £2 million this year.
Today we’re excited to have Alan Fenwick share the SCI’s ongoing efforts to increase global treatment programs for people infected with schistosomiasis.
By Alan Fenwick OBE, Director of SCI, Imperial College, London
SCI urgently needs to expand our treatment programs. As of 2014, we currently work in 16 countries to treat almost 40 million individuals a year. In order to expand coverage, SCI is looking initially to raise over £2 million, rising annually to £10 million per year thereafter. These funds will help us in our efforts to cost effectively use drug donations from pharmaceutical companies to reach 60 million children every year by 2017—and hopefully more thereafter. To date SCI has not yet used any donated funds to raise more money, but we have now decided that we need to invest more to expand our treatment efforts. The chart below shows that we have promised funding to deliver almost 240 million treatments through 2018 (blue columns).* SCI would like to have funding to deliver 325 million treatments by 2019 (blue plus red columns), an extra 85 million treatments.
The consequences for the children infected with schistosomiasis include anaemia and blood in the urine. Serious liver disease and bladder cancer are the consequences later in life. For the 1 billion children infected with intestinal worms worldwide, symptoms include malnutrition, anaemia, and stunting.
During 2013 we passed the milestone of having delivered over 100 million treatments against schistosomiasis since 2003, and with funding from the Department for International Development (DFID) and other donors, we are committed to supporting the delivery of another 160 million treatments between 2014 and 2018.
A child infected with schistosomiasis. About 200 million people are inflected with schistosomiasis worldwide. Photo credit: SCI
So with DFID and private funding available, why do we need to expand coverage and what does that mean in terms of funding? Well, the answer lies in the amazing generosity of Merck. The Merck KgGA donation of praziquantel against schistosomiasis has been increased – from 20 million tablets per year in 2008 to 120 million tablets in 2015, and a commitment for 250 million tablets annually from 2016. Two hundred-fifty million tablets of praziquantel are enough to treat 100 million children, and to date in our best year we have treated 30 million, so expansion is essential. For the first time ever, the availability of donated medicines will exceed the funding available to deliver them.
There are some funds already available from DFID and USAID, but for SCI to ensure that these medicines are not wasted, we believe that we will need to assist the delivery of at least half of these donated drugs annually and so will need to raise an additional £2 million this year and £10 million per year subsequently through 2019 (and even beyond). If we can deliver these medicines, imagine the effect on the health of the children in Africa who are currently ravaged by parasitic infections which cause stunting, malnutrition, and liver and bladder diseases. For just an extra £2 million in 2014/15, rising each year to £10 million, we will eventually deliver an extra 85 million treatments, thus improving the health of millions of school-aged children, thereby improving their quality of life, education and prospects of growing into healthy adults.
The medicines we use to treat schistosomiasis are donated by various pharmaceutical companies–Merck KgGA (praziquantel), GSK (albendazle) and Johnson and Johnson (mebendazole)–and most of the recipients are school-aged children. SCI’s role includes advocacy at all levels from Ministers down through regional officials to teachers and health staff who deliver the medicines. These medicines are safe to swallow and effective. For the most part they are delivered annually through schools or through communities.
We assist with transportation of the medicines, training of teachers where necessary, and collection of baseline data and follow-up data to allow us to report back to donors on the success of the campaigns in each country.
SCI oversees the distribution of medication to treat schistosomiasis throughout rural Niger, one of the 16 countries in which SCI works to treat people infected with the tropical parasite. Photo credit: SCI
SCI was established in 2002 with funding from the Bill and Melinda Gates Foundation, with the mission to offer annual treatment free of charge against schistosomiasis and intestinal worms to children and high-risk adult populations in the poorest populations in Africa. Schistosomiasis infects over 200 million people, and occurs when children swim in snail-infested fresh water in tropical countries.
The three charity evaluators The Life You Can Save, GiveWell, and Giving What We Can have each recommended SCI as a cost effective organization due to the fact that SCI assists Ministries of Health to deliver treatments against parasitic diseases in rural Africa for just 50 pence per person per year. The result of these recommendations has been an increase in donations from the public, and an increase in the number of children that have received treatments.
Portions of this post were originally published by the Institute of Global Health Innovations.
*The 240 million treatments we will deliver will not be to 240 million different individuals because in some countries we offer annual treatment for several years to school-aged children, to ensure they are better protected from serious disease.