Professor Sir Roy Anderson
Director, London Centre for Neglected Tropical Disease Research
Logistics plays a major role in ensuring and maintaining adequate drug coverage and, in turn, control or eliminate neglected tropical diseases.
Professor Sir Roy Anderson, professor of infectious disease epidemiology at Imperial College London, explains that major neglected tropical diseases (NTDs), including schistosomiasis and trachoma, can be controlled with mass administration of relatively simple drugs, which are donated by pharmaceutical companies to poorer countries.
“The problem is not one of availability, but of logistics,” he says. There is the need to ensure that the drugs that are delivered to warehouses in capital cities are then transported to primary health centres in villages and communities, particularly those in remote rural areas. But there are indications that, at least for some NTDs, this is not happening and that, as a result, not all children and adults who need treatment actually receive It.
One of the best ways of improving drug supply is to create local demand.
“We have examples of this in South Africa, South East Asia and India, where the reported drug coverage is much greater than research suggests,” says Anderson, adding that some countries are also not monitoring whether or not children and adults with NTDs take their medicines as often as necessary.
Improving drug supply
He goes on to say that, whilst the logistics of drug supply to NTD-affected poor communities poses significant challenges, a number of factors – including building local support, strengthening systems for the good flow of goods and services, and disease surveillance – can help towards its improvement.
The following interventions, in particular, are paramount, continues Anderson. “Firstly, one of the best ways of improving drug supply is to create local demand. This can be achieved by increasing awareness, among community leaders, of the fact that treatment can greatly improve the health of children, enabling them to grow and develop.
Close collaboration between ministries of health and ministries of education is crucial.
“Secondly, local ministries of health should make it a priority to get NTD drugs out of the warehouses into local villages and communities. It might be useful, in this regard, to look at examples from the commercial world. If soft drink companies can get their products to the smallest villages in Africa, then surely ministries of health can get critical healthcare supplies out there, too.
“Thirdly, there should be more primary healthcare centres to which drugs are distributed, with people who are trained in administering those drugs. Close collaboration between ministries of health and ministries of education is also crucial, because schools can be a very important setting in which to deliver life-saving healthcare messages and treatments.”
We need the will
The fact is, there is no shortage of supply of drugs to countries with NTDs. And there are systems and tools available to ensure these drugs are delivered to the children and adults who need them, says Anderson. What is needed is the will to harness all this potential.