World NTD Day 2022

More than 1 billion people living in the poorest and most marginalised communities worldwide are suffering the impact of Neglected Tropical Diseases (NTDs). 

These diseases blind, disable and disfigure people- taking away not only their health, but also their chance of an education, their opportunities for earning a living and the acceptance of their families and their communities. 

January 30th marks the anniversary of the London Declaration when hundreds of organisations agreed to increase their efforts towards the elimination of NTDs across the globe.  

At CBM, we have worked for over fifty years on the prevention, treatment, and rehabilitation of those impacted by NTDs. 

Currently CBM’s Inclusive Eye Health and NTDs Team and their partners are collaborating with the government on 10 NTD projects, in 9 Provinces in the Democratic Republic of Congo (DRC), treating around 20 million people annually. 

To mark World NTD Day 2022 we are focusing on just one of these projects- the recent training of surgeons and the implementation of a surgical trachomatous trichiasis (TT) campaign in the Sud Ubangi Province of DRC. 

TT is a condition resulting from a bacterial infection (trachoma) of the eye. This causes scarring on the inside of the eyelid, and progressively inverts the eyelid so that the lashes start to rub on the cornea. This rubbing gradually results in the cornea becoming opaque, leading to loss of vision and eventually, blindness. 

Without surgery, vision deteriorates progressively. The damage is irreversible. In addition, the constant sensation of rubbing on the eye is very painful and debilitating and has psychological effects. People are unable to carry out their normal daily routine. Their relationships and economic situation suffer, and this often results in greater poverty. The condition is also stigmatising, and people experience isolation from the community. 

Trachoma was identified as being endemic in DRC in 2014, and CBM started support for drug campaigns with azithromycin® in 2018. To date, CBM has facilitated treatment in over 20 Health Zones in the country. 

In 2019, CBM agreed to support TT surgery in DRC. An estimated 50,000 people are currently in need of sight-saving treatment. A training for National TT Trainers was funded in February 2020, and following a delay due to COVID, a refresher training was held in 2021 when three national trainers were certified, along with four local surgeons from Sud Ubangi Province. 

In December 2021, the first TT surgical campaign started in Boto Health Zone and over 200 people have now received surgery. It is hoped that the 300 plus people identified with TT in the area will have surgery in the next few weeks.  

Many of the health zones that are known to be endemic for trachoma have received the required number of rounds of drug treatment, but these now need to be re-surveyed to check the level of infection in the population. 

There are many health zones in DRC that haven’t been mapped yet and CBM is planning to support the government to complete this work over the next few years. Any areas that are found to be endemic, will require at least one treatment campaign. The wider TT surgical service needs will also have to be addressed. 

Sud Ubangi, where the recent TT surgeries have taken place, has a reasonable road system but most of its area has no phone network, so communication is more difficult and the communities that need treatment often live in remote and difficult to access areas. Currently, CBM is the only organisation supporting TT surgery.  

“It is a feature of CBM that we have always worked, and will continue to work, in contexts where the geography, conflict and logistics cause extra difficulties. DRC is one of these countries. There is still a lot of work ahead and a lot of challenges still to overcome, but if we keep going and if we maintain our commitment, we will eventually achieve elimination of trachoma in DRC",  says CBM’s Head of NTDs Girija Sankar.