Last week on the morning that the story broke that UK overseas development aid was being squandered on finding a mate for Nemo, I was addressing the Gates Foundation on the occasion of their progress report on neglected tropical diseases. I hope that readers will agree that, unlike tropical fish fancying, eradicating disease is a perfectly proper use of our overseas aid.
These diseases, such as the scourge of Leprosy, have been around since Biblical times. In 2010 former US President Jimmy Carter came to a conference in Britain to galvanise a renewed effort to eradicate them, which resulted in the ‘London declaration’ expressing our ambition to eradicate them by 2020. Last week was the 5th anniversary of the declaration and an opportunity to review how we are progressing.
A medical research scientist once explained the difficulty of searching for cures by comparing the endeavour to a piece of Confucian wisdom: apparently the sage once said that the most difficult thing is to search for a black cat in a room without light, and particularly so…if there is no cat. I can understand the simile: the enormous effort searching with no guarantee that there will be a cure at the end of it. Of course there is scope for further research into these diseases, and we are paying some of it. Our problem however, is of a very different nature. The clue is in the name: neglected tropical diseases.
The irony is that we are awash with cures, what we have lacked is the will to distribute them.
Between 2010 and 2020 the pharmaceutical companies will have donated $17.8 billion’s worth of free cures. These numbers are so large that they scarcely mean anything to us – but reflect on it, only one billion minutes ago we would be back in Biblical times.
The cost of a pill to protect a child from bilharzia (a ghastly disease that eats away your organs from the inside) costs as little as 20 cents. The difficulty is not so much in finding cures for these diseases, as in providing the infrastructure and health systems to distribute them by the billion to remote and impoverished populations, and this is the proper role of international development aid, investing to increase the capacity and effectiveness of health services in the world’s poorest countries.
At this half way point between the declaration of our intent to eradicate these diseases, and the target date of 2020, I think we deserve a small pat on the back. We have certainly raised our game. The UK will spend £250 million over the decade on this endeavour. Poor countries themselves are spending their own meagre resources too. Ethiopia has launched a major initiative to clear a backlog of surgery to deal with trachoma (an excruciatingly painful cause of blindness). We have built up a fantastic international partnership with the UN, USAID, the Gates Foundation, Charities, and the Private sector – last year these companies donated 1.3 billion cures. The impact these partnerships are having can be dramatic: in 1987 there were 35 million cases of guinea worm disease (another really painful and debilitating condition), last year there were just 127, and so far this year only 4.
‘But’, because there is still a big ‘but’. There are still 1.4 billion people suffering from one or more of these dreadful tropical diseases, and half a million people die from them every year.
Medical science can be a grizzly business, as anyone who has thumbed through the pages of a medical text book to look at the photographs will know. These particular diseases are among the world’s most grizzly, the grizzliest of the grizzly, in terms of the grotesque disfigurement and disability that they cause. This leads to stigma, isolation and poverty.
We need to redouble our efforts to eradicate them if we are to realise our ambition to do so by 2020. My message to the conference last week was that, were we to fail, and still to be able to sleep at night, we had to make sure that no one could accuse any of us of not having done enough.