ENVISION

Controlling and eliminating seven neglected tropical diseases in low-income countries around the world

Client
U.S. Agency for International Development (USAID)
Partner(s)
CBM International, The Carter Center, Fred Hollows Foundation, Helen Keller International, IMA World Health, Light for the World, Sightsavers, World Vision

One-sixth of the worldwide population–more than 1 billion people—suffers from one or more neglected tropical diseases (NTDs). Impacting the world’s most vulnerable populations, NTDs are devastating to the almost exclusively poor and powerless people living in the rural areas and urban slums of low-income countries most afflicted with these diseases.

Many NTDs cause severe disfigurement and disability, including blindness. NTDs come hand-in-hand with poverty because the diseases thrive where access to clean water and sanitation is limited. These diseases, in turn, contribute to poverty because they can impair intellectual development in children, reduce school enrollment, and stymie economic productivity.

Seven of the most common NTDs are

  • Lymphatic filariasis
  • Trachoma
  • Onchocerciasis (river blindness)
  • Schistosomiasis
  • Three soil-transmitted helminthes—hookworm, roundworm, and whipworm.  

All seven NTDs can be controlled and treated through administration of drugs to entire populations or mass drug administration, which use safe, single-dose medicines donated by pharmaceutical companies. Treatment of at-risk populations for multiple years can lead to control or elimination of these diseases in communities and can relieve populations from daily suffering.

According to the World Health Organization, only 43.3 percent of the global population requiring treatment for at least one NTD is receiving the needed care.

Improving Treatment Coverage for the Seven Most Common NTDs

Funded by the U.S. Agency for International Development (USAID), RTI is the lead implementer of ENVISION, a project that aims to empower governments of endemic countries to lead national NTD control programs and scale up the delivery of preventive chemotherapy—regular anthelminthic drug administration—for the seven most common NTDs.  

We set out to improve the evidence base for determining and assessing action to control/eliminate targeted NTDs, increase mass drug administration coverage among at-risk populations in endemic communities, and strengthen national capacity for implementing integrated NTD control and elimination programs.

Among the major implementing and coordinating partners supporting NTD control and elimination, ENVISION plays a lead coordinating role to ensure that gaps in disease mapping are being adequately funded, whether through USAID funding, other funding, or a combination of sources. 

ENVISION’s efforts are focused on supporting countries to scale up their mass drug administration efforts to 100% geographic coverage for at-risk populations, and examining program performance in reaching those at risk and living in areas targeted for preventive chemotherapy.

Through ENVISION, we work closely with NTD program managers to help countries measure the impact of their programs and make important determinations about the continuation or discontinuation of treatment and other complementary interventions.

The ENVISION project develops, disseminates, and provides training and technical assistance on the tools and resources necessary for effective NTD program implementation. ENVISION also supports the implementation of several training courses to strengthen the capacity of national NTD programs.

Nearly Half a Billion NTD Treatments Supported By ENVISION  

Since the beginning of ENVISION, the project has supported the delivery of 429 million NTD treatments across Africa, Asia, and in Haiti—and those numbers continue to grow as delivery rates increase.

As ENVISION scaled up within countries and expanded to additional countries, the rate at which we are able to deliver treatments has increased. In FY2014, ENVISION delivered 25% more treatments than in FY2012, an increase that highlights the success of scale-up and expansion.

ENVISION operates in coordination with the largest public-private partnerships in USAID’s history, supporting the distribution of $6.5 billion worth of donated medicines from major pharmaceutical companies dedicated to fighting NTDs.

Due to the substantial investment made by national NTD programs, ENVISION, drug donation programs, and other partners to date, multiple ENVISION countries are beginning to now measure the impact of interventions and finding a dramatic reduction of the most common NTDs. 

Indeed, many countries—including Benin, Cameroon, Haiti, Indonesia, Mali, Nepal, and Uganda—have stopped mass treatment for lymphatic filariasis, onchocerciasis, and/or trachoma in certain areas as these NTDs have been effectively controlled. 

In April 2017, the entire NTD community set the Guinness World Record for most medicines donated in a 24-hour period—more than 207 million doses. The award was physically accepted in Geneva, Switzerland, on behalf of the NTD community by Uniting to Combat NTDs, a collective of invested, interested, and dedicated partners, working to fulfil the London Declaration on Neglected Tropical Diseases. As a global partner, our ENVISION team shares in the partnership of NGOs, pharmaceutical companies, donors, government agencies, and many others that made this achievement possible.