ENVISION: A World Free of Neglected Tropical Diseases

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

U.S. Agency for International Development (USAID)
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). These diseases devastate the world’s most vulnerable populations, striking the almost exclusively poor and powerless people in rural areas and urban slums in low-income countries.

Many NTDs cause severe disfigurement and disability, including blindness. NTDs come hand-in-hand with poverty because they 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 helminth infections—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 62 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 for the seven most common NTDs. 

We set out to improve the evidence base for determining and assessing action to control and 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.

Over One Billion NTD Treatments Supported By ENVISION 

ENVISION operates in coordination with the largest public-private partnerships in USAID’s history, supporting the distribution of $10.2 billion worth of donated medicines from major pharmaceutical companies dedicated to fighting NTDs.  In the countries we support, ENVISION has provided more than 1.1 billion NTD treatments.

Due to the substantial investment made by national NTD programs, ENVISION, drug donation programs, and other partners to date, multiple ENVISION countries are measuring the impact of interventions and finding a dramatic reduction of the most common NTDs. To date, more than 165 million people are no longer at risk of lymphatic filariasis and more than 61 million people have been spared from the risk of trachoma.

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 September 2017, the World Health Organization announced that trachoma is no longer a public health problem in Laos and Cambodia, which follows a previous announcement that Cambodia has eliminated lymphatic filariasis.

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 fulfill 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.

As more countries prepare for their final push to control and eliminate NTDs, our efforts will shift. We will target the hardest-to-reach and most vulnerable communities, conduct surveys to assess impact, and help countries complete the World Health Organization’s certification process, which confirms the successful elimination of these diseases.