The 2030 Agenda for Sustainable Development acknowledges the human development impacts of TB, malaria and NTDs, and as such, calls for ending these epidemics by 2030 as a development priority. Despite progress in recent decades against these ‘diseases of poverty’, challenges have persisted in delivering promising new technologies to prevent, diagnose and treat them. The COVID-19 pandemic has further exacerbated these challenges. The Sustainable Development Goals Report 2022 paints a sobering picture of the reversal of gains against these diseases, threatening decades of progress in global health. Health systems and essential health services were severely disrupted, causing a drop in immunization coverage for the first time in a decade and a rise in deaths from TB and malaria.1
TB, malaria and NTDs persist as diseases of poverty and inequality. They are disproportionately prevalent among the poorest and most vulnerable people and communities. Conditions associated with living in poverty, such as the lack of adequate housing, sanitation, access to safe drinking water and nutritious food, as well as access to health services, contribute to risk of exposure and increase the likelihood of transmission.
Each year, approximately 10 million people fall ill with TB, and 1.5 million of them die,2 while malaria claims the lives of more than 600,000 people, with children under the age of 5 years old being the most vulnerable.3 In 2020, COVID-19 disruptions caused TB and malaria diagnoses to drop by 59 percent and 31 percent, respectively, and there were 1 million fewer people treated for TB and 45,000 additional malaria-related deaths.4
NTDs, an umbrella term covering a diverse group of tropical infections, continue to impact the lives of 1.7 billion people worldwide, causing approximately 200,000 deaths and the loss of 19 million disability-adjusted life years (DALYs) annually.5 There is a continuing and urgent need for safe and effective tools to prevent, diagnose and treat NTDs. The poorest households with the lowest level of education are twice as likely to have people infected with NTDs, which in turn perpetuates the already high level of human, social, economic and financial burdens. Sub-Saharan Africa is particularly affected, with over 500 million people at risk of NTD infection. In 2019, over 360 million cases of NTDs were reported in this region, causing a total loss of almost 5 million DALYs.6
Addressing TB, malaria and NTDs requires equity-based health infrastructure that will support wider health and well-being for all, and include the provision of basic needs, such as clean water and sanitation. At the same time, this health infrastructure must adopt prevention and control measures, such as vector control and ensuring access to diagnosis and treatment. Increased and enhanced access to health services for TB, malaria and NTDs can be regarded as a benchmark of progress towards UHC.
Responding to this, UNDP and the Government of Japan joined forces in 2013 in a strategic partnership to combat TB, malaria and NTDs, through two interlinked and innovative projects. The Global Health Innovative Technology (GHIT) Fund stimulates innovation and research for the development of new health technologies for TB, malaria, NTDs and other diseases, while ADP focuses on enabling and strengthening capacities in LMICs to access and deliver the new products as they become available.
The GHIT Fund invests in the discovery and development of medicines, diagnostics and vaccines for neglected diseases, through its support for partnerships that bring together Japanese organizations with global actors in research and development (R&D) initiatives. ADP brings together four core partners—UNDP, WHO, TDR and PATH—in a unique collaboration to support governments and other stakeholders to strengthen national health systems. ADP partners help LMICs to ‘connect the dots’ from the development of policies and laws, to building human and institutional capacities, to systems and processes to ensure access to and delivery of health technologies.
The partnership between the GHIT Fund and ADP enables an innovative and synergistic approach that combines accelerated health technology R&D and product development with focused capacity and systems development to ensure their timely access and delivery in countries. This integrated approach is vital to achieving UHC and, in turn, human security. It is also strategically aligned with the 2030 Agenda for Sustainable Development and the Sustainable Development Goals, which call for a broad systemic approach to tackle the epidemics of TB, malaria and NTDs.
Despite differences in national contexts, common challenges can be identified across different health systems. ADP has identified capacity gaps that persist in LMICs, and focuses on strengthening these capacities to enable the multiple institutions and mechanisms to work together to effectively introduce and improve access to health technologies for patients in need.
“Together, GHIT and ADP demonstrate that by investing in both research and development and health systems, we can drive faster progress on equitable access to care, end the COVID-19 pandemic and prepare for future health emergencies.”
ADP promotes a whole-of-government approach aimed at strengthening the entire value chain of access and delivery, from enabling policy and legal frameworks, implementation research, regulatory approval, procurement and supply chain management to, ultimately, service delivery and patient safety monitoring. Working with country stakeholders across this broad range of sectors and disciplines, ADP interventions help countries prepare for and accelerate the introduction and scale-up of new health technologies.
The COVID-19 pandemic has unleashed cascading health and development crises, which further underscores the critical importance of ADP’s support to build strong and resilient national health systems. The ADP approach has already helped strengthen the foundation for national COVID-19 responses in a number of countries and has supported the development of policies and tools that have been adapted to meet urgent health system demands of COVID-19. Importantly, these efforts also contribute to pandemic preparedness in the future.
The support from the Government of Japan for both the GHIT Fund and ADP demonstrates its strategic vision and foresight on health and human security, and the need for strong, resilient health systems for sustainable human development.7