As many as 15 million people in sub-Saharan Africa will be treated for schistosomiasis over the next four years as part of an international effort now being expanded to cover six countries.
Figure 1.
Schistosomiasis is transmitted through fresh water and the snails that harbour the parasite
Credit: DIETER TELEMANS/PANOS
Five countries will be joining Uganda in the schistosomiasis control initiative, which operates from Imperial College, London, and is funded by the Bill and Melinda Gates Foundation.
“Schistosomiasis is a visible and growing problem in sub-Saharan Africa; and Tanzania, Zambia, Mali, Burkina Faso, and Niger have now joined Uganda in grasping the nettle and tackling this disease on a national scale,” said Dr Alan Fenwick, the initiative's director.
“With these extra countries now on board it will be possible to roll out a truly multinational programme to control this disease across Africa. We also hope this will become a model which other countries will use to tackle this growing problem.”
Schistosomiasis affects about 200 million people across the globe, 85% of whom live in sub-Saharan Africa. It is transmitted through fresh water and the freshwater snails that harbour the parasite.
Historically the disease had not been considered a major cause of mortality in Africa, but as other pathogens have come under better control it has been given more attention.
“Although schistosomiasis is not an acute disease, it does eventually kill those suffering from it,” noted Professor Roy Anderson, from Imperial College. “In the past, most of the population in Africa did not live long enough for it take effect, but now that the population is living for longer it is a growing problem.”
Treatment in the programme consists of praziquantel, along with albendazole to counter intestinal worms. The cost of praziquantel made available through the initiative works out at $0.07 (£0.04; €0.06) per 600 mg tablet. Each patient will receive two or three doses a year for up to three years.
The people running the programme hope to help countries maintain a supply of the drug at a decent price once the four year initiative is over.
“What we're trying to do is develop their own negotiating capacity to get the price of the drug down,” programme manager Howard Thompson said. The programme hopes to do this through bulk buying, registering other manufacturers of the drug, and encouraging countries to coordinate their orders.
The programme is also conducting surveillance and monitoring, and results from the first year in Uganda are promising, Mr Thompson said.
“The reduction in prevalence and intensity is demonstrably very significant,” he said. “What we are having to prove is that these countries are efficient enough to actually deliver it, and so far we are proving that they can do it.”