By Sally Theobald, Liverpool School of Tropical Medicine
“If you do not know where you came from you will not know where you are going” Akan proverb cited by Daniel Boakyo, APOC
Looking backwards and learning from history in order to inform and improve current and future partnerships to address Neglected Tropical Diseases (NTDs) was a key theme that emerged from LSTM’s NTD day. David Molyneux kicked off the day with an overview of the great (white, male) scientists of the past – Prof Ronald Ross who made the links between malaria and mosquitoes and Prof Dutton who identified the cause of sleeping sickness. This historical overview is interesting and important and the resulting records, photos and artefacts reflect the scientific breakthroughs of the time. Fast forward a hundred plus years to today’s meeting and key learning as we move forward to address NTDs is as follows:
Strategic collaborative partnerships are critical:
The critical importance of strategic collaborative partnerships to address NTDs within and beyond countries in the global south was clearly illustrated. Many of the presentations showcased partnerships between researchers, practitioners, pharmaceutical companies and policy makers. The importance of building relationships within and beyond the health system was clearly stressed, including multi-sectoral approaches and joint working with ministries and organisations working on agriculture, education and gender. Missing from the discussions (with the exception of a video from GSK) were the views, perspectives and experiences of people living with NTDs from endemic communities and front line health workers such as community health workers and community based drug distributors. This is not unusual in the world of NTDs or health per se but we need to rise to the challenge of developing meaningful relationships, methods and communication channels to ensure these voices and priorities have a seat at the table and inform ongoing NTD priorities and strategies.
The whole is bigger than the sum of the parts – we need multidisciplinary research:
The importance of multidisciplinary research going beyond the classic scientific and laboratory based approaches was also clearly illustrated – for example Steve Torr discussed the importance of health economics in assessing the costs of different approaches to stop tsetse flies in spreading sleeping sickness; while Imelda Bates outlined strategic and evidence informed steps for capacity building; and Russell Stothard discussed how social science research will inform and underpin the new COUNTDOWN programme of research. Social science methods also have much to offer in collating and analysing the views and experiences of affected communities who are all too often not at the policy table or the research debate. Photovoice, life histories and participatory approaches including workshops and seasonal calendars are all powerful methods which can capture, analyse and present the experiences of different stakeholders including women, men, girls and boys affected by disabling NTDs. The need for strategic and context embedded approaches to research uptake were also stressed – research that responds to country and community priorities and doesn’t simply “gather dust” on library shelves or in cyberspace.
Context is key:
There is a lot of exciting innovation and good practice in NTDs being rolled out in different contexts. But what works in one place may not work in another – we need to understand the physical, geographical, social, cultural and NTD contexts. Also contexts are not static: David Molyneux highlighted how unpredictable events such as extreme climate events, war and conflict bring additional challenges to NTD elimination. Alvaro Acosta Serrano showed how conflict in Syria is exacerbating the spread of cutaneous leishmaniasis – with war reducing the focus on disease control and how diseases can be spread as individuals and communities are forced to leave their homes to seek safety.
In COUNTDOWN we will generate evidence and also want to learn from the field as a whole and the NTD day provided a fantastic opportunity to learn from others and build new networks, particularly with NGO partners such as LEPRA and Sightsavers. It was heartening that there was a clear demand for social scientists to work in partnership with COR-NTDs, parasitologists, Ministries of Health and others, and great to meet other social scientists taking forward work on NTDs, such as Dr. Mary Amuyunzu-Nyamongo from the African Institute of Health and Development. As we move forward in COUNTDOWN we will rise to the challenge of further strengthening our strategic partnerships to deploy multidisciplinary research within different contexts to ensure our research feeds into policy and practice and meets the needs of different constituencies.