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Bundling of Services Used to Treat Neglected Tropical Diseases in Africa

Many Africans suffer from what are commonly called neglected tropical diseases. These illnesses, such as river blindness (onchocerciasis) and bilharzia (schistosomiasis) damage people but don’t kill them. Because they’re not fatal, they don’t get the financial backing needed for treatment and research and development. The problem was the subject of a conference in Washington, DC, entitled “Global Health in the 21st Century – a Roadmap for International Collaboration.” Among the organizations taking part was the Carter Center, based in Atlanta, Georgia, which promotes a grassroots approach to treatment. Dr. Frank Richards directs the center’s program for river blindness. He told VOA English to Africa reporter Cole Mallard, who covered the conference, about the concept of “integration.”

Dr. Richards says they realized that the strategy for controlling river blindness is the same as that used to control other neglected tropical diseases, so they decided to integrate these medicines, creating a “bundling of services” to deliver safe and effective medications at the community level. Richards says the safe, cost effective approach is to get people in the community together once or twice a year and dispense medications for several conditions.

The Carter Center doctor says millions of people are being treated using the integrated approach because “it builds on a system that we know works…. The idea is, ‘Oh, we’re treating schistosomiasis over here; why don’t we add the drug to treat river blindness in that program? And here we’re treating river blindness; why don’t we add the drug to treat schistosomiasis in that program?’ And therefore we’re sort of building on systems that are in place and logistics that are already there, and there are clear cost savings to doing that rather than building a new program.”


Richards says the grassroots approach is fundamental to the program’s success; communities find their own best ways to deliver health education so people understand what’s happening. He says, “Generally speaking, when you take these medicines you feel a lot better; they sell themselves…so you’re really harnessing the great power that exists in the people of these communities.”

The doctor goes on to say that rather than take the attitude that we have to do this or that for the communities, they “are able to do for themselves…. People become excited when you talk about their health and provide them with the knowledge and tools to make their lives better. Then they say, ’What else can we do? We’re ready to do something else!’ In that case we can say, ‘Hey we have something else you can do – you’ve learned how to do this; this is just like what you did before; here’s another tablet to give,’ ands that’s how it works.”