I suspect many people won't have even heard of some of the diseases Bill and Melinda Gates mention in their annual letter - issued today - entitled Our Big Bet for the Future. However for millions of people living in some of the poorest parts of the world, elephantiasis, river blindness (also known as Lymphatic Filariasis and Onchocerciasis respectively) and blinding trachoma are a very real health threat, and the symptoms are debilitating and disfiguring.
So I was excited to read this year's letter from Bill and Melinda, revealing their vision for the world by 2030, as they have drawn attention specifically to these diseases which are part of a group called Neglected Tropical Diseases (NTDs). Neglected, not just because people haven't heard of them but because they are diseases of the most neglected people - those living in the poorest parts of the world and in the hardest to reach places with limited access to health care.
It was envigorating to read such a rallying call - Sightsavers has been working on these diseases for several decades, and it is only in the last few years that we have come to believe that elimination is possible. We used to think we were supporting programmes to just control them, and were worrying about how to sustain them indefinitely. We now have evidence that we can halt transmission of river blindness altogether. We are close to elimination in a number of countries like Niger, Senegal and Guinea Bissau. We have also realised that we can reduce infection levels of trachoma so far down that nobody need be blinded by it again, or suffer the agony of their eyelashes turning inwards and relentlessly scraping their eyeballs.
I reckon if these NTDs were horses within the panoply of global health goals, Bill and Melinda have probably bet on the favourites. We have a clear roadmap from WHO outlining how to combat them, and the drugs needed to treat and prevent them are being freely donated by pharmaceutical companies like Merck, GlaxoSmithKline and Pfizer. We know that the programmes are incredibly cost effective. And for trachoma we will have a complete global map, district by district, of where the disease is endemic by the end of the year, thanks to the support of the UK government.
It's not going to be easy, but it can be done. What will really help to accelerate progress on these three diseases (and on the other NTDs) is for them to be included within the new set of development goals (the Sustainable Development Goals or SDGs) being finalised this year at the UN. Elimination is possible within the timeframe of the SDGs, and my own vision for 2030 is one where the diseases Bill and Melinda mention are no longer the scourges they once were. One of my colleagues and I found hieroglyphics on a wall of a small tomb in Sudan describing trachoma - showing this disgusting disease was rife in the ancient land of Kush. It's time it was gone.
To end suffering due to NTDs we need to ensure that the health systems in the countries affected by these diseases are given the support they need not only to reach elimination, but to sustain this achievement. We will need to maintain surveillance to ensure they don't come back - especially where one country has eliminated a disease but a neighbour has not yet done so.
I am hoping that issues such as conflict and the Ebola virus don't undo the amazing progress already made, and push back elimination on NTDs like river blindness. I remember being struck, on a visit to Sierra Leone after the civil war, by the number of young people who had gone blind due to river blindness. The fighting had interrupted the distribution of Mectizan treatments for several years and because we had not yet reached the elimination stage, the disease came surging back. At present our programmes in Sierra Leone and Liberia are similarly interrupted and I have to say I am worried about what will happen if this continues for much longer.
We know that poverty is the root cause for why communities are at risk from these diseases, and it is a vicious circle in that NTDs themselves cause poverty. If we can ensure that the fight against NTDs is a key part of global efforts to combat extreme poverty over the next 15 years, both adults and children will be given the opportunity to live healthy and productive lives, no matter where they live. Specific reference to these diseases in the SDGs will also help ensure coordination with other sectors that play a vital role in elimination, such as water, sanitation and hygiene and education.
In short, I really welcome Bill and Melinda's rallying call, and sincerely hope they win their bet. Ending these diseases is an ambitious but achievable goal which could deliver a lasting legacy for future generations.
In 2012, also inspired by Bill Gates, a group of organisations came together in London to form a global NTD alliance, uniting to combat NTDs. These included the UK and US governments, the pharmaceutical companies, a range of INGOs and academic institutions and of course the Gates Foundation itself. Other major donors have since joined in the fight, including the Queen Elizabeth Diamond Jubilee Trust, which has given over £40 million to the battle against blinding trachoma. At Sightsavers we also have a myriad of smaller donors who are excited by the idea that they can be part of history in eliminating these horrible diseases. We need more people and governments to join us in this endeavour.
By 2030 the only place I want to see blinding trachoma is on the wall of an ancient tomb, and river blindness and elephantiasis should be no more than an unpleasant memory.