Module 4: Innovations in the Control, Treatment and Prevention of Environmentally Related Infectious Diseases

The Carter Center

The Carter Center provides health programs to prevent suffering in developing nations around the world. Experts work with the people of developing regions, implementing various education and treatment programs. The Carter Center has done extensive work on various neglected tropical diseases. This module provides a summary of The Carter Center’s work to eradicate many of these diseases.(1)

Guinea Worm: The Carter Center has carried out extensive work in the eradication of Guinea Worm, which is believed to be the next major disease to be eradicated. Eradication efforts have already impacted communities throughout Africa, enabling children and adults to return to productivity. The Center also spearheaded a major international campaign which has reduced cases by more than 99% since 1986. (2)

Trachoma: The Carter Center’s work with Trachoma has included improving sanitation and hygiene, which are critical to public health. The Center’s control efforts also include the construction of more than 1 million household latrines in the Amhara region since 2002. (3)

River Blindness: The Center has assisted with delivering more than 100 million treatments in 11 river blindness endemic countries in Latin America and Africa since 1996. It is leading a movement to eliminate this disease by 2015. (4)

Lymphatic Filariasis: The Center has set up support groups for lympathic filariasis where affected individuals can learn how to properly care for themselves when living with the condition. The Carter Center is working to show that the transmission of lymphatic filariasis can be stopped on a large scale in Nigeria with mass community drug treatment and health education. The Center has been a principal NGO assisting the national lymphatic filariasis program in Nigeria. (5)

Schistosomiasis: The Center is reducing schistosomiasis through village-based drug distribution programs in Nigeria. Additionally, The Carter Center has implemented improved agricultural techniques in sub-Saharan African countries, established a Malaria Control Program in Ethiopia to manage risk of malaria, and increased efforts to reduce stigma and discrimination towards people with mental illness. The Center also established an International Task Force for Disease Eradication, which has reviewed more than 100 infectious diseases, and identified seven potentially eradicable ones. (6)

Partners in Health for TB

Over the past 15 years, incomplete TB treatments occurred due to shortages of medicines and medical personnel, civil disruptions, and socioeconomic barriers for patients. The shortened treatment regiment led to a proliferation of strains of tuberculosis that are resistant to two or more TB medications. These strains, known as multi-drug resistant tuberculosis, or MDR-TB, are now present throughout the world.(7)

MDR-TB can be treated and cured. Treatment egimens, however, are complicated, lengthy and expensive, especially in developing countries where governments are unable to fund the costs of treatment. These drugs are also highly toxic with dangerous side effects. However, as stated by PIH co-founder Dr. Jim Yong Kim, “If you don’t treat it now, and you don’t spend the money now, you will be spending much, much more money later.” Thus, PIH set out to treat a small group of patients with drug-resistant TB, sending the message that this was a growing concern.(8)

Partners in Health launched the effort against TB in 1996, in Peru and Russia, and PIH became a world leader in developing and demonstrating the effectiveness of clinical regimens and community-based strategies for combating MDR-TB in resource-poor settings. PIH partnered with a sister organization in Peru called Socio En Salud (SES), which initiated the world’s first community-based treatment program for MDR-TB in a resource-poor setting. A treatment strategy was created to cure affected individuals and to stop ongoing transmission. Their work led to the publication of clinical care manuals for management of MDR-TB in languages of English and Spanish. PIH and Socios En Salud trained and hired members of the community to accompany patients through the complex regimen of drugs. This strategy achieved a cure rate of 83%, which was one of the highest cure rates for MDR-TB ever reported.(9) These extremely positive results led to several further developments in the global eradication of MDR TB. In 2002, the WHO began approving treatment plans for MDR-TB on a country-by-country basis. In 2006, new guidelines for treatment of MDR-TB were released jointly by the WHO, the CDC, and PIH. The new guidelines were influenced by research that documented the success of PIH’s MDR-TB program in Siberia. PIH-Russia worked to strengthen MDR-TB care for patients by renovating hospitals, training medical personnel, and distributing educational materials on MDR-TB throughout the former Soviet Union.(10)

PIH is also working to develop and carry out a research agenda to demonstrate the effectiveness of treatment for MDR-TB. The research is also meant to disprove that adding treatment for MDR-TB would undermine the standard Directly Observed Treatment, Short Course (DOTS) program for non-resistant TB. PIH has been a world leader in the development of effective TB eradication programs, setting new standards for treatment, and achieving remarkable results.(11)

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Footnotes

(1) “The Carter Center Health Programs.” (2010). Accessed 7 July 2010.

(2) Ibid.

(3) Ibid.

(4) Ibid.

(5) Ibid.

(6) Ibid.

(7) “Tuberculosis and MDR-TB.” (2009). Accessed 7 July 2010.

(8) Ibid

(9) Ibid

(10) Ibid

(11) Ibid