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BRICS in the response to neglected tropical diseases Amber Cashwell,a Anupama Tantri,a Ashley Schmidt,a Greg Simona & Neeraj Mistrya

Brazil, the Russian Federation, , burdens, , , India and BRICS’ engagement China and – the countries South Africa can make a substantial Leading by example known as BRICS – are transitioning contribution to reducing the global from emerging economies to leaders burden of neglected tropical diseases. In recent years, the four BRICS coun- in geopolitical affairs. While BRICS By building on their individual and col- tries where neglected tropical diseases face increasing prevalence of noncom- lective mechanisms for shaping policy are endemic have made great strides municable disease and injury, they and promoting cooperation, all five of in controlling and eliminating such also continue to be burdened by many the BRICS countries can enhance the diseases within their borders – by scal- infectious diseases, including neglected global response to neglected tropical ing up and sustaining their national tropical diseases. diseases and help other countries to neglected tropical disease programmes. Neglected tropical diseases are scale up their neglected tropical disease Such effective national leadership should endemic in all of the BRICS countries programmes – to reach the remaining encourage other countries and advance except the Russian Federation. Lym- 1.4 billion people worldwide who are at the global neglected tropical disease phatic filariasis is endemic in Brazil risk of developing one or more of these response. and India, soil-transmitted helminths debilitating diseases of poverty.4 Brazil launched a national inte- are endemic in Brazil, China, India grated neglected tropical disease plan in and South Africa, trachoma is endemic Global progress 2012. By linking this plan to Brasil sem in Brazil, China and India, schistoso- Miséria – the national plan for poverty miasis exists in Brazil and China and Since the World Health Organization reduction – Brazil has institutionalized onchocerciasis persists in parts of Brazil. (WHO) released its neglected tropical the strong links between poverty and BRICS account for more than 30% of disease roadmap in 2010, the World neglected tropical diseases and helped the world’s children at risk of infection Bank, major pharmaceutical companies, to implement effective cross-sector ap- with soil-transmitted helminths.1 India bilateral aid agencies, endemic countries proaches. alone accounts for nearly half of the and other public and private sector or- India, which accounts for more than world’s population at risk of lymphatic ganizations have increased their support 35% of the global neglected tropical filariasis.2,3 The morbidity and disability for the global neglected tropical disease disease burden, is already implementing caused by neglected tropical diseases – response. In January 2012 – in the the world’s largest programme against such as lymphoedema caused by filarial declaration on neglected tropical diseases lymphatic filariasis and has contrib- infection or blindness caused by tracho- – these partners pledged to increase drug uted greatly to the research and body of ma – perpetuate poverty and inequality.4 donations, research and development and knowledge on this disease. India is also Since these diseases prevent children bilateral efforts in support of the goals set using innovative models, such as inte- from attending school and parents from by WHO. The goals are to control or elim- grating deworming with school health working, they also decrease education, inate guinea worm, leprosy, lymphatic and nutrition programmes, to expand worker productivity and overall wealth. filariasis, trachoma and sleeping sickness the reach of its neglected tropical disease The five BRICS countries are and to control schistosomiasis, onchocer- programmes. uniquely positioned – as a group and ciasis, soil-transmitted helminths, Chagas Given their geographical and de- as individual countries – to ensure that disease and visceral leishmaniasis by mographic diversity and the large scale neglected tropical diseases receive the 2020. The growing momentum to address of their neglected tropical disease pro- international attention they deserve. these diseases was further demonstrated grammes, both Brazil and India serve as Each of these countries is increasing its by the Sixty-sixth World Health Assem- useful incubators of innovation in the role in international cooperation. It has bly’s adoption of a resolution that urged fight against neglected tropical diseases. been estimated that BRICS provided 5.6 Member States to increase their owner- The lessons learned from their unique billion dollars in foreign ship of – and financing for – neglected approaches can be applied to many other assistance in 2010.5 As BRICS launch a tropical disease programmes. countries. new development bank and institution- Although more than 70 endemic Sharing expertise alize dialogue between their heads of countries have now developed national state, they will expand their influence plans to control and eliminate neglected As BRICS advance their national goals, from the regional stage to the global tropical diseases and more than 700 they can share their acquired knowl- stage and strengthen their role as drivers million preventive treatments are being edge and technical expertise with other of innovative cooperation.5 delivered annually, these activities are endemic countries. Brazil and India are By demonstrating leadership and still reaching less than 40% of the global already working with their neighbours addressing their domestic disease population at risk.4 to address onchocerciasis and visceral a Global Network for Neglected Tropical Diseases, Sabin Vaccine Institute, 2000 Pennsylvania Avenue NW, Suite 7100, Washington, DC, 20006, United States of America. Correspondence to Neeraj Mistry (email: [email protected]). (Submitted: 31 October 2013 – Revised version received: 14 March 2014 – Accepted: 31 March 2014 )

Bull World Health Organ 2014;92:461–462 | doi: http://dx.doi.org/10.2471/BLT.13.132555 461 Perspectives BRICS and neglected tropical diseases Amber Cashwell et al. leishmaniasis. Such collaboration not tion that is a member of both the support national ownership and leader- only helps reduce the problem of the and BRICS – can help draw the attention ship in the field of inclusive sustainable transmission of communicable diseases of the rest of sub-Saharan Africa to the development. By building on this expe- across borders but also serves as a model issue of neglected tropical diseases. rience, a BRICS’ development bank and for collaboration and partnership that With strong support from the WHO Re- a renewed commitment to continued can be applied beyond countries that gional Office for Africa, over 35 African dialogue could be instrumental in mo- share borders. governments have developed national bilizing more resources and partners to China eliminated lymphatic fila- neglected tropical disease plans. These strengthen the fight against neglected riasis in 2007 and is now working plans reflect recognition of the devas- tropical diseases. Additionally, all of towards the elimination of trachoma tating impact that neglected tropical the BRICS countries could support the and schistosomiasis and sharing its diseases have had on economic growth inclusion of neglected tropical diseases expertise through a growing portfolio and development in many areas of Af- in national and regional discussions on of bilateral cooperation. The 2013 Min- rica. In 2013, at the Sixth Conference the post-2015 development agenda. isterial Forum on China–Africa Health of Ministers of Health, Development identified schistosomiasis officials identified neglected tropical Call to action as a priority for their cooperation. A diseases as a top priority. As Chair of pilot project is now underway to test the African Union Commission, South In 2013, at the fifth BRICS , the the feasibility of China’s approach to Africa can build on these milestones and countries reiterated their commitment schistosomiasis control in the African advance the regional neglected tropical to the eradication of poverty and the context.6 China has also signed an agree- disease response. promotion of sustainable, inclusive and ment with Australia to deliver aid and The Russian Federation has played balanced growth.8 BRICS’ leaders have address health issues together in the an important role in elevating global an opportunity to pool capacity, techni- Asia–Pacific area.7 health on the world stage, particularly by cal expertise and financial resources to Multilateral and regional meetings making infectious diseases a top priority accelerate progress towards the 2020 that bring global decision-makers to- of the Group of Eight (G8), for the first goals for neglected tropical disease gether – such as the Group of 20 (G20) time, at the Summit in control and elimination. First, they can Summit – could serve as useful plat- 2006. The Russian Federation has also lead by example. Brazil, China, India forms for the exchange of experiences provided technical assistance to help its and South Africa can help close the and the sharing of expertise in the field neighbours in the Commonwealth of In- treatment gap by prioritizing neglected of neglected tropical disease control. dependent States control leishmaniasis tropical diseases, scaling up national The annual BRICS’ heads of state and and other infectious diseases. In 2013, programmes and achieving domestic BRICS’ health ministers meetings – both leaders of the G20 nations issued the goals for control and elimination of the of which will be hosted by Brazil in 2014 Saint Petersburg Development Outlook diseases relevant to their settings. Sec- – are also occasions to discuss this topic. Report, which renewed the G20’s com- ond, by sharing expertise – each BRICS Shaping the policy agenda mitment to economic growth as a way of country can help other countries tackle reducing poverty and promoting inclu- neglected tropical diseases, through new As they continue to shape their collec- sive growth. Future G20 meetings offer partnerships. Third, BRICS can shape tive agenda and pursue joint coopera- further opportunities for the Russian the policy agenda, increasing political tion projects on poverty reduction and Federation to shape the G20’s approach commitment, mobilizing resources and health, BRICS can use their voices to to neglected tropical disease treatment implementing policies that support ensure that neglected tropical diseases and control. neglected tropical disease control and are included at the forefront of global The India–Brazil–South Africa tri- elimination on the international level. ■ development. lateral dialogue was established as early South Africa – the only African na- as 2003, to encourage cooperation and Competing interests: None declared.

References 1. WHO Preventive Chemotherapy and Transmission Control Databank 6. Forum on China–Africa cooperation. The Fifth Ministerial Conference [Internet]. Geneva: World Health Organization; 2003. Available from: http:// [Internet]. Beijing: Ministry of Foreign Affairs; 2012. Available from:http:// www.who.int/neglected_diseases/preventive_chemotherapy/sth/en/ www.focac.org/eng/ltda/dwjbzjjhys/ [cited 2013 Oct 25]. index.html [cited 2011 Oct 10]. 7. Australia and China enter new development cooperation partnership 2. Progress report 2000–2009 and strategic plan 2010–2020 of the global [Internet]. Barton: Department of Foreign Affairs and Trade; 2013. Available programme to eliminate lymphatic filariasis: halfway towards eliminating from: http://foreignminister.gov.au/releases/2013/bc_mr_130410.html lymphatic filariasis. Geneva: World Health Organization; 2010. Available [cited 2014 Feb 27]. from: http://whqlibdoc.who.int/publications/2010/9789241500722_eng. 8. Fifth BRICS Summit declaration and action plan [Internet]. Durban: pdf [cited 2011 Oct 25]. Department of and Cooperation; 2013. Available 3. Towards eliminating lymphatic filariasis: progress in the South-East Asia from: http://www.brics5.co.za/fifth-brics-summit-declaration-and-action- Region. New Delhi: World Health Organization; 2013. plan/ [cited 2013 Oct 25]. 4. Delivering on promises and driving progress. Uniting to Combat NTDs; 2014. Available from: http://unitingtocombatntds.org/sites/default/files/ document/NTD_report_04102014_v4_singles.pdf [cited 2014 Apr 15]. 5. Shifting paradigm: how the BRICS are reshaping global health and development. New York: Global Health Strategies initiatives; 2012. Available from: http://g8civil.org/documents/brics/ghsi_brics_report.pdf [cited 2014 Apr 7].

462 Bull World Health Organ 2014;92:461–462| doi: http://dx.doi.org/10.2471/BLT.13.132555