International Coalition for Trachoma Control

Neglected tropical diseases, or NTDs, are not the first things that usually come to mind when thinking about the challenges faced by refugees seeking safety and security. In fact, until recently, little has been known about NTD prevalence among refugee populations, which should be surprising given that many NTDs are known to disproportionately affect poor and marginalized populations.

As part of Ethiopia's strategy to eliminate all NTDs in the country, leaving no one behind, the Federal Ministry of Health recently began a new mapping initiative to identify the prevalence of five NTDs in all refugee camps in Gambella and Beneshangul-Gumuz regional states.

This is an important step in the country's elimination strategy as it currently hosts over 780,000 refugees, many of which come from neighbouring countries with poor health system infrastructure and that are endemic for many NTDs.

Implemented by the Ethiopian government, UNHCR, RTI International and other partners, and with funding from the US Agency for International Development through the ENVISION Project, the mapping initiative tested refugees for schistosomiasis, soil transmitted hellminths, lymphatic filariasis (commonly known as elephantiasis), onchocerciasis and trachoma. While these may not be household names in most developed countries, the World Health Organization estimates they, along with 15 other NTDs, threaten the lives and livelihoods of over one billion people worldwide.

Results from the mapping are still emerging, however preliminary results have already confirmed that levels of trachoma infection are high enough to require distribution of drugs to the affected population.

This is of great concern and requires urgent attention if Ethiopia is to meet its health targets. Ensuring good health for refugees is not only the right thing to do but also it is epidemiologically imperative. A population of hundreds of thousands of refugees could introduce an NTD into an area where it has been eliminated, or may themselves be at risk for infection if moving into a host community with a high NTD prevalence.  

As the Federal Ministry of Health Team Leader Biruck Kebede Negash said in a recent interview, "the global community needs to be as open and welcoming to refugees as Ethiopia. It is only by welcoming refugees as our guests that we can build the trust necessary to understand and address diseases that are a threat to everyone and which will not respect borders."

It is crucial that more mapping initiatives like this are funded, both in Ethiopia and abroad, so that we can identify exactly where NTD transmission is occurring and target our resources accordingly.  Support for future mapping and treatment of refugee camps is currently being sought and is essential if we are serious about eliminating NTDs.

*The refugee mapping initiative was conducted by the Federal Ministry of Health NTD Case Team and RTI International, with funding from the United States Agency for International Development. Technical support was provided by Ethiopian Public Health Institute, Gambella Regional Health Bureau, Beneshangul-Gumuz Regional Health Bureau, ARRA, UNHCR, CDC, International Trachoma Initiative, Sightsavers and the World Health Organization 

This blog was written by Scott McPherson. ICTC Vice Chair