TAG overview

Schistosomiasis

Danger in the water

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Challenge

There is a disease that kills about 200,000 people each year, yet many people have never heard of it. Manyazewal is one of these people. He is eight years old and lives in a rural area of Ethiopia. One of his favorite pastimes is to play in the local lakes and rivers, together with the other children of his village. The water is dangerous, but not for the reasons the children may think. The disease schistosomiasis spreads through snails that live in freshwater.

We take up the fight

Leaving no one behind

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Solution

We work with partners around the world to fight schistosomiasis, a neglected tropical disease. We regularly donate large quantities of medication primarily for the treatment of school-aged children in sub-Saharan Africa. Suitable tablets for pre-school age children, however, are currently not available. We are, therefore, also working on developing and registering a safe, effective medication for children below the age of six. We want to be able to offer appropriate treatment even for the youngest patients. In accordance with the new WHO NTD-roadmap we are working towards elimination of schistosomiasis as a public health problem in several countries by 2030.

Learn more

There are millions of people like Manyazewal who do not know about the risks of contracting schistosomiasis. Almost 240 million people across 78 countries in Africa, Asia and South America are affected by the disease. Our vision is to create a world free of this devastating disease, which is why we were a founding member of the Global Schistosomiasis Alliance.

Our mission is elimination

Our ultimate aim in all our schistosomiasis-related work is eliminating the disease as a public health problem. Ultimately, we want to bring the global infection rate down to below 1%, meaning that the prevalence of heavy infections among children aged 5–14 years is reduced to less than 1%. And we are making good progress. To help achieve this goal, we use a comprehensive schistosomiasis strategy. The approach focuses on five areas:

We supply medicine:

Wheel Graphic 1 (graphic)

We donate up to 250 million tablets annually to the World Health Organization to treat schistosomiasis.

We research solutions:

Wheel Graphic 2 (graphic)

Our experts work with a consortium of partners to develop and provide access to a pediatric drug against schistosomiasis suitable for children under six years of age. We engage in research collaborations regarding drug discovery activities for potential new anti-schistosomal candidates; we work on new sensitive diagnostics as well as on technologies to control transmission factors.

We work with many partners:

Wheel Graphic 3 (graphic)

Among other partnerships, we are a founding member of the Global Alliance. The Alliance hosts many cross-sector partners working together to accelerate progress towards schistosomiasis control and elimination.

We support water, sanitation and hygiene projects:

Grafik 4 (Grafik)

In order to prevent the transmission of the disease, we support projects that focus on improving the relevant infrastructure through financing and expertise.

We inform the public:

Wheel Graphic 5 (graphic)

Our experts participate in health education initiatives that enhance local research expertise and raise awareness of the causes and dangers of schistosomiasis as well as how to prevent it.

Integrated schistosomiasis strategy

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The three stages of schistosomiasis infection

Do you know enough about schistosomiasis?

Infection with schistosomiasis occurs when people come into contact with water contaminated by the schistosome parasite. These free-swimming parasites burrow into the skin and move through the body. They develop into worms, lay eggs and cause damage to the bladder, kidneys and liver. In some cases, schistosomiasis can lead to death, if left untreated. In children, the disease often leads to anemia, stunted growth and impaired learning ability. All these can have devastating consequences for the lives of the infected children. In areas where sanitation is poor and hygiene is a challenge, eggs that are excreted by humans easily pass back into streams, rivers and lakes. There, they hatch and burrow into certain types of snail, where they develop before leaving the snail as a free-swimming parasite at risk of infecting a human. And so, the cycle of infection continues.

Learn more about it in this video:

Video

How do we get the medicine to those who need it?

We donate up to 250 million tablets of our medicine a year to the World Health Organization (WHO). In 2019, we reached the landmark of 1 billion donated tablets over 12 years. The WHO distributes the medication free of charge to high-disease burden countries in sub-Saharan Africa.

After we produce the tablets, we deliver them through the WHO to national warehouses in the affected countries. WHO and local implementing partners handle the delivery and distribution down the so-called “last mile”. But our commitment doesn’t stop there. We aim to track our donations in Kenya electronically, using a high-tech solution for improving transparency in medicine donation supply chains. The recipients of the medicine can easily acknowledge that they received the new supplies of tablets and state how many children were treated via their cell phones. We can then monitor the volume of medicines reaching schools as well as any remaining unused supplies. This is particularly useful in the case of “last mile” deliveries to remote, rural locations. We can also use the tool to inform the WHO and partners of stock levels and expiration dates, and to organize the best way to retrieve unused medicines from the field and store them centrally for future use.

1 billion tablets for 47 African countries

In 2019, we reached the milestone of 1 billion donated tablets.
WHO research has shown that we treated 72% of all school-age children in need of treatment in sub-Saharan Africa in 2017. Our donation scheme has been a major contributor to this drop in incidence of the disease.

Recipient countries in Africa

How do we know who needs to be treated?

Schistosomiasis is one of the most prevalent parasitic diseases in sub-Saharan Africa – and it is dangerous. It can lead to chronic inflammation of the organs, which can be fatal. But it can also lead to anemia, stunted growth and impaired learning ability. All these can have devastating consequences for the lives of the infected. The economic and social impact of the disease is significant. 

It is therefore vital to not only treat the disease, but to detect the infected patients early. Stool sampling and urine filtration are the two schistosomiasis diagnostic methods currently used in the field, but they tend to lack sensitivity. So new diagnostics are urgently needed. In 2019, we initiated a collaboration with the Foundation of Innovative New Diagnostics (FIND ) and the Bill and Melinda Gates Foundation (BMGF) to develop sensitive rapid diagnostic tests (RDTs) that help improve mapping and case detection for schistosomiasis. The current focus is on RDTs that detect circulating anodic antigens (CAA) in the blood.

Making Schistosomiasis history

David Rollinson

Director of the Global Schistosomiasis Alliance

David Rollinson is Director of the Global Schistosomiasis Alliance, a Merit Research Scientist at the Natural History Museum in London and Director of their WHO Collaborating Centre on schistosomiasis. With considerable experience of working in endemic areas in Africa he is passionate about reducing the suffering caused by schistosomiasis and actively promotes strong collaboration between different sectors to achieve better health for all.

Education: BSc Hons, PhD, DIC
Joined GSA in: 2017
Focus areas: Methods for mapping Schistosomiasis, medication delivery, disease pathologies, new diagnostics, behavior change and new interventions for snail control.

Our commitment to the SDGs

Help end epidemics

We take the UN Sustainable Development Goal 3 – ensuring healthy lives and promoting well-being for all at all ages – very seriously. In particular, we support the development processes of medicines for diseases that primarily affect low- and medium-income countries (SDG target 3.b.) as well as achieving universal health coverage, access to quality healthcare services and access to safe, effective, quality and affordable essential medicines for all (SDG target 3.8.). We enter strong partnerships all over the world to further the cause of health for all, enhancing regional and international cooperation on and access to science, technology and innovation (SDG target 17.6).

A world without schistosomiasis: This is our vision and our contribution to help achieve the 2030 UN Sustainable Development Goals.

Schistosomiasis Quote (photo)

We are determined to see our battle against schistosomiasis through to the end and achieve global elimination of the disease as a public health problem.”

Johannes Waltz Head of schistosomiasis elimination program at Merck

Schistosomiasis
A parasitic disease spread in warm lakes and ponds by snails that serve as intermediate hosts.

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