Programs Against the Diseases of Poverty: Chagas, River Blindness, Schistosomiasis, Sleeping Sickness, Leprosy and Rabies

The model that others copied. In 1991 health ministers of Argentina, Bolivia, Brazil, Chile, Paraguay and Uruguay committed to eliminating the triatomine bug Triatoma infestans and screening blood donations, and the work was credited with cutting estimated new Chagas cases from about 700,000 a year to under 200,000 between 1990 and 2000.

Created in 1997 for Colombia, Ecuador, Peru and Venezuela and modeled on the Southern Cone effort. Its progress has been slower because the region has several native vector species, and about 12.5 million people were estimated to be at risk.

Launched in 1997 by seven countries, it set a clear test for success: more than three consecutive years free of vector infestation. By 2011 the elimination of Rhodnius prolixus had been certified in Mexico, Guatemala, Honduras, El Salvador, Nicaragua and Costa Rica, and Mexico joined in 2013.

The path moves to Africa and river blindness. From 1995 this World Health Organization coordinated program used community directed treatment with ivermectin donated by Merck, and ran until 2015, when parts of its work passed to the elimination effort for neglected tropical diseases.

Founded in 2002 with a 20 million pound Gates Foundation grant, it set out to prove that a national schistosomiasis control program could be delivered at scale. By 2008 it had helped establish programs in six African countries, and in 2019 it became the independent organization now called Unlimit Health.

Sleeping sickness, spread by tsetse flies, is the target here. The World Health Organization road map aimed for elimination as a public health problem by 2020, which was met, and for interruption of transmission of the gambiense form by 2030, with an estimated 55 million people at risk for 2016 to 2020.

A long-running disease gets a new ambition. After multidrug therapy arrived in 1982, recorded cases fell from more than 5 million to under 200,000 by 2016, and the 2021 to 2030 strategy, Towards Zero Leprosy, aims further at zero infection, zero disability and zero stigma.

The path ends with a One Health plan published in 2018 by four organizations together. It targets zero human deaths from dog-mediated rabies by 2030 through mass dog vaccination, public awareness and prompt treatment after bites.