“To Whom Should She Go First?” – Prioritizing the Poor in Global Health

For this week's Common Good Forum, we invited Emily Conron, the outreach coordinator for END7, a campaign of the Global Network for Neglected Tropical Diseases at the Sabin Vaccine Instituteto write on tangible ways the Church can become a "poor Church for the poor" by joining the effort to end a group of diseases that are trapping billions of people in poverty.

In November, Pope Francis issued a stirring call in Evangelii Gaudium for the Church to rediscover her “missionary impulse.” “If the whole Church takes up this missionary impulse,” he wrote, “she has to go forth to everyone without exception. But to whom should she go first? When we read the Gospel we find a clear indication: not so much our friends and neighbors, but above all the poor and sick, those who are usually despised and overlooked, ‘those who cannot repay you’ (Luke 14:14)” [48].

With these words, and with so many other statements he has made in less than a year as Pope, the Holy Father described his compelling vision of a “Church of the poor” – a Church whose activities are oriented by a preferential option for the poor and vulnerable. While Francis has stressed the need for a special focus on the poor to infuse every aspect of the Church’s ministry, there is a particular area where the Church’s renewed “missionary impulse” could have a tremendous impact: in calling attention to diseases that have been plaguing humanity for thousands of years and today are trapping billions of people in poverty.

These are diseases relatively unknown in high-income countries but which are all too familiar to the world’s poorest people. They’re called neglected tropical diseases (NTDs) – grouped together both by common geographic overlap, modes of transmission, and treatment strategies, but also by their relative neglect on the global health agenda because they tend to target people who have been marginalized by the health system.

More than a billion people worldwide suffer from one or more of the seven most common NTDs, parasitic and bacterial infections contracted through insect bites or dirty water or unhygienic living conditions, and endure stigmatization, pain, and chronic unemployment as a result. Catholic-majority countries shoulder a large proportion of the global burden of NTDs, but these diseases do not discriminate on the basis of creed or color. They are found in every area where extreme poverty persists, and by virtue of their disabling, disfiguring, and debilitating symptoms – from swelling of the limbs and genitals, to anemia and malnutrition, to blindness – they trap communities in poverty by keeping children from school and adults from work.

NTDs are called diseases of “neglected people” because they primarily affect the most marginalized communities, those who often live in hard-to-reach, remote areas and have little voice in national or international affairs. As Dr. Paul Farmer, a global health visionary and founder of the organization Partners in Health, wrote in Sojourners in December, “Any serious examination of epidemic disease has always shown that microbes also make a preferential option for the poor. But medicine and its practitioners, even in public health, do so all too rarely.”

However, we have a tremendous opportunity to end the neglect of these diseases and make a preferential option for the poor communities they affect. Two years ago, pharmaceutical companies pledged to donate the medicines necessary to treat the hundreds of millions of people at risk for or currently infected with NTDs in order to reach the ambitious goal of controlling and eliminating the most common NTDs by 2020. Through “mass drug administration” programs that distribute donated medicines to everyone at risk in a community, an individual can be treated and protected from all seven of the most common NTDs for just $0.50 per year – a “best buy” in public health.

We know that treating NTDs has implications far beyond alleviating the devastating physical symptoms they cause. Studies have demonstrated that treating children for intestinal worms can reduce school absenteeism by 25%, leading to greatly increased economic productivity in adulthood (one randomized controlled trial showed that treating children chronically infected with  hookworm, one type of intestinal worm, can boost their future earnings by an astonishing 43%). Thus, treating communities for NTDs is a targeted way to address the structural causes that trap the poor in an intergenerational cycle of poverty.

The Church has an essential role to play in the effort to control and eliminate these preventable and treatable diseases of poverty. By shining a light on NTDs and advocating for the policy changes necessary to combat them, the Church can begin to erode the “globalization of indifference” that has allowed these diseases to flourish in areas of poverty, out of sight of scientists and policy-makers. Pope Francis quoted his predecessor’s words in Deus Caritas Est to remind the faithful of their duty in this regard: “If indeed ‘the just ordering of society and of the state is a central responsibility of politics’, the Church ‘cannot and must not remain on the sidelines in the fight for justice’” [Evangelii Gaudium 183].

Members of the Church can join this fight for justice by raising their voices in support of increased funding, both from donor and endemic countries, for NTD treatment programs around the world. While NTD control is one of the most cost-effective public health interventions available today, funding, research, and the political will to tackle NTDs lags significantly behind that of other health and development issues. The US has been a leader in this effort, signing the largest-ever funding allocation for NTD programs into law with the passage of the 2014 federal budget, but more countries must follow suit if we are to reach our control and elimination goals.

Catholics can contribute to the effort to build momentum behind this cause by motivating our leadership to speak up about the need for increased domestic and international funding for NTD elimination programs. In addition, Catholics can join the Global Network for Neglected Tropical DiseasesEND7 campaign, an international advocacy and resource mobilization effort. On a local level, parishes can fundraise to help END7 fill funding gaps and organize educational events in their communities. A coordinated push at every level of the Church could have a tremendous impact on the effort to control and eliminate these diseases over the course of the next decade. 

Few times in human history has a problem so serious been so completely solvable. The unnecessary suffering of over one billion people is a challenge to the conscience of the Church and the world.  The Church is in a powerful position to speak on behalf of these marginalized and vulnerable communities, raise awareness of the impact of NTDs, encourage the adoption of policies to mitigate their adverse impact, and help attract new resources critical for NTD control and elimination programs. Catholics of all backgrounds can play a crucial role in advocating for the voiceless poor and vulnerable communities afflicted with these diseases. By joining this effort, people of faith can heed Pope Francis’ call to fight the globalization of indifference and act on the missionary impulse to build a Church of the poor.

For more information about END7 and how faith communities can get involved, please contact Emily at emily.conron@sabin.org.

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