NGOs Try Power in Numbers Approach in Call to Action against Diarrheal Disease

Nothing is sexy about diarrhea. Its advocates have been outshouted and overshadowed by the celebrity-backed “big three” in recent years, yet diarrheal disease – mostly caused by the human consumption of water contaminated by bacteria and other microbes (e.g. shigella, rotavirus, cholera, E. coli) from human feces – remains the second largest killer of children under 5 in the world (over 4,000 casualties every day). To turn the tide on this disease, traditional supporters have recruited reinforcements to provide a more comprehensive strategy and advocacy push to bring needed attention to this preventable and curable scourge.Last week, over 80 NGOs issued a Call to Action, demanding immediate and concerted attention and resources be paid towards tackling diarrheal disease head on. Understanding that the causes and effects of this disease are widespread, its civil society supporters must also be drawn from many corners. In an effort to broaden its reach, additional emphasis has now been put on prevention, with traditional global health and diarrheal disease groups reaching out to water, sanitation and hygiene advocates as well. More impressive than the sheer number of organizations signing on is their breadth of foci. A cross-section of groups working together in this initiative shows advocates across several communities: global health (Global Health Council, Partners in Health); water/sanitation (Safe Water Network, WaterAid); the environment (Society for Conservation and Protection of Environment (SCOPE), Earth Day Network); children (Save the Children, Child Health Foundation); nutrition (Bread for the World, Action Against Hunger); poverty (CARE, ONE Campaign) and others. What’s more, these organizations span the length of the supply chain – from R&D innovators PATH and Institute for OneWorld Health, to on-the-ground implementers John Snow, Inc. and Management Sciences for Health – and include a good deal of developing country groups like African Medical and Research Foundation (AMREF) and Haitian Health Foundation.Significant progress was made with treatment interventions like oral rehydration therapy (ORT) in the 80’s and 90’s, cutting diarrheal deaths almost in half. Yet it was, in part, due to this success that those reductions have both stagnated and even reversed in many low-income countries. Many viewed diarrheal disease as a problem that had been solved, as HIV/AIDS took the spotlight and continues to get top billing (and funds). For example, the WHO’s treatment-focussed Diarrheal Disease Control program, initiated during the late 1970s, was funded at nearly $50M with a staff of 25 in 1985. A shadow of its former self, the DDC currently employs a staff of 2, with a budget of $2M (current dollars).The Call to Action hopes to leverage and combine the separate advocacy efforts of the various communities above, with a unifying focus on diarrheal disease that presents the problems and solutions in a compelling and fully-formed way for policymakers. When traditional global health advocacy efforts never reach farther than an organization’s specific disease or intervention, it will be interesting to see what can be learned from this convergence and cooperation between sectors.And it comes at a good time too: in the wake of the Obama administration’s new Global Health Initiative, which called for Congress to spend $63 billion over the next 6 years on a strategy that is generally seen as being broader and more far-reaching than his predecessor’s AIDS-centric approach. Focusing on issues like maternal and child health (MCH), the president’s statement released by the White House last week affirmed, “The world is interconnected, and that demands a more integrated approach to global health.” With its broad coalition of supporters, the Call to Action to Defeat Diarrheal Disease is right in line with this new interconnected approach and MCH focus espoused by the White House. Both initiatives are in the early stages of planning and have not been in contact with each other, so we’ll have to wait and see what forms they both take. If successful, both can make real progress on MCH in the developing world, not least on preventable and treatable diarrheal disease, which has claimed the lives of 15 children in the 5 minutes it took you to read this.