Turned-in eyelashes that scratch the cornea, relentless itching due to millions of worms in the skin, blindness, bloody urine, enlarged scrotums, extremely swollen legs and feet… These are but a few examples of the devastating impact neglected tropical diseases (NTDs) have on people.
One and a half billion people—almost 20% of the world’s population—need treatment for NTDs. That is one out of every five people alive today. Among the poorest in the world, the individuals affected often drop out of school, see their earning potential plummet and wind up living on the margins of society as a result of their diseases, which also cause anemia, malnutrition, stunted growth and stunted cognitive development.
On a wider scale, NTDs, which include intestinal worms and trachoma, contribute to billions of dollars in economic losses each year that impact the global economy. If countries in Africa met the World Health Organization’s 2020 goals for the five most common NTDs, they would collectively gain $52 billion in increased productivity in the following 10 years. While the diseases are especially prevalent in African countries such as Ethiopia, Nigeria, Democratic Republic of the Congo, Rwanda, and Zimbabwe, U.S. communities have also been afflicted.
Throughout the first half of the twentieth century, hookworm—an intestinal worm—was a major public health concern in the U.S. South. But there is hope. As shown in the new book Under the Big Tree: Extraordinary Stories from the Movement to End Neglected Tropical Diseases (Johns Hopkins University Press, January 2019), even as nations worldwide turn their focus increasingly to domestic issues, a number of unsung heroes, armed with cutting-edge science and a drive to improve lives, are turning this story around. Written by Ellen Agler, CEO of the END Fund, with award-winning writer Mojie Crigler, Under the Big Tree shines a spotlight on these heroes and chronicles how society is making progress toward ending these diseases that until recently received little-to-no attention.
“I’m optimistic that together we can lift the burden of these preventable diseases and improve the lives of millions of people around the world,” says Bill Gates in his Foreword. As the book explains, nearly two dozen illnesses have been designated “neglected tropical diseases” to date. In addition to intestinal worms and trachoma, the most prevalent are river blindness, lymphatic filariasis, and schistosomiasis.
The people who suffer (and recover) from NTDs and the extraordinary stories of the fight to cure them are the focus of Under The Big Tree, which demonstrates the enormous amount of planning, resources, labor, and preparation required to tackle NTDs. The book also shows how, when a few lucky pivotal moments occur amid the planning, change at a near-miraculous caliber can ensue.
Among the more granular angles the book explores are:
● How a chain of remarkable coincidences led to the discovery and distribution of the drug that is bringing river blindness under control and resulted in a Nobel Prize.
● How efforts to end NTDs have given rise to a new model of collaborative, innovative philanthropy.
● The staggering, yet surmountable, hurdles along the “last mile” that must be crossed to deliver medicines or goods to the most inaccessible areas.
● How smartphones can help end NTDs.
● The remarkable ways in which fiercely competitive big pharma companies have actually worked collaboratively to stem the spread of NTDs.
Among Under The Big Tree’s many important implications is the valuable lesson that often the simplest, smallest of measures can have a far-reaching impact.
Advance Praise for Under the Big Tree
“Under the Big Tree makes a passionate, persuasive argument. Ending NTDs is a low-cost, high impact way to radically improve the lives of the world’s poorest citizens.”
—George Stephanopoulos, Chief Anchor, ABC News
“Under the Big Tree is an inspiring reminder of what is possible when those in the global health field put their faith in people and their trust in evidence.”
—Margaret Chan, Former Director-General, World Health Organization
“Under the Big Tree blends fascinating stories, from all sides of the fight against neglected tropical diseases, with takeaway lessons of collaboration, creativity, and positive systemic change. The result is a book that is accessible, inspiring, and deeply necessary.”
—Klaus Schwab, Founder and Executive Chairman, World Economic Forum
“Under the Big Tree is a concise and vigorous exploration of the devastating effects of neglected tropical diseases and the sweeping benefits that follow their demise.”
—Paul Farmer, MD, PhD, Kolokotrones University Professor and Chair, Department of Global
Health and Social Medicine, Harvard Medical School; and Co-Founder, Partners in Health
About Ellen Agler
Ellen Agler serves as the CEO of the END Fund, a private philanthropic initiative working to end five neglected tropical diseases (NTDs) affecting 1.5 billion people—1 in 5 people alive today. She is a member of the World Economic Forum’s Global Health Security Advisory Board and the Uniting to Combat Neglected Tropical Diseases Stakeholders Working Group. Ellen holds graduate degrees in International Health from the Harvard School of Public Health and in Development Studies from the London School of Economics.
About Mojie Crigler
Mojie Crigler is the author of Get Me Through Tomorrow: A Sister’s Memoir of Brain Injury and Revival (University of Nebraska Press, 2015). Her short fiction and nonfiction works have appeared in Glimmer Train, Los Angeles Review, Drunken Boat, Hunger Mountain, The Rumpus, and The Believer. A graduate of Stanford University and Vermont College of Fine Arts, Mojie received the 2010 Howard Frank Mosher Prize for Short Fiction.
Title: Under the Big Tree: Extraordinary Stories from the Movement to End Neglected Tropical
Author: Ellen Agler, Mojie Crigler
Publisher: Johns Hopkins University Press