This is another very good example of the type of coalitions you need to make progress, because on neglected tropical diseases and the wider issue of water and sanitation, I would say we're not going to make the kind of progress we need to make, and have already made, without these coalitions of governments as well as the private sector. The private sector has been a key component of this, alongside the World Health Organization, and many NGOs and people like Jimmy Carter. They have championed this issue.
What we've seen, as you know, in parts of West Africa and other parts of the world is enormous progress on things like guinea worm as a result of very specific interventions that have combined new medicines, but also awareness and treatment and improved water and sanitation. I don't have the exact numbers—you may have them in front of you—but the dramatic drop as a result of that intense effort has been really remarkable.
I would say that you can make that kind of progress on things like neglected tropical diseases, just as we've made progress on polio, and we can make progress on diarrhea, pneumonia, and malaria. I think where it's more difficult is with water and sanitation more generally—with latter often the root cause of some of these other things like diarrhea or even NTDs—you need a campaign that changes behaviour, because open defecation is a big part of this. You need to change behaviour in schools and in communities on hand-washing, which is another big part of it. But you also need a whole new system of cheap and available toilet facilities, pit latrines, and treatment for things like rotavirus.
It's about research and development. It's a product. It's a behavioural change strategy, and then you need the government to really back this with NGOs. I think what we're finding is that in the coming 10 or 15 years we might be able to make progress on specific issues, whether they be neglected tropical diseases or polio, but unless we address the more structural issues in a more comprehensive way, we won't make bigger progress. I think that applies to water and sanitation, and it also actually applies to health system strengthening, something that Canada has also championed in the past.