How to eliminate noma worldwide

One year after WHO added noma to its list of neglected tropical diseases, there remains much to be done to raise awareness, support survivors, and safeguard vulnerable communities.

A mother sits on a hospital bed with her child recovering from noma in Nigeria.

Abdulkadir, center, has been diagnosed with lesions typical of the second stage of noma. He received care for noma as well as malnutrition. | Nigeria 2024 © Alexandre Marcou/MSF

A year after noma was included in the World Health Organization (WHO)’s list of neglected tropical diseases, Doctors Without Borders/Médecins Sans Frontières (MSF) continues working to encourage early detection and treatment to save more lives from this deadly disease. 

“The inclusion [of noma] in WHO’s list of neglected tropical diseases is an important step, but not the final one,” says Mark Sherlock, MSF health program manager. “This recognition got noma and noma survivors the attention they deserve, but that attention needs to be maintained and translated into real measures to achieve its elimination. The global health community and donors must continue to prioritize treatment efforts and research to eventually see the end of noma worldwide.”

Doctors examine a young girl with noma who underwent life-changing reconstructive surgery in Nigeria.
Doctors examine a young girl with noma who underwent life-changing reconstructive surgery. | Nigeria 2023 © Alexandre Marcou/MSF

What is noma?

Noma is a preventable and treatable disease that primarily affects people living in poverty, especially young children, and is linked to malnutrition and unsanitary living conditions. The disease usually afflicts people in isolated communities with limited access to health care and vaccinations. It begins as gum inflammation but can rapidly escalate, destroying facial tissue and bones. Few other infectious diseases cause such rapid fatalities. When untreated, up to 90 percent of those affected may die, often within a few weeks. The 10 percent who survive are frequently left with severe facial disfigurement, impacting their ability to eat, speak, see, or breathe, and they often face stigma due to their appearance.

The team in Nigeria shows leaflets to check if someone identifies a noma case in the area.
The outreach team at the Noma Hospital in Sokoto raises awareness about noma signs and causes in the village of Sayinna. | Nigeria 2023 © Fabrice Caterini/Inediz

Raising awareness about noma

In 2020, MSF, together with other organizations, noma survivors and Nigeria’s Ministry of Health, launched an international campaign to raise awareness about noma and add it to WHO’s list of neglected tropical diseases. After three years of intense advocacy and communication efforts and the engagement of 30 other nations, noma was officially added as the twenty-first disease on the list. One year on, MSF continues to prioritize efforts tackling the disease.

This recognition got noma and noma survivors the attention they deserve, but that attention needs to be maintained and translated into real measures to achieve its elimination.

Mark Sherlock, MSF health program manager

“MSF is focusing on three pillars,” explains Sherlock. “The first is to integrate noma screening and treatment in MSF projects around the world, enhancing early recognition and treatment of noma. We want children in endemic countries to be screened for noma at the first sign of symptoms when lives can still be saved. Secondly, MSF is calling for more research into the disease, specifically in the causes of noma and the global epidemiology. Finally, MSF is advocating for the global health community and donors to prioritize the disease and ensure efforts are made to eventually eliminate noma globally.”

A noma survivor speaks with a mental health counselor in Nigeria.
Funke Adagboyega, an MSF counselor in the mental health department, talks to Aisha, a noma survivor from Yobe state, before her surgery. Aisha is proud to be an example to other people suffering noma. "Anyone with noma who sees me would be willing to come to the hospital and get treated," she says. | Nigeria 2023 © Fabrice Caterini/Inediz

Noma survivors lead campaign

The three-year campaign was largely led by noma survivors, who shared their experiences to convey a simple yet crucial message: Noma is a preventable and treatable disease that should no longer exist.

“A year ago, noma was included in the WHO list of neglected tropical diseases and this is the result of our collective efforts,” says Mulikat Okanlawon, a noma advocate and cofounder of Elysium, the first noma survivors’ association. “We have done it together and I’m sure we can do more starting today. We can bring positive change to the lives of people affected by noma, the ones at risk, and their communities.” 

With continued efforts in the early detection and treatment of the disease, along with more funding for global research, noma can be eliminated.

Since 2014, MSF has supported the Nigerian Ministry of Health’s Sokoto Noma Hospital in northwestern Nigeria by providing reconstructive surgery, nutritional support, mental health services, and outreach activities. In these 10 years, MSF's surgical team has performed 1,481 surgeries on 953 patients. MSF conducts specialized and free reconstructive surgeries for noma survivors every four months, targeting around 40 patients per surgical intervention with a team of international and national surgeons and anesthetists. 

Missing Maps: Tackling noma and malnutrition in Sokoto, Nigeria

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A year ago, the global community made an important step to bring noma more public attention to help vulnerable communities who are affected by the disease. Progress must not stop there. With continued efforts in the early detection and treatment of the disease, along with more funding for global research, noma can be eliminated.