A focus on NTDs in sub-Saharan Africa: Supporting scale-up of interventions

A focus on NTDs in sub-Saharan Africa: Supporting scale-up of interventions

Russell Stothard & COUNTDOWN consortiumLSTM, UK

The COUNTDOWN project is a research programme funded by

The Research and Evidence Division (RED) of The Department for International Development (DFID).

Sustainable Development Goals (SDGs) 2030

Goal 3. Ensure healthy lives and promote well-being for all at all ages

Edinburgh 6-7th October: Evidence & Organisations

• Introducing COUNTDOWN

• Changing NTD landscape: policies with practicalities

• Some examples with discussion points

• Outlook towards 2020 & 2030 targets

Introducing COUNTDOWN?

• Implementation research consortium

• Interdisciplinary methods & approaches

• Focused on preventive chemotherapy

- lymphatic filariasis- onchocerciasis- schistosomiasis- soil-transmitted helminthiasis- trachoma

• Towards health system strengthening

Introducing COUNTDOWN?

Liberia GhanaCameroon

MDA Scale-up Theme (MST 1 – 3)

Nigeria

ICST 1

ICST 2Integrated Complementary Strategy Theme

Research uptake & capacity strengthening

MST 1: Evidence synthesis

MST 2: Applied social science

MST 3: Health economics

ICST 1: ‘Hotspots’ and SAEs lymphatic filariasis & onchocerciasis

ICST 2: Access to MDA and WASH schistosomiasis & soil-transmitted helminthiasis

Introducing COUNTDOWN?

• Website www.countdownonntds.org

• E-communications blog site & twitter account

Introducing COUNTDOWN?

• Website www.countdownonntds.org

• E-communications blog site & twitter account

• Introducing COUNTDOWN

• Changing NTD landscape: policies with practicalities

• Some examples with discussion points

• Outlook towards 2020 & 2030 targets

Changing NTD landscape: policies with practicalities

Community

Global

Regional

National

District

Flux of stakeholders & interests

Changing NTD landscape: policies with practicalities

https://www.infontd.org/

An A to Z of agencies

Alliance for Disability-Inclusive Development (ADID) ….WVI - World Vision International

Disease focused (pharmaceutical industry)http://eliminateschisto.org/

www.who.int/topics/schistosomiasis/

Challenges in the provision of MDA, as NTDs are:

• Embedded in complex social/biological systems shaped by ecological/political contexts

• Control vertically focused, ‘outside’ the primary health care system in sub-Saharan Africa

• Promoting community ownership is central but is dynamic sometimes, often with local complex power structures evolving as programmatic integration ensues

• Programmes need to adapt and reflect the realities of the communities they serve by voicing opinions/needs of affected communities (NB: control to elimination settings)

Changing NTD landscape: policies with practicalities

Changing NTD landscape: policies with practicalities

5-points to consider:

1. A move from a single disease to addressing multiple NTDs through a coordinated health systems approach

2. Strategic partnerships amongst multiple stakeholders

3. Robust and appropriate data for evidence-based action

4. A strong equity stance and focus upon addressing poverty and achieving universal health coverage

5. Strong women’s leadership and roles in health

• Introducing COUNTDOWN

• Changing NTD landscape: policies with practicalities

• Some examples (schistosomiasis) with discussion points

• Outlook towards 2020 & 2030 targets

1

2

3

Attack points in the lifecycleSome examples with discussion points

Schistosomiasis

250M+ with disease

Urogenital• FGS/HIV

Intestinal • Uganda

Access to PZQ• ?affordable

Urogenital - FGS/HIV: cross-sector engagement IN the health system

Intestinal – Uganda: inter-sectoral engagement ACROSS the health system

Related-issues

Government

• UPE (coverage)

• UPE (erosion)

NGDO

• WVI

• Leeds University

Intestinal – Uganda: inter-sectoral engagement ACROSS the health system

Challenges in large lake settings- natural or man-made

Infection starts soon after birth- occupational risk

Access to PZQ: SEVERAL bottlenecks to be addressed for universal access

Drugsdonated/purchased/delivery

DeliverersCDD or teachers or bothMaternal & child healthEPI

RecipientsPre-SACSAC (in-school and out-of-school)Adults - ?pregnant

EnvironmentVectors/sanitation/modificationALB & PZQ drug distribution in Liberia 2012

Outlook towards 2020 & 2030 targets

Thank You

The COUNTDOWN project is a research programme funded by

The Research and Evidence Division (RED) of The Department for International Development (DFID).

Ghana

Cameroon

Liberia

Nigeria

UK

USA