COUNTDOWN Anthony Bettee - Launch 2015

The Impact of Ebola on NTDsPresented by Anthony K. Bettee

Onchocerciasis Coordinator

Outline

• Neglected Tropical Disease (NTD) Situation before Ebola

• Overview of Ebola Crisis in Liberia

• Ebola Virus Disease impact on NTDs in Liberia

• Way forward

Map of Liberia

NTD situation before Ebola

Priority Neglected Tropical Diseases in Liberia

•Onchocerciasis• Lymphatic Filariasis• Soil Transmitted Helminths• Schistosomiasis• Leprosy•Buruli Ulcer

Mapping Status

PCTs # of Endemic IUs Population at risk

Onchocerciasis 15/15 3155572

Lymphatic Filariasis, 13/15 2468231

Shistosomiasis 4/15 421889

Soil Transmitted Helminthes

15/15 989549

Buruli Ulcer 3/15 1,512,879

Neglected Tropical Disease Situation in Liberia

Data of Two Mass Drug Administration Rounds

2012 2013

DiseasesEligible Population Pop Treated

Therapeutic Coverage

Eligible Population Pop Treated

Therapeutic Coverage

Onchocerciasis 2931633 2384832 81.30% 3155572 2627282 83%

Lymphatic Filariasis 2300055 2213340 81.10% 2468231 2445275 83%

Schistosomiasis 425922 322253 76% 421889 308742 73%

Overview of Ebola Crisis in Liberia

Ebola Case and Death Summary by County

County

DAILY EMAIL REPORT Laboratory2

Confirmed Cases (Alive and Dead)

Confirmed Cases on

Contact List

Cumulative3 cases 23 May-FEBUARY 24th 2015

Cumulative deaths2

New1 suspected and probable cases (Alive and Dead)

Total Suspect Probable Total Suspect Probable Confirmed

Bomi 0 0 0 0 0 330 112 79 139 175

Bong 0 0 0 0 0 701 428 33 150 168

Gbarpolu 0 0 0 0 0 35 16 3 16 14

Grand Bassa 0 0 0 0 0 181 56 71 54 81

Grand Cape Mount 0 0 0 0 0 370 224 52 94 241Grand Gedeh 0 0 0 0 0 11 8 0 3 6

Grand Kru 0 0 0 0 0 36 14 18 4 27

Lofa 3 3 0 0 0 720 142 146 332 447

Margibi 0 0 0 0 0 1327 481 453 392 584

Maryland 0 0 0 0 0 34 28 2 4 28

Montserrado 10 10 0 0 0 5294 2620 869 1796 2248

Nimba 0 0 0 0 0 359 112 131 116 70

River Gee 0 0 0 0 0 37 24 5 8 19

River Cess 0 0 0 0 0 44 10 10 24 27

Sinoe 0 0 0 0 0 64 39 7 18 27

NATIONAL 13 13 0 0 0 9507 4479 1879 3149 4177

Number of days since the last confirmed EVD case per county

Moving to maintain zero cases in Liberia

Liberia hasn’t had a new confirmed case in 20 days

LiberiaEbola Free

Days since last negative

Days since last confirmed

Countdown days

Overview Continued

• Last known confirmed case (BY) was discharged from Chinese ETU on March 5, 2015

• Liberians and partners are CAUTIOUSLY celebrating victory over EVD, as Guinea and Sierra Leone (Liberia Neighbours) still in active combat against the virus

• Efforts are being made to restore normal health services

• Building confidence among health workers remains a huge challenge

• Cross borders collaboration between Liberia, Sierra Leone and Guinea ongoing

Ebola Virus Disease Impact on NTDs in Liberia

Confirmed EVD cases and deaths among health workers

Collapse of the Already Fragile Health System

• More than 180 health workers contracted and died from EVD in Liberia• Some of these staff played a key function in the NTDs intervention at county

level• Deterioration in and distrust of routine health services

As EVD mimics other diseases, a lot of health workers unknowingly contracted and did not survive the disease

Lack of confidence among health workers returning to service provision remains a huge challenge

Some professional health workers are considering changing their profession due to fear of EVD

• Like all other health services, MDA was disrupted in 2014

• Deterioration in and distrust of routine health services

EVD Impact Continued

• If NTDs program does not get support to conduct immediate MDA especially for schistosomiasis, thousands of PZQ will expire come June 2015

• Disruption of M&E activities for LF and Schistosomiasis

• Amidst ebola vaccine trial and drugs fear, community members are resisting some routine health services especially for their children

• Number of CDD that contracted the EVD and died NOT known

EVD Impact Continued

• Drug Distributors have relocated to unknown communities from their original communities

• As a fear of the EVD, some NTDs staff left the country and may not return

• Almost all National level NTDs staff including the Program Director ((Key person for the COUNTDOWN research) reassigned to fight EVD, it might be difficult to bring all NTDs staff back to NTD program

• A lot of Liberians have resulted to limited or no international travels (conferences) due to the Ebola stigma

Way Forward

• Conduct assessment in counties to determine level of readiness of County Health Team and communities

• Building capacity of in country team for all NTDs interventions

• Engagement of stakeholders to advocate restoration of NTDs activities

• Community engagement to alleviate community fear so that they accept MDA and other NTD interventions

• Identification and training of more health care workers and drug distributors

• Cash incentive for NTD staff is indispensable right now for NTD interventions

• Provision of basic personal protective equipment for Community Drug Distributors and health workers

• Provision of infection prevention control support for health workers and Community Drug Distributors as we resume NTDs activities

• Continue with cross border engagement

Thanks