a focus on ntds in sub-saharan africa: supporting scale-up of interventions
TRANSCRIPT
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
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
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