A brief overview of SCI past and current activities

SCI Open DayJune 27 2013

Director Professor Alan Fenwick OBE PhD

Department of Infectious Disease EpidemiologyImperial College

Faculty of MedicineSt Mary’s

University of London

Schistosomiasis Schistosomiasis Control Initiative (SCI)Control Initiative (SCI)

WelcomeWelcomeWelcome to the members of the SCI Advisory BoardWelcome to the members of the SCI Advisory Board

Chairman, Sir Roy AndersonChairman, Sir Roy Anderson

Justine Fraine Justine Fraine Clint EvansClint Evans

Sam ZarambaSam Zaramba David HeymannDavid Heymann

Stuart SmithStuart Smith Richard VinerRichard Viner

Lorenzo SavioliLorenzo Savioli David CromptonDavid Crompton

Lord Andrew Stone Lord Andrew Stone Peter DranfieldPeter Dranfield

Apologies from Profs Neil Ferguson and Elio RiboliApologies from Profs Neil Ferguson and Elio Riboli

Welcome to all present: guests, partners, and donorsWelcome to all present: guests, partners, and donors

and especially staff from overseas – Dr Narcis Kabatereine, and especially staff from overseas – Dr Narcis Kabatereine,

Dr Dhekra Annuzaili and from Ethiopia Oumer ShafiDr Dhekra Annuzaili and from Ethiopia Oumer Shafi

The SCI aims to assist implementation of control of NTDs to national scale in

Africa• Based at Imperial College London within the School of Public Health

• Established in 2002 • SCI has moved through 4 phases

• 2002-07 Bill and Melinda Gates support

• 2007-10 Add in USAID/RTI, Geneva Global

• 2010-13 DFID plus private donations• 2013 - Expansion towards

elimination

Within the College

• Imperial College has “charity exempt” status

• IC Trust gives us charity status in UK• Our financial income is ring fenced • UK Coalition against NTDs• London Centre for NTDs

Recent wider funding sources Recent wider funding sources

• GNNTDC funded projects in Uganda and Yemen (SCI Founder member) – Yemen support now funded by ENDFUND

• Yemen World Bank partnership 2010-2015• Gates funding (neuro-cysticercosis in 3 countries)• ENDFUND/Geneva Global grant (2010-13) for Rwanda• ENDFUND small grant for Zimbabwe• DFID award ICOSA (2010-2015)• SCORE – 3 grants for operational research (Mozambique

and Niger) (2010-2015)• Sightsavers – partnership on mapping and implementation

in Nigeria• Private donations from US and UK public (ongoing)

CollaborationCollaborationPartnership with :•Developing World Health (fund raising)•PCD (Imperial College) - Ethiopia•Deworm the World (school health)•Sightsavers (UK NTD Coalition)•CNTD Liverpool (DFID ICOSA)•GSK (albendazole donation)•WHO and Merck Serono (pzq donation)•Natural History Museum/SCORE (Zanzibar)•SCORE (Niger and Mozambique)•www.givingwhatwecan.org •www.givewell.org

NigerMauritania

Senegal

Uganda

Tanzania

Zambia

SCI control programmes in Africa 2012-2016

Rwanda – SCI/ENDFUND

Burundi Malawi

Mozambique

Cote D’Ivoire

Mapping and development of control in DRC, Mauritania,

Senegal, Ethiopia, Zimbabwe And Madagascar

YemenWorld Bank and

ENDFUND

Liberia

Madagascar

Ethiopia

Zim

DRC

Nigeria

June 2012 – June 2013June 2012 – June 2013

We have been implementing our praziquantel and albendazole treatments in 8 countries as per DFID contract in partnership with Liverpool and Crown Agents.

(75 million treatments over 5 years)We have been collecting data and treating in Niger and

Mozambique as grantee partners in the SCORE project at UGA

We now have in place 4 years funding for Burundi from a private donor and ENDFUND support for Rwanda for 3 years. MoH carry out twice a year deworming of school children and annual praziquantel treatment where indicated

June 2012 - June 2013June 2012 - June 2013Recommendations on their websites from both www.Givingwhatwecan.org and www.Givewell.orghave led to generous donations from the British & US

public.With this funding we have:• Assisted Senegal to expand mapping• Assisted round 2 treatments in Yemen (10 million

treatments this year alone)• Transfered funding to Ethiopia for

• 1.5 million treatments spread over all health regions Ethiopia, • a launch of the national plan plus NTD symposium in Addis

Ababa in June 2013• Pledged funding for schistososmaisis and STH mapping

nationally during 2013 with EHNRI,

Follow up from January 2012Follow up from January 2012Since the January 30th 2012 meeting in London (The

London Declaration):

• Meeting at World Bank in December 2012• WHA resolution on elimination of NTDs May 2013• Scorecard towards elimination developed

Country Fundingtreated 2012: Schisto/STH

planned for 2013/14

Burundi Donor600,000 3,800,000

600,000, 3,800,000

Cote D'Ivoire

DFID 295,943, 295,943 3,026,719, 3,026,719

Ethiopia Donor 0 1,500,000, 6,800,000Liberia DFID 17,400, 17,400 440,719, 440,719

Malawi DFID2,037,487 2,037,487 5,600,000, 5,600,000

Mozambique

DFID1,819,000 1,819,000 3,664,345, 3,664,345

NigerDFID

(SCORE/USAID)490,000 490,000

490,000 490,000

Rwanda ENDFUND 600,000 3,800,000

Senegal Donor 450,000, 450,000

TanzaniaDFID

(Cysticercosis)122,996, 122,996 2,276,453, 2,276,453

Uganda DFID/GNNTDC 200,000, 200,000 700,000, 700,000

Yemen World Bank GNNTDC2,050,000 2,050,000

10 million, 10 million

Zambia DFID 19,800, 19,800 650,000, 650,000Zanzibar DFID/ZEST 827,778, 827,778 1,037,672, 1,037,672

PZQ treatments 8,930,404 25,545,908Total Deworming 12,130,404 37,245,908

2012 and 2013 treatments2012 and 2013 treatments

And the future ?And the future ?Elimination by 2020 ?Elimination by 2020 ?

We plan to consolidate our support in each of the “SCI” countries so that they reach and sustain national coverage

We will pursue fund raising opportunities as they arise to increase resources going to NTD control

With increased support from DFID promised for 2013-2017 we anticipate a closer partnership with PCD and an increase in treatments in the existing countries, plus expansion into Ethiopia and DRC

We are working more closely with USAID and their contractors, and with Deworm the World to avoid duplication of donations

SCI Organogram

Deputy Director Dr. Wendy Harrison

Director M and E Prof Joanne Webster

Support staff Finance Kieran Bird Shaivali Shah Office Manager Anna Wilhelm Advocacy Alix Weldon

SCI Director Professor Alan Fenwick

Health Economist vacant

Programme Manager Dr Giuseppina Ortu (Rwanda, Burundi)

DFID Project Manager Dr. Lynsey Blair

Programme Manager Dr Anna Phillips (West Africa and Mozambique)

Senior Biostatistician Dr Sarah Knowles

Modeller, Ethiopia and Yemen manager Michael French

Programme Managers Narcis Kabatereine Fiona Fleming (Uganda , Malawi Zambia)

Research students (Ph.D and M.Sc.)

AdvocacyAdvocacyMembership of WHO Scientific and Technical Advisory Group

(STAG)

Director of UK Coalition (Wendy Harrison)

London Centre (partners)

APPMG (Author of NTD report)

ENDFUND (Technical Advisory Board)

Publications and TeachingPublications and Teaching• Approximately 100 publications have been

published or are in press in 2005-2011 (list available)

• Staff teach in B.Sc. Module (Life Sciences) and Bio-Medical Sciences

• B.Sc. For 4th medical students (Hepatology and Global health)

• M.Sc. course at Imperial College London• Short course on Global Health at Imperial College

(this week !)• Supervise several B.Sc. and M.Sc. students with

their projects

To achieve elimination

• Improved education and coverage especially in “difficult countries”

• Water and sanitation

• Reduction in poverty

• Socio-economic development

Proportion of PC for schistosomiasis, soil-transmitted helminthiases, lymphatic filariasis, onchocerciasis and trachoma, 2011

Population requiring preventive chemotherapy

0%

10%

20%

30%

40%

50%

60%

70%

80%

2006

2007

2008

2009

2010

2011

2006

2007

2008

2009

2010

2011

2006

2007

2008

2009

2010

2011

2006

2007

2008

2009

2010

2011

2005

2006

2007

2008

2009

2010

Pro

port

ion

, %

SchistosomiasisSoil-transmitted

helminthiasesLymphaticfilariasis

Onchocerciasis

~ 243 million ~ 873 million ~ 1 410 million ~ 127 million

13

.3

31

.1

41

.8

77

.1

Trachoma

~ 281 million

13

.7

2011 Schistosomiasis

Soil-transmitted helminthiases

Lymphatic filariasis

Onchocerciasis

Trachoma

# of counties reported

24 63 34 28 ND

# of people treated 28,140,136 302,523,800 557,434,305 98,089,495 ND

Coverage (%) 10.4 30.6 39.5 77.1 ND

Where we are nowWhere we can get with

existing tools and strategies 2020Goals

Diseases Targeted For Elimination

Diseases Targeted For Control

Schistosomiasis

River blindness

Soil-Transmitted Helminthes

VisceralLeishmaniasis

Chagas

Guinea worm

Leprosy

Lymphatic filariasis

Blinding trachoma

Sleeping sickness

Where we can get with new tools and strategies

AcknowledgementsAcknowledgementsTo the SCI staff, past and present

To Sir Roy Anderson who has chaired the Advisory Board annually since we started

To Professor Elio Riboli and Neil Ferguson for their support

DIDE administrator Ruth Tipples

To all our partners especially in Liverpool.

In country - among many othersIn country - among many others • In Uganda - Drs. Narcis Kabatereine, Edridah Tukahebwa and

the VCD staff; Dr. Sam Zaramba • In Tanzania – Drs. Ursuline Nyandindi, Mweli Malacela, Peter

Kilima, Upendo Mwingira• In Zanzibar - Dr. Khalfan Mohammed; • In Zambia – Dr. Mutale Nsakashalo• In Niger – Drs. Amadou Garba, Ali Djibo• In Rwanda – Drs Irenee Umulisa, Corine Karema• In Burundi – Drs Dismas Baza; Jean-Paul Nyarushatsi; Onésime

Ndayishimiye; Ndyabanirwa Janvier; Didace Mbaririmbanyi• In Senegal – Dr Idrissa Talla• In Ethiopia – Mr Oumer Shafi• In Yemen – Dr Dhekra Annuzaili• In Malawi – Dr Samuel Jemu• In Cote D’Ivoire – Dr Aboulaye Meite, Professor Elizier N’Goran

• And WHO staff of NTD Department

• a.fenwick@imperial.ac.uk