Advancing One Health NTD Strategies: Key Insights and Expansion Opportunities from Madagascar Meeting
Antananarivo, Madagascar – In a significant stride towards combating Zoonotic Neglected Tropical Diseases (zNTDs), the Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN), represented by Dr. Pauline Mwinzi, the ESPEN focal person for Soil-Transmitted Helminthiasis (STH), Schistosomiasis, and Taeniasis, recently partook in a pivotal mission in Madagascar. Held from August 13 to August 19, 2023, the visit concentrated on the One Health approach to zoonotic NTDs (zNTDs), aiming to showcase and assess the One Health NTD project in Madagascar, evaluate the lessons learned, and explore possibilities for expansion both within Madagascar and across the African region.
Madagascar's pioneering role in applying the One Health model for zNTDs offers invaluable insights for other African nations. The meeting, facilitated by the Department of Livestock, Veterinary, and Fisheries Research of the National Agricultural Research Centre (FOFIFA) under the Madagascar Ministry of Higher Education and Scientific Research, saw substantial international engagement, including key donors and partners. Notably, the German Corporation for International Cooperation GmbH (GIZ) provided significant support and presence, underscoring the collaborative nature of this global health effort.
The initiative, financially bolstered by the International Development Research Centre Canada (IDRC) and implemented by the Ministry of Health and the Veterinary Services of Madagascar, coordinated by FOFIFA (Research Agricultural Centre), is co-led by the University of Melbourne and with WHO and the Indian Ocean Commission as partners, has demonstrated a sustainable and replicable approach to zNTD control, achieving impressive coordination between human and animal health sectors. ESPEN's technical guidance has been pivotal in advancing this initiative.
One of the visit's focal points was tackling Taeniasis/Cysticercosis, a key concern in the NTD Roadmap 2021-2030, necessitating an integrated One Health method. The project's advancements, including extensive treatments and vaccination campaigns, have been vital in curtailing the spread of these diseases.
The project has successfully reduced the prevalence of Taenia solium in pigs, decreasing from 31% to 8%. Remarkably, all vaccinated pigs tested negative, with positive cases found exclusively in non-vaccinated pigs. Additionally, the prevalence of human taeniasis has been halved, falling from 1.25% to 0.63%. This is notable considering that in highly endemic areas, taeniasis prevalence typically remains below 2%. The post-treatment prevalence levels can be partly attributed to the moderate coverage (62%) of the Mass Drug Administration (MDA). This lower coverage was linked to the community's hesitancy to participate, influenced by an unfortunate incident where a death occurred following a schistosomiasis MDA in a nearby district just six months prior.
Additionally, the mission spotlighted innovative coordination methods, such as aligning government sectors for effective stakeholder involvement and resource management, a model beneficial for other sectors like WASH and vector control.
In summation, the Madagascar meeting highlighted the critical role of collaborative ventures and the One Health methodology in battling NTDs. The success story of the Madagascar project, supported by partners like GIZ, serves as a blueprint for similar initiatives in other countries, heralding a more cohesive and potent approach to zNTDs.