Fast-Tracking NTD Elimination: Key Takeaways from the 9th PC NTDs Advisory Group Meeting

31 Oct 2024

The urgency to intensify efforts toward the NTD Roadmap 2030 targets has never been more pronounced as we enter the final five years of this critical timeline. The Regional Programme Advisory Group (formerly known as the Regional Programme Review Group (RPRG)) on Preventive Chemotherapy for Neglected Tropical Diseases (PC-NTD RPAG) convened from October 28 to 30th, 2024 to tackle the pressing challenges to progress and to outline actionable strategies for achieving elimination goals. The RPAG emphasized sustained advocacy and smarter use of tools and resources to fast-track elimination efforts, issuing key recommendations for ESPEN, African nations, and partners.

Data-Driven Decision-Making and the ESPEN Portal

The role of reliable data for effective decision-making took center stage, with the ESPEN Portal spotlighted as a key resource. New tools, like the ESPEN IU Planner, support impact assessment and funding prioritization, helping countries reduce medicine waste and improve treatment coverage. To maximize the portal’s reach, the RPAG encouraged enhanced data accessibility—especially in French and Portuguese—to support regional implementation.

Innovation and Local Partnerships for Sustainable Success

Regional success stories underscored the pivotal role of local partnerships, particularly in leveraging WHO’s expertise for mapping and onchocerciasis elimination efforts. The RPAG recommended onchocerciasis mapping and post-validation surveillance for lymphatic filariasis (LF), soil-transmitted helminthiases (STH), and trachoma to ensure robust, sustainable elimination. ESPEN was encouraged to support capacity-building efforts, enabling countries to mobilize resources and implement innovative solutions adapted to their specific challenges.

Tackling Loiasis

The meeting acknowledged the neglected issue of loiasis, caused by the parasitic worm Loa loa, which is transmitted through the bite of the day-feeding fly Chrysops. Despite affecting millions in Central and West Africa, loiasis has historically been underestimated, in part due to its classification as a benign disease. However, studies now link high levels of L. loa microfilariae with increased mortality rates, bringing new urgency to addressing loiasis and its public health implications.

To effectively manage the spread of loiasis, the meeting urged WHO to advocate for its inclusion among recognized NTDs. By incorporating targeted diagnostics like the LoaScope and increasing monitoring efforts can help protect progress toward onchocerciasis elimination, especially in regions where loiasis is co-endemic. It’s essential to note that current onchocerciasis elimination strategies cannot be applied in these areas due to severe treatment complications caused by L. loa. This calls for tailored interventions to support broader NTD elimination goals effectively.

According to The Lancet, “Loa loa infections affect up to 20 million people in Central and West Africa, but options for treatment and control are widely inadequate.” With numerous individuals experiencing debilitating symptoms like fatigue, severe itching, and the unsettling migration of worms through the eyes, the disease imposes severe physical and socio-economic burdens. For further insight into how loiasis affects the region, read the full article in The Lancet here.

Embedding NTD Programs in National Systems

Transitioning NTD programs into national health systems was emphasized as critical to long-term sustainability, especially in addressing diseases with broader public health implications like Female Genital Schistosomiasis (FGS). Countries were encouraged to begin dossier preparations after ceasing MDA and ensure consistent data-sharing for regional tracking and better integration with One Health approaches. Collaborative high-level advocacy with stakeholders—such as the Africa Union, African Development Bank, and Africa CDC—was advised to secure funding and reinforce program continuity, particularly for vulnerable communities.

Key Recommendations

To ESPEN and WHO:

  • Advocacy and Capacity Building: Strengthen high-level advocacy to secure consistent medicine donations and engage with African Union bodies on customs fee waivers. Collaborate with the Reaching the Last Mile Fund to enhance resource mobilization skills and deliver specialized M&E training.
  • Cross-Border Initiatives: Promote cross-border efforts for onchocerciasis elimination to improve regional coordination.
  • Enhanced Data Accessibility: Make resources available in French and Portuguese and introduce a standardized dashboard for tracking and transparency post-meetings.

To Countries:

  • NTD Program Integration: Prioritize integrating schistosomiasis and STH programs with LF and onchocerciasis initiatives where feasible. Use WHO/ESPEN resources and tools to align strategies in co-endemic areas, optimizing limited resources and increasing reach.
  • Dossier Preparation and Compliance: For countries halting MDA, begin dossier preparations promptly. Reinforce timely submission of the Joint Application Package (JAP) to facilitate ESPEN’s review, minimizing delays in medicine distribution.
  • Engagement with Stakeholders: Leverage local partnerships and establish regular dialogues with program coordinators for data-sharing and tracking. Such engagement ensures responsiveness to emerging needs and enhances program transparency.

To Partners:

  • Targeted Support for Low-Hanging Fruit Countries: Prioritize support for countries nearing elimination, especially small island nations, and boost advocacy for schistosomiasis impact assessments.
  • Innovative Funding Mechanisms: Engage in co-financing models and innovative funding, such as the Reaching the Last Mile Fund (RLMF), to increase financial support for impact assessments for all PC-NTDs, particularly in resource-limited countries, and for schistosomiasis which is lagging in terms of data.

Conclusion: Commitment and Collaboration for Success

The RPAG concluded with a renewed commitment to coordinated action and sustained advocacy, recognizing the critical contributions of stakeholders and partners. Through a shared vision, data-driven strategies, and regional collaboration, achieving the 2030 NTD targets is within reach. The dedication of all partners to support African nations in eradicating NTDs reflects a regional commitment to improved health outcomes for all.