WHO Interim Guidance
Considerations for implementing mass treatment, active case‐finding and population-based surveys for neglected tropical diseases in the context of the COVID-19 pandemic
In April 2020, WHO recommended that mass treatment campaigns, active case-finding activities and population-based surveys for NTDs be postponed until further notice. However, the situation is dynamic, and in May 2020 WHO recommended that countries should monitor and re-evaluate the necessity for an ongoing delay at regular intervals.
In August 2020, WHO issued revised interim guidance for NTD programmes in accordance with the public health measures put in place to curb the COVID-19 pandemic.
WHO have proposed a two-step approach:
- a risk-benefit assessment, to determine if planned NTD activities should proceed;
- consideration of precautionary measures that should be applied with the aim of decreasing the risk of transmission of COVID-19 associated with NTD activities and strengthening the capacity of the health system to manage any residual risk.
Crucially, the decision if and how to proceed with NTD activities should rely on a case-by-case, risk-based approach, tailored to the specificities of the geographical zone (country or area) targeted by the planned NTD intervention. WHO have issued a document outlining this decision-making framework, which is outlined in the interim guidance.
ESPEN country support activities have been adjusted in alignment with this framework. A continued priority for ESPEN is to determine the impact of a potentially prolonged delay or complete suspension of NTD activities in 2020 and beyond on disease resurgence and 2030 targets. We are working with countries and partners to develop mitigation approaches for remedial strategies where possible, and where resources will allow in the context of economic recoveries.
Dr Mwelecele Ntuli Malecela
Director for the WHO Department of Control of Neglected Tropical Diseases, to all WHO Country Offices:
The current Covid-19 pandemic is affecting almost every WHO Member State and unparalleled containment and mitigation measures, including physical distancing and restrictions on movement, are being put in place. WHO recommends WHO Country Offices to advise health ministries to postpone all community-based surveys, active case-finding activities and mass treatment campaigns for neglected tropical diseases until further notice.
However, it is important that health systems be supported to ensure (1) prompt diagnosis, treatment and care of neglected tropical diseases for patients presenting to healthcare facilities, and (2) essential vector control measures, as these are critical interventions. This should be done in line with prevailing national policies, directives and recommendations.
WHO Country Offices may also wish to encourage local health authorities to use existing NTD platforms, surveillance mechanisms and WASH/health education opportunities to support implementation of Covid-19-related measures, as appropriate.
Recommendations will be updated on a regular basis to reflect the evolution of the pandemic.
Thank you for your kind collaboration, and for your continued support and solidarity in these difficult times.
Country support activities have been adjusted in alignment with the WHO interim guidance to NTD programmes. A key priority for ESPEN is to determine the impact of a potentially prolonged delay or complete suspension of MDAs in 2020 on disease resurgence and 2030 targets.
ESPEN is working with the NTD Modelling Consortium to model the possible impact of this scenario on the different countries. Another key priority is the expiry of donated medicines earmarked for distribution in 2020. ESPEN are working with the supply chain forum to analyse this data, with the context that all MDAs are currently suspended until further notice.
ESPEN is looking to utilize the data from the modelling analysis, which will show how much delay each of the SCH programmes can tolerate before seeing a negative impact of suspended MDA programmes, and will propose mitigation approaches that will then be discussed with countries for remedial strategies where possible, and where resources will allow in the context of economic recoveries.