Neglected Tropical Diseases – Situation analyses and intervention options appraisals in eastern Africa

Situation:

Neglected tropical diseases (NTDs) are so called because they exclusively affect the poor and marginalized in low-income countries and, until recently, received little advocacy and funding. They strike the world’s poorest people, living in remote and rural areas of low-income countries in Sub-Saharan Africa, Asia and the Americas. The most important NTDs are three vector-borne protozoan infections – leishmaniasis, human African trypanosomiasis (HAT) and Chagas disease; three bacterial infections – trachoma, leprosy and Buruli ulcer; and seven helminth infections – hookworm, ascariasis, trichuriasis, lymphatic filariasis (LF), onchocerciasis, guinea worm and schistosomiasis. Although these diseases are thought to kill up to 500,000 people per year, mortality figures alone do not capture their main impact on public health, which largely arises from chronic disability and morbidity. For some NTDs, such as LF and onchocerciasis, disability is also associated with severe stigma and trauma, destroying individuals’ lives and family support systems. In an effort to control or eliminate this disease burden, a number of vertical global initiatives have been established. Since 2004, there has been increased advocacy for the logistical and economic benefits of integrated NTD control whereby different treatment strategies are bundled together and for the development of new tools for those diseases that are lacking adequate control measures. As a result of international advocacy increased emphasis is now being given to controlling NTDs, but much remains to be done to mobilize the required resources and strengthen the evidence base, particularly with regards to integrated control. To access new fund for integrated NTD control, such as those recently made available by the US Agency for International Development, countries will need to conduct detailed assessments of their NTDs and current status of control.

Response:

Since 2005, Malaria Consortium has engaged in conducting situation analyses and intervention options appraisals in a number of countries in eastern Africa. The first of these was conducted in Uganda in close collaboration with senior staff of the Vector Control Division of the Ministry of Health and Dr Simon Brooker from the London School of Hygiene and Tropical Medicine (www.lshtm.ac.uk/dcvbu/staff/simon_brooker.htm). Similar work has since been completed in Ethiopia and Southern Sudan. The latter was conducted as part of Malaria Consortium’s work under the Research Programme Consortium COMDIS.

Points to note:

Reports documenting the above work have been widely distributed and been written up for publication in international peer reviewed journals. While adding to the literature on NTDs and their control in eastern Africa, the main purpose of this work is to advocate for funds to support the identified interventions and ensure that the analyses translate into scaling up of appropriate NTD interventions.

Publications:

Kolaczinski J, Kabatereine N, Onapa A, Ndyomugyenyi R, Kakembo A, Brooker S. (2007) Neglected tropical diseases in Uganda: the prospect and challenge of integrated control. Trends in Parasitology 23 (10): 485-493.

Tadesse Z, Hailemariam A, Kolaczinski J (2008) Potential of integrated control of neglected tropical diseases in Ethiopia. Transactions of the Royal Society of Tropical Medicine and Hygiene 102: 213-214.

MoH GoSS. 2008. Neglected Tropical Disease in Southern Sudan: Situation Analysis, Gap Analysis and Intervention Options Appraisal. Ministry of Health, Government of Southern Sudan.