Abstract
Combining the delivery of multiple health interventions has the potential to minimize costs and expand intervention coverage. Integration of mass drug administration is therefore being encouraged for delivery of preventive chemotherapy (PCT) to control onchocerciasis, lymphatic filariasis, schistosomiasis, soil-transmitted helminthiasis, and trachoma in sub-Saharan Africa, as there is considerable geographical overlap of these neglected tropical diseases (NTDs). With only a handful of countries having embarked on integrated NTD control, experience on how to develop and implement an efficient integrated programme is limited. Historically, national and global programmes were focused on the control of only one disease, usually through a comprehensive approach that involved several interventions including PCT. Overcoming the resulting disease-specific structures and thinking, and ensuring that the integrated programme is embedded within the existing health structures, pose considerable challenges to policy makers and implementers wishing to embark on integrated NTD control. By sharing experiences from Uganda, Tanzania, Southern Sudan, and Mozambique, this symposium article aims to outlines key challenges and solutions to assist countries in establishing efficient integrated NTD programmes.
Highlights
Resources for disease control are limited and need to be used efficiently [1]. This need is apparent for the control of neglected tropical diseases (NTDs), which, until recently, was largely unfunded [2]
We focus on a group of NTDs for which regular mass drug administration (MDA) of preventive chemotherapy (PCT) is key to effective control, namely onchocerciasis, lymphatic filariasis (LF), schistosomiasis, soil-transmitted helminth (STH) infection, and trachoma
Integration is usually applied to creation of ‘‘PCT packages’’ by combining MDA for more than one NTD
Summary
Resources for disease control are limited and need to be used efficiently [1] This need is apparent for the control of neglected tropical diseases (NTDs), which, until recently, was largely unfunded [2]. Integration of diseasespecific programmes is being encouraged for onchocerciasis, lymphatic filariasis (LF), schistosomiasis, soil-transmitted helminth (STH) infection, and trachoma [3,4]. These NTDs occur over more or less the same areas and their control depends, not exclusively, on regular mass drug administration (MDA) of safe and effective preventive chemotherapy (PCT) [5]; combined PCT delivery should minimize costs and increase coverage [6,7]. ‘‘real world’’ experience of implementing such integrated NTD control is limited [8,9], making it difficult to decide how best to embark on, and proceed with, the development of an integrated NTD control programme in a manner that promotes efficiency and local ownership—both prerequisites for sustainability
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