Abstract
With the coronavirus disease 2019 (COVID-19) pandemic showing no signs of abating, resuming neglected tropical disease (NTD) activities, particularly mass drug administration (MDA), is vital. Failure to resume activities will not only enhance the risk of NTD transmission, but will fail to leverage behaviour change messaging on the importance of hand and face washing and improved sanitation—a common strategy for several NTDs that also reduces the risk of COVID-19 spread. This so-called “hybrid approach” will demonstrate best practices for mitigating the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by incorporating physical distancing, use of masks, and frequent hand-washing in the delivery of medicines to endemic communities and support action against the transmission of the virus through water, sanitation and hygiene interventions promoted by NTD programmes. Unless MDA and morbidity management activities resume, achievement of NTD targets as projected in the WHO/NTD Roadmap (2021–2030) will be deferred, the aspirational goal of NTD programmes to enhance universal health coverage jeopardised and the call to ‘leave no one behind’ a hollow one. We outline what implementing this hybrid approach, which aims to strengthen health systems, and facilitate integration and cross-sector collaboration, can achieve based on work undertaken in several African countries.
Highlights
We have described the world as being “assaulted by COVID-19” [1]
The longer-term economic implications for Africa have been analysed in a United Nations Conference on Trade and Development (UNCTAD) report [5] which predicts a reduction of 1.4% of gross domestic product (GDP), with the countries with smaller economies being more severely impacted: “Mainly a result of export adjustments affecting primary commodity exporters, and the attendant losses to tax revenue which reduce the capacity of government to extend public services necessary to respond to the crisis
Any protracted suspension of Neglected tropical diseases (NTDs) activities, mass drug administration (MDA), will have a detrimental impact by enhancing the risk of NTD transmission, but will fail to leverage behaviour change messaging on the importance of hand and face washing and improved sanitation—a common strategy for several NTDs that reduces the risk of COVID-19 spread [1, 13]
Summary
We have described the world as being “assaulted by COVID-19” [1]. The term ‘post-COVID-19’ has been used to provide assurance the assault will end, the impact will be temporary, and a post coronavirus disease 2019 (COVID-19) world will emerge. By adapting an existing WHO risk assessment tool for mass gatherings, the Ascend West and Central Africa programme was able to address key considerations for NTDs through the creation of the Risk Assessment and Mitigation Action (RAMA) tools for the resumption of MDA, surgery, and surveys These tools ensured that countries would identify COVID-19-related risks and install proficient mitigating actions. NTD/MDA and seasonal malaria chemotherapy (SMC) and immunisation programmes can work together to ensure the most vulnerable are not deprived of access to life-saving interventions The resumption of these activities will have a dramatic impact, in particular, for SMC and children’s immunisation, decreasing risk of mortality in a group less vulnerable to the impact of COVID-19 and calm any knock-on effect to the current public health crisis. The NTD community reach and the ‘beyond MDA’ supplementary interventions (hand/face washing/limb care, sanitation) are powerful COVID-19 mitigating factors readily applicable and presently receiving donor support
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