Restarting Neglected Tropical Diseases Programs in West Africa during the COVID-19 Pandemic: Lessons Learned and Best Practices

Achille Kaboré ,Yao Kassankogno,Justin Tine,Kisito Ogoussan,Marie Denise Milord,Anders Seim,Daniel Tesfaye,Franck Sintondji,Bolivar Pou,Rose Monteil,Virginie Ettiègne-Traoré ,Stephanie L Palmer ,Diana Stukel ,Ernest Mensah ,Katherine Sánchez ,Benoit Dembelé ,Angela Weaver ,Steven D Reid ,Brian Fuller ,Joseph P Shott

doi:10.4269/ajtmh.21-0408

Abstract

ABSTRACT.Countries across West Africa began reporting COVID-19 cases in February 2020. By March, the pandemic began disrupting activities to control and eliminate neglected tropical diseases (NTDs) as health ministries ramped up COVID-19–related policies and prevention measures. This was followed by interim guidance from the WHO in April 2020 to temporarily pause mass drug administration (MDA) and community-based surveys for NTDs. While the pandemic was quickly evolving worldwide, in most of West Africa, governments and health ministries took quick action to implement mitigation measures to slow the spread. The U.S. Agency for International Development’s (USAID) Act to End NTDs | West program (Act | West) began liaising with national NTD programs in April 2020 to pave a path toward the eventual resumption of activities. This process consisted of first collecting and analyzing COVID-19 epidemiological data, policies, and standard operating procedures across the program’s 11 countries. The program then developed an NTD activity restart matrix that compiled essential considerations to restart activities. By December 2020, all 11 countries in Act | West safely restarted MDA and certain surveys to monitor NTD prevalence or intervention impact. Preliminary results show satisfactory MDA program coverage, meaning that enough people are taking the medicine to keep countries on track toward achieving their NTD disease control and elimination goals, and community perceptions have remained positive. The purpose of this article is to share the lessons and best practices that have emerged from the adoption of strategies to limit the spread of the novel coronavirus during MDA and other program activities.

Highlights

Neglected tropical diseases (NTDs) are a diverse group of 20 conditions found in tropical and subtropical settings across 149 countries
Some NTDs can be controlled or eliminated with the assistance of mass drug administration (MDA), sometimes called preventive chemotherapy, a strategy in which NTD medicines are provided to at-risk persons living in an endemic geographic area
The apparent success of mitigation measures put into place by ministries of health in the 11 countries enabled strict lockdowns to be lifted after a few weeks, providing opportunities for countries to restart planned NTD activities

Summary

Introduction

Neglected tropical diseases (NTDs) are a diverse group of 20 conditions found in tropical and subtropical settings across 149 countries. They affect more than one billion people and cost developing economies billions of dollars every year.[1,2] In Africa alone, NTDs cause an estimated 200,000 deaths per year in the absence of appropriate treatment.[3,4] Populations living in poverty, without sufficient access to clean water and adequate sanitation infrastructure, and who live in close contact with infectious vectors and domestic animals and livestock are the most affected. According to the WHO, MDA is a cost-effective approach that, over time, can lead to national control or elimination of PC-NTDs such as lymphatic filariasis, onchocerciasis, trachoma, schistosomiasis, and soiltransmitted helminthiases.[5]

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