Advances and innovations in research empower national programmes in the fight against NTDs, making it possible to treat more people faster. Since the signing of the London Declaration in 2012, multinational collaboration has led to advances in the delivery and monitoring of treatment and has streamlined programmes so that they can detect multiple diseases at once.

 

These innovations drive countries ever closer to the goal of eliminating NTDs.

NTD programmes are nested in ministries of health, so that maximizing their resources is a gain for countries. One innovation, the confirmatory mapping tool for lymphatic filariasis (LF), has already saved money for programmes, as it gives a clearer picture of LF infection than previous methods, which yielded uncertain results. Confirmatory mapping can prevent needless mass drug administration (MDA). For example, in Ethiopia and the United Republic of Tanzania, the tool saved the national programmes an estimated US$ 9 million by establishing that MDA was not required in 52 districts.

 

A researcher

Photo: © The Carter Center

Research has also addressed challenges to MDA. Programme staff must know who has received NTD treatment and whether enough people have been reached. Unless they achieve high coverage, they might have to repeat MDA. The supervisor’s coverage tool was designed to help programme managers assess the coverage of MDA while it is being implemented. It was effective in identifying treatment gaps in Ethiopia and Nigeria, improving the coverage of the programmes.

NTD programmes do not operate in a vacuum, and stopping treatment for one disease may have an effect on another. This is the case for soil-transmitted helminthiasis (STH), which responds to the drugs for LF. Thus, as LF programmes are scaled down, STH infections could become more prevalent again. In 2015, the World Health Organization (WHO) published guidelines to help programme staff understand how LF treatment affects STH. By following the guidance, programme staff can determine whether MDA should be continued to control intestinal worms. This integrated approach has been extended to malaria, LF and STH in Haiti. Knipes AK, Lemoine JF, Monestime F, Fayette CR, Direny AN, Desir L et al. Partnering for impact: integrated transmission assessment surveys for lymphatic filariasis, soil-transmitted helminths and malaria in Haiti. PLoS Negl Trop Dis. 2017;11: e0005387.

These and other innovations address key barriers between NTD programmes and disease elimination goals. Each tool has been influenced by the programmes in which they are used and endorsed by WHO. Their success proves the power
of innovation in the fight against NTDs.

This is part of Reaching a Billion, the fifth progress report of the London Declaration on NTDs. Read the full report.