Neglected Tropical Diseases

In partnership with the END Fund, IMA World Health’s Urgent Continuation of Visceral Leishmaniasis Services project has been providing lifesaving VL treatment by supporting 25 health facilities in the four VL-endemic states (Upper Nile, Jonglei, Unity, and Eastern Equatoria) of South Sudan since 2021. The project provides WHO-donated medication to the supported health facilities, trains health care workers on VL identification and treatment, and deploys community health volunteers (CHVs). In the first 18 months of programming, 1,187 patients were enrolled in treatment, 262 medical personnel were trained in diagnosis and treatment, 75 CHVs were engaged to support active case detection and promote community awareness, and 4,309 people were reached by advocacy and sensitization activities. 

Since 2014, IMA World Health has led implementation of the SAFE project across five regions of Tanzania, targeting 19 trachoma-endemic districts inhabited by nearly 4 million people. The Sightsavers-funded SAFE project focuses on strengthening district-level eye care departments, providing the technical and managerial skills and capacity to independently treat trachoma-related blindness by facilitating case finding and organizing field outreach surgeries in accordance with WHO’s SAFE strategy for trachoma control. By partnering with government-sponsored clinics and tapping into faith-based networks, IMA World Health focuses on strengthening local capacity and has been able to implement in some of the most remote, hard-to-reach settings in Tanzania. As of December 2022, IMA has managed more than 12,000 trachomatous trichiasis (TT) cases and trained 3,658 community case finders along with 57 screeners, 76 assistant surgeons and 23 surgeons.  

Through the CDC-funded Elimination of Lymphatic Filariasis in Haiti project, IMA World Health works closely with the Haiti Neglected Tropical Disease Control Program (HNTDCP) to create evidence-based LF technical guidance documents and implement awareness activities to enable communities to prevent, treat and control LF. Through the project, IMA World Health is supporting the rollout of triple-drug (IDA) therapy for LF for the first time ever in Haiti. Despite the extremely challenging security context in Haiti, the country team has worked to improve drug access among hard-to-reach populations, conducted a school census to better understand the population requiring treatment and collaborated closely with key local stakeholders, such as religious leaders and teachers, to gain community acceptance.

Through the Advancing the Control and Elimination of NTDs project, IMA advanced NTD prevention, control and treatment across the globe from 2012 to 2018. IMA provided LF transmission assessment survey (TAS) trainings in Ghana, Senegal, and Uganda. In Haiti and Tanzania, IMA formulated global guidelines for integrated TAS surveys for LF, STH, and malaria in close collaboration with the CDC. In India, IMA worked with local partner, Church’s Auxiliary for Social Action, to develop and implement community-led home-based care and treatment programs for patients suffering from LF-induced lymphedema, reaching more than 6,000 people. In 2018, IMA supported the implementation of an improved urban mass drug administration (MDA) strategy for LF in the metropolitan communes of Port au Prince in Haiti. 

The Act | East project built on more than a decade of USAID investment in the control and elimination of five NTDs through ENVISION (see below) and other predecessor projects. With leadership from RTI International, IMA World Health led the implementation of activities to support the Haiti NTD Control Program's efforts to eliminate LF and control STH through mass drug administration (MDA), transmission assessment surveys (TAS)and surveillance. IMA oversaw MDA in 22 communes. By the end of IMA's programming, 122 out of 140 communes (87%) had achieved the criteria for stopping mass drug administration for LF. That means 7,334,355 Haitians, out of the original target population of about 11 million, are no longer at risk. Additionally, STH prevalence among school-age children significantly decreased thanks to MDA, from 37% in 2002 to 14.5% in 2019 — resulting in better health, nutrition, school attendance and achievement for hundreds of thousands of children.

In Tanzania, IMA World Health led the implementation of activities with Tanzania's Ministry of Health and Social Welfare to eliminate three NTDs (LF, trachoma and onchocerciasis or river blindness) and control two NTDs (schistosomiasis and STH). IMA oversaw MDA in 19 regions and 134 districts throughout Tanzania. Through IMA's involvement in Act to End NTDs | East, 3,400 health workers, 8,900 teachers and 35,700 community drug distributors were trained to support treatment of 20 million individuals annually. Over 9 million treatments were administered in 41 districts with a target coverage rate of 80%, and 65 local government authorities received grants to implement preventative chemotherapy.

The ENVISION project, funded by USAID and led by RTI International, aimed for the control and elimination of five neglected tropical diseases in the DRC: LF, onchocerciasis, schistosomiasis, STH and trachoma.

In Haiti, IMA was the lead implementing partner and worked alongside the Haiti Neglected Tropical Disease Control Program, a joint effort between the Ministry of Health and Population (MSPP), the Ministry of Education and other partners. IMA helped the government to provide MDA through community posts and schools across Haiti’s 10 departments to treat LF and STH. IMA trained approximately 34,000 community leaders, promoters and distributors to educate the population about LF and STH, persuading the highest number of households possible to participate in MDA and conduct MDA. In Haiti, IMA led the scale-up of nationwide treatment and treated nearly 6 million people annually for LF and STH. Following guidance from the World Health Organization (WHO), IMA and its partners also conducted TAS in communes that have had at least five consecutive MDA at high coverage and a prevalence of MF <1% or Ag <2% in sentinel and spot-check sites.

In Tanzania, IMA collaborated with the Ministry of Health and Social Welfare to eliminate and control five NTDs endemic in Tanzania. IMA coordinated MDA in 19 regions and 134 districts throughout Tanzania, training more than 11,414 front line health workers, 27,087 teachers and 90,284 community drug distributors to support treatment for over 20 million individuals annually. Supporting the World Health Organization’s global control and elimination goals, IMA, along with the Tanzania NTD Control Program, carried out MDA, disease specific assessments (DSAs) and other interventions in all NTD-endemic districts across mainland Tanzania.

In DRC, IMA conducted annual MDA of three medications among more than 500,000 people in six zones in northern Maniema Province in 2015-2016 and in three zones in 2017, with the goal of treating 80% of the population for LF, onchocerciasis, schistosomiasis and STH.

IMA assisted DRC's Ministry of Health in 52 health zones to integrate NTDs within the overall basic health care package and to better plan and implement MDA in the ASSP project, funded by UK Aid's Department for International Development (DFID) (now FCDO). Through ASSP, IMA organized a Vitamin A supplementation campaign for children 6-59 months and de-worming with mebendazole of children 12-59 months in all of ASSP’s supported health zones. In total, 1,542,053 children received Vitamin A and 1,261,398 children received mebendazole during this campaign. Learn more.

IMA worked with partners to provide emergency response for treatment of visceral leishmaniasis (kala-azar) in the former Jonglei and Upper Nile states. Kala-azar, which is transmitted by the sandfly, is almost always fatal if not treated. This program improved diagnosis and effective treatment, built surveillance capacity and improved the ability to respond to outbreaks. To accomplish these goals, IMA trained 318 health workers to date, supervised kala-azar treatment centers, established emergency response teams, provided pharmaceuticals and supplies and supported the Ministry of Health’s NTD departments and the National Reference Laboratory.

IMA contributed to the global goals of LF elimination by 2020 through a non-research cooperative agreement with the CDC. IMA’s activities included providing TAS trainings in Ghana and Uganda. IMA worked closely with the CDC to lead efforts to contribute to the development of global guidelines for integrated LF TAS surveys through pilot LF TAS, STH and malaria surveys in Tanzania and Haiti. IMA also worked with a nationwide non-government organization in India, Church’s Auxiliary for Social Action, to develop and implement community-led home-based care and treatment programs for patients suffering from lymphedema.