Neglected Tropical Diseases

BACKGROUND

Nearly one in six people worldwide suffer from neglected tropical diseases (NTDs). This collection of diseases primarily impact those living in poverty, who commonly contract them through bites from insects or by having contact with contaminated water or soil. Controlling and eliminating NTDs is critical, as they impact the achievement of most health and development indicators. NTDs inhibit children from learning and developing to their full potential and prevent adults from working and supporting their families economically. NTDs can also lead to physical deformities along with disability, stigma, social isolation and shame.

IMA World Health has been working to address NTDs for more than 20 years in Asia, Africa and the Caribbean. IMA World Health projects primarily target five NTDs that cause the greatest morbidity and mortality: lymphatic filariasis (LF), onchocerciasis (known as River Blindness), trachoma, schistosomiasis and soil-transmitted helminths (STH). IMA has also addressed visceral leishmaniasis, commonly known as kala-azar, in endemic areas within South Sudan.

As a recognized leader in the control and elimination of NTDs, IMA World Health uses a combination of evidenced-based strategies to map and scale-up NTD control in partnership with governments and civil society partners. Following the World Health Organization's Neglected Tropical Disease Road Map, IMA World Health's NTD programming is moving the needle towards meeting the WHO's 2030 control and elimination goals.

IN PRACTICE

Through IMA's recent NTD programming - with funding from USAID, SCI Foundation and Hilton Foundation, and in partnership with Sightsavers International and RTI International - we have achieved the following:

In Tanzania

• 21.5 million people are no longer at risk for LF
• Over 16 million people are no longer at risk for trachoma
• 10,000+ people have received sight saving eye surgery
• 7.2 million children received treatment for schistosomiasis and intestinal worms
• 87% of districts have eliminated trachoma

In Haiti

• 61% decrease in the number of children with intestinal worms between 2002 and 2019
• 7.3 million Haitians are no longer at risk for LF
• 87% of Haiti’s communes no longer require LF treatment

PROJECT HIGHLIGHTS

HAITI

Act to End NTDs | East (2018-2021)

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.

ENVISION NTD Control and Elimination Project (2012-2019)

As the lead implementing partner for ENVISION in Haiti, IMA 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. With funding from USAID and leadership from RTI International, 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, persuade 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 conduct TAS in communes that have had at least five consecutive MDAs at high coverage and a prevalence of MF <1% or Ag <2% in sentinel and spot-check sites.

TANZANIA

Act to End NTDs | East (2018-2021)

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 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.

Tanzania NTDCP Mass Drug Administration (2019-2020)

In 2020, the SCI Foundation provided gap funding to support MDA for STH and SCH in 93 districts in 15 regions that needed coverage. Between these efforts and those under Act | East, in 2020 7.2 million school-aged children (of the 7.6 million targeted) received treatment for STH and SCH in 134 districts — a coverage rate of 95%.

ENVISION NTD Control and Elimination Project (2012-2019)

With funding from USAID through RTI International, 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 with the Tanzania NTD Control Program carried out MDA, disease specific assessments (DSAs) and other interventions in all NTD-endemic districts across mainland Tanzania.

SAFE NTD Project (2015-Present)

With past support from FCDO, current support from the Hilton Foundation and leadership from Sightsavers, IMA provides trachoma sufferers with surgical services and other case management support to help relieve pain, enable them to return to work and prevent vision loss and blindness. IMA leads implementation in Mtwara region, building district surgical team capacity with the expectation to reach 11,800 patients with sight-saving surgery.

DEMOCRATIC REPUBLIC OF CONGO

Access to Primary Health Care Project (ASSP) (2013-2019)

IMA assists the 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). 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.

ENVISION NTD Control and Elimination Project (2015-2019)

The ENVISION project, funded by USAID and led by RTI International, aims for the control and elimination of five neglected tropical diseases in the DRC: LF, onchocerciasis, schistosomiasis, STH and trachoma. As an implementing partner, 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 percent of the population for LF, onchocerciasis, schistosomiasis and STH. In keeping with USAID’s updated strategy for DRC, in 2018 IMA began conducting rapid assessments and mapping surveys to determine the extent of trachoma in suspected regions of the country. To date, mapping has been completed in Ituri and Bas Ulele provinces, and rapid assessments have been completed in Equateur, Mbandaka, Tshopo and Maindombe provinces to determine if mapping is needed.

SOUTH SUDAN

KalaCORE South Sudan Emergency Response (2015-2019)

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 improves diagnosis and effective treatment, builds surveillance capacity and improves the ability to respond to outbreaks. To accomplish these goals, IMA has trained 318 health workers to date, supervises kala-azar treatment centers, establishes emergency response teams, provides pharmaceuticals and supplies and supports the Ministry of Health’s NTD departments and the National Reference Laboratory.

GLOBAL

Advancing the Control and Elimination of NTDs (2012-2017)

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. It has worked closely with the CDC to lead efforts in contributing to the development of global guidelines for integrated LF TAS surveys through pilot LF TAS, STH and malaria surveys in Tanzania and Haiti. IMA has 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.