NTDs in Southern Sudan

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NTDs in Southern Sudan

• Where we could be by 2015
• and how to get there

Jan Kolaczinski
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Integrated NTD Control

• Intuitively appealing, because
• Large areas of co-endemicity
• Safe and free/cheap treatment available
• Treatments can be co-administered using mass drug
  administration (MDA)

? Potential cost saving of up to 46 when
compared to stand alone programmes
Integration should not become the goal, but may
provide the means to achieve them
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Goals
Elimination
Table adapted from Brady et al. 2006, Trends in
Parasitology 22
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Drug Intervention
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Ivermectin albendazole
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Lymphatic filariasis tends to be distributed over
the largest geographical area
Table adapted from Brady et al. 2006, Trends in
Parasitology 22
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Where should we be by 2015?
Main graph from Ottesen et al. 2008, PLoS Negl
Trop Dis 2 e317 Effect of MDA on Mf prevalence
in all sentinel sites
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How to get there?

• Complete LF mapping using integrated mapping
  approach (i.e. including schisto STH)
• Strengthen community-based delivery (CDTI
  guinea worm network)

• Use these to deliver drugs complementary
  interventions for other NTDs

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Conclusion

• Lymphatic filariasis elimination is the ideal
  driver for integrated NTD control

• Provides clear goal achievable within 5 7 years
• Prospect of little to no further investment once
  elimination has been achieved
• Controls onchocerciasis, STH, lice and scabies
• Strengthens health systems in the process

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Acknowledgements

• MoH-GoSS Leadership, commitment, facilitation
• COMDIS/DfID NTD Situation Analysis
• USAID/RTI Current Funding of NTD Programme
• NGO Partners CBM, The Carter Center
• World Health Organization
• Mectizan Donation Programme
• LSHTM/KEMRI Operational Research Support