This post was written by Amy Alabaster and first appeared on the End the Neglect blog.
In many parts of the world where NTDs run rampant, it’s not uncommon to see communities affected by 2, 3 or even all seven of the most common NTDs. Because of this, countries and other stakeholders involved in NTD control are increasing efforts to integrate disease control programs. Integration helps to reach more people with the drugs needed to treat and prevent NTD infections, while cutting down on costs and resource demands.
In 2007, Mali was one of five ‘fast-track’ countries, supported by the United States Agency for International Development (USAID), managed by RTI International and assisted by Helen Keller International, to launch an integrated national NTD Control Program. A paper recently published in the Public Library of Sciences (PLoS) NTDs describes the successes and lessons learned so far through the implementation of this program.
All seven major NTDs- lymphatic filariasis (LF), onchocerciasis, schistosomiasis, trachoma and the soil-transmitted helminthes (hookworm, roundworm and whipworm) are endemic in Mali. Extensive mapping and surveillance showed that there was significant overlap between disease distributions, with some regions suffering from all seven of the NTDs. However, before 2007 these diseases were controlled through independent disease control programs, with varying degrees of success. With the integrated approach, data from disease mapping was used to combine drugs and drug delivery to meet the needs of individual districts. Packages of drugs were distributed to whole communities using mass drug administration (MDA), a strategy known at preventative chemotherapy (PCT).
According to the paper, by 2009 Mali had scaled up drug treatment and was able to reach 100 percent of the districts needing PCT for each disease. For LF, coverage increased significantly, from 24 percent to 100 percent in just two years. The number of districts receiving trachoma treatment actually decreased because of near elimination of the disease in many areas.
Because of the commitment of the Government of Mali to integrated NTD control, and thanks to support from USAID and other donors, around 10 million people in Mali received one or more drug package each year since 2009. While challenges to eliminating or reducing disease morbidity exist- such as a need for improved coordination and more comprehensive control strategies- the success seen in Mali is promising. Lessons learned throughout the program can also be used to begin implementing integrated programs in more countries throughout the world.