The Lancet recently published a report on gains made towards reaching the 2020 neglected tropical disease (NTD) elimination goals set by the 2012 London declaration. Despite being one of the world’s poorest countries, Sierra Leone, in particular, has made incredible strides.
Before the current NTD control programme, approximately half of the districts saw over 50% of their children infected with schistosomiasis (snail fever) before they reached 14. By 2010 mass drug administration had reached, and has since maintained, 100% geographic coverage of those at risk of NTDs, outperforming neighbouring countries.
This rapid progress has been unexpected in the post-conflict setting. By the end of the rebel war in 2002, most health facilities were damaged, ill-equipped and their staff and communities traumatised. Many health professionals had been evacuated during the war and had little opportunity or incentives to return.
While sustained funding from USAid is one explanation behind the country’s success, other countries like Nigeria, with strong funding and better resourced health sectors and public communications systems, have not made the same level of progress. So why has progress in NTD control in Sierra Leone been so swift? Here are some key lessons behind Sierra Leone’s success.