Neglected Tropical Disease Scale-upProf. Louis-Albert Tchuem Tchuenté

Cameroon

On the Road to Overcome the Global Impact of Neglected Tropical Diseases…

Strategy…

2006 2010 2012 2015

Invest to…

2013

Working to… Accelerate to… Sustain to…

Country Example: Cameroon

Country in Central Africa

Surface area: 475 650 Km²

Total Population (2013): 22.8 million

Annual growth rate: 2.6%

Net primary School enrolment: 88%

Administration:• 10 Regions• 58 Divisions• 360 Sub-divisions • 181 Health Districts• 14 000 Primary Schools

High Co-endemicity of Neglected Tropical Diseases

Priority NTDs

Number of Health

Districts suspected to

be endemic

Number of Health

Districts known to be

endemic

Schistosomiasis 181 77

STH 181 181

Onchocerciasis 181 110

LF 181 158

Trachoma 50 16

Guinea Worm Eradicated Eradicated

HTA 11 6

Buruli Ulcer 41 5

Leprosy 181 102

Leishmaniasis 45 7

Yaws 181 27

Loaisis 82

Priority Neglected Tropical Diseases

Neglected Tropical Disease Integration/Coordination

NTD Control/EliminationProgramme

Datestarted

Onchocerciasis 1998

HAT 1998

Buruli Ulcer, Yaws, Leishmaniasis, Leprosy*

2001

Schistosomiasis and STH 2003

Lymphatic Filariasis 2008

Trachoma 2010

NTD Coordination Unit formally

created in 2013

6 Existing NTD Control Programmes

National NTD Master Plan 2012-2016

Launched in Oct 2012

3 Drug Distribution Channels for

PC-NTDs

School-based deworming for Schistosomiasis and SoilTransmitted Helminths

Community-basedinterventions for Onchocerciasis , Lymphatic Filariasis and Trachoma

Vaccination campaigns for deworming Pre-School AgedChildren (<5 years)

Coordination at all levels

Joint planification at national, regional and district levels

Integrated interventions

Mass Drug Administration Scaling-up

• MDA boosted by

donated medicines

• Decline of

Schistosomiasis

treatment in 2013

due to a late arrival

of drug

Insufficient

Praziquantel

Deworming

conducted in the

highest endemic

regions only

0

50

100

150

200

250

300

350

400

450

500

LF ONCHO STH SCH TRA

Pe

rso

ns

req

uir

ing

PC

(m

illio

ns)

2008

2009

2010

2011

2012

2013

Status of PC 2013 in the African Region

PC implementation 2013 (incomplete data) LF ONCHO STH SCH TRA

Number of countries requiring PC in 20131 34 27 43 41 27

Number of people treated 2013 139M 100.5M 100.1M 27.5M 53.7M

Coverage (%) 29.7 59.5 30.9 10.4 30.2

331M

472.1M

224M

324.2M

213M

240.7M

124M

177.6M168M

67.5M

Regional Neglected Tropical Disease scale-up - Low Progress

Regional treatment coverage is far below the target …

Key Bottlenecks

• Insufficient funding for Mass Drug Administrationimplementation

• Insufficient funding for monitoring and supervision

• Incentive issues for Community Drug Distributors

demotivation and increase of attrition rates

• Co-endemicity Lymphatic Filariasis/Onchocerciasis/Loa Loa Low treatment coverage

• High reinfection rates (transmission dynamics)

• Mapping gaps in some countries

• Absence or limited vector control

COUNTDOWN Boost and Contributions

• Scale-up of integrated access to Mass Drug Administration and Community LedTotal Sanitation for the control and elimination of Schistosomiasis and SoilTransmitted Helminths: Equitable access to treatment for preschool-aged-children,out-of-school-children and adults Contribution to Universal Health Coverage

• Optimized strategies related to transmission dynamics Rapid reinfection rates inhigh transmission settings

• Implementation of complementary strategies for hotspots with reduced efficacy orat risk of Severe Adverse Events (Oncho/Loa co-endemicity)

• Applied Social Science research to address impediment to control and scale-up