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UK aid’s flagship neglected tropical disease programme is supporting countries during COVID-19

Ron Bannerman, July 2020
A man washes his hands.
Mark Nimely, the neglected tropical disease (NTD) focal point for Gbarpolu county, Liberia, washes his hands.

Ron Bannerman, director of Ascend West and Central Africa, explains how Sightsavers and its partners are using their expertise to help countries combat the pandemic, while ensuring they preserve the gains made in their fight against neglected tropical diseases (NTDs).

The COVID-19 pandemic has meant pausing NTD treatments worldwide. When the pandemic broke, the World Health Organization (WHO) advised that NTD activities, including community-based surveys, active case-finding and mass treatment campaigns, should be ‘postponed until further notice’. Hence, the UK Department of International Development (DFID) offered the organisations it works with the chance to adapt their programmes to respond to these exceptional circumstances.

This means certain aspects of the Ascend West and Central Africa programme (2019-2022) have needed to be adapted. The programme, funded by DFID, aims to make major progress towards eliminating five painful NTDs in 13 countries by, among other things, delivering 400 million treatments. It is made up of a consortium of partners including Sightsavers, Mott MacDonald, the Schistosomiasis Control Initiative Foundation (SCI) and the Liverpool School of Tropical Medicine (LSTM).

The programme consortium embraced the opportunity to use its years of combined expertise to help tackle this humanitarian challenge through adapting NTD interventions that are proven to be an effective way of reaching the most in need with delivery of large-scale, cross-national impacts at low cost.

A child drinks water from a cup during a drug administration session in Nigeria.

Ascend: fighting disease in West and Central Africa

The Ascend West and Central Africa programme aims to protect millions of people in 13 countries from neglected tropical diseases.

About the programme

Our proposals

The consortium lost no time in submitting proposals to DFID outlining how it could utilise the programme’s expertise and capability, known as ‘flexing’, to help mitigate the effects of the pandemic. To do this, we worked with ministries of health, national task forces and partners to prepare a plan for each country and were able to deliver proposals in just 10 days.

We are proud that the main activities Ascend West and Central Africa is, and will be, supporting include:

  • Mass media behaviour change communication – We are working with ministries and partners to develop appropriate communication materials for the COVID-19 response. These will include tackling misinformation as well as messaging on prevention behaviours such as hand hygiene, physical distancing and wearing masks. People living in remote communities often have less access to formal health services so we try to reach them in alternative ways, such as posters in public places, local radio ads and via WhatsApp. The behaviour change materials have a particular focus on reaching vulnerable groups, including children, people with disabilities, rural and border communities, and minority groups. Messages will be accessible and culturally appropriate, tailored to local languages.
  • Training – We will train community volunteers, community leaders and district heads to spread and reinforce key messages to communities.
  • Supporting supervision at national, regional, district and community level – For example in regional health directorates and health districts in Côte D’Ivoire, and monitoring implementation at county and district levels in Liberia.
  • Strengthening surveillance – We do this by training health workers, volunteers and contact tracers. In Guinea-Bissau we’re training health information system officials, and in Ghana we are training health workers in disease surveillance in target border facilities.
A man distributes treatment to a smiling student.
Rita prepares to take treatment to protect her against schistosomiasis, prior to the COVID-19 pandemic.

Challenges

As anticipated, there are still some areas of concern we are dealing with.

For instance, reports from the WHO and other UN agencies have shown that people with disabilities are being disproportionately affected by COVID-19, not only because of increased risk for those with existing health conditions, but also because of discrimination in the health, social and economic crisis responses. We have made sure the Ascend West and Central Africa programme is including people with disabilities in its design, delivery and evaluation.

We also do not know yet what the full impact COVID-19 will have on Ascend West and Central Africa’s drug supply chain. Issues are already emerging in drug manufacturing and delivery as options are restricted. Plus, drugs that are already in country but are not being used due to paused programmes, are at risk of expiring.

Encouragingly, the programme has already begun to prepare for when safe mass drug administration can resume. However, it is unlikely that these mass treatment campaigns will look the same. The Ascend West and Central Africa programme is fully engaged with the WHO, governments and partners in outlining how to restart these activities whilst ensuring social distancing measures.

To this end, Sightsavers, in close collaboration with governments, partners and donors, developed a ‘resume activity matrix’ risk assessment tool. This ensures decisions made to resume NTD work outweigh the risk of spreading COVID-19 in targeted areas. This risk assessment also factors in the health system’s capacity to effectively conduct safe and high-quality health interventions in the context of the COVID-19 pandemic.

Three men sit next to each other for a photo.
Abubakar Muhammadu (middle) sits with Sightsavers programme staff in Sokoto State, Nigeria. Abubakar, who has a disability, received trichiasis surgery before COVID-19.

Importance of health system strengthening

Strengthening health systems is vital in the COVID-19 environment, and in many countries, the focus is how to best meet the challenges of the virus.

Sightsavers and the Ascend West and Central Africa consortium have strong relationships with the governments we work with, which will help meet the demands of COVID-19 and NTD control and elimination. Meeting the challenge together is only likely to strengthen the working relationships we have around our NTD programmes.

Looking to the future

I am proud that DFID gave the Ascend West and Central Africa partners the opportunity to flex our work to support the fight against COVID-19 in programme countries. I know that supporting the health of the population during the pandemic will stand us in good stead in our fight against NTDs.

We also believe this pandemic further shows the need to build stronger health systems across the world and our work, together with the work of our partners and ministries of health, contributes to that aim.

We are confident that by working collaboratively and using our combined expertise we will be able to resume NTD activities this year.

“I know that supporting the health of the population during the pandemic will stand us in good stead in our fight against NTDs.”

Author


Sightsavers logoRon Bannerman
Ron is Sightsavers’ director for the UK aid-funded Ascend West and Central Africa programme, and is based in the United Kingdom.

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