ENDING
NEGLECTED
DISEASES
THROUGH 10 STEPS
ENDING
1. SECURE FUNDING
Identify partners such as corporations, foundations, and individuals to sponsor high-impact neglected tropical disease programs
We believe that giving should be a joyful and transformative experience that enhances the lives of donor and grantee alike. With this ethos in mind, a group of dedicated visionaries, humanitarians, and entrepreneurs embarked on a challenge to summit Mt. Kilimanjaro with the END Fund in 2014. By climbing, they raised awareness for NTDs and over $300,000 for treatment initiatives.
The END Fund represents a smart approach to development and pools resources from our generous partners to ensure they will be used to have the greatest impact. Thanks to this generosity, much needed treatment has reached those who need it most to lead healthier, more prosperous lives.
2. PLAN
Engage implementing partners, Ministries of Health, and scientific technical experts to design a coordinated program
In 2014, the Ethiopian Federal Ministry of Health (FMoH) and the END Fund worked in concert to identify how best to coordinate an intestinal worm treatment strategy. This collaborative planning enabled the FMoH to deworm 7.8 million school-age children in three priority regions.
By engaging scientific technical experts, ministries of health, and implementing partners, the END Fund ensures that NTD programs are a coordinated and targeted effort. This leads to more on the ground ownership for positive long-term results.
3. MAP
Conduct disease prevalence and intensity mapping baseline data collection
Disease mapping is a vital part of determining effective treatment plans and strategies. In Angola, comprehensive mapping was conducted in three provinces to assess the presence and intensity of intestinal worms and schistosomiasis.
Through these mapping activities, children were tested for intestinal worms and schistosomiasis to help create a roadmap for large-scale treatment.
Disease prevalence mapping is a vital step for END Fund programs and a best practice in NTD control.
New technology has been instrumental in not only identifying where treatment is needed, but what the remaining disease intensity is in areas that have already been treated.
Integrated Treatment - Mapping gives detailed information about the prevalence of each NTD. This allows for countries to plan integrated treatment strategies for communities at risk for multiple NTDs.
Mapping measures the prevalence and intensity of a disease. This gives a snapshot of a community or population with a disease at a moment in time.
312,600
165,244,500
16,760,000
*Low numbers in 2014 are credited to extensive mapping completed in several countries in 2013. The END Fund, along with its partners, were able to move on to the next stage of the programs for these countries by 2014.
4. TARGET
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Define a target population
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Formalize a treatment strategy
In the Democratic Republic of Congo (DRC), a country with one of the highest NTD burdens in sub-Saharan Africa, mapping data from early 2014 was analyzed and used to inform future treatment strategies. New disease prevalence data has made it possible to develop larger, more effective treatment interventions.
The new data enabled the development of disease prevalence maps, which assisted in defining a target population and indicating what community needed which drugs. Now, treatment is focused on lymphatic filariasis, intestinal worms, schistosomiasis, and river blindness in 11 provinces, including integrated control efforts for areas endemic with multiple NTDs.
In order to treat a population in the most high-impact, efficient, and cost-effective way, targeting allows the END Fund and its partners to see what areas can be treated for multiple diseases at once, at times even with the same drugs.
5. SUPPLY
Facilitate procurement of pharmaceutical donations in partnership with ministries of health
A generous consortium of pharmaceutical companies has donated the majority of medicines needed to treat the five most common NTDs. The END Fund coordinates and provides access to technical assistant for governments, like the Angolan Ministry of Health (MoH), in procuring and in the supply chain of these drugs through the World Health Organization (WHO) donation program.
The MoH applied to the WHO’s drug donation program for treatments for intestinal worms and schistosomiasis. The END Fund assisted the MoH through the application process and interceded when the supply was delayed to make sure Angola was on the distribution list so that thousands of children could receive treatment through a school-based campaign.
The pharmaceutical industry has generously committed approximately $17.8 billion worth of medication from 2014-2020; enough drugs for the NTD community to meet the control and elimination agenda. However there still exists a funding gap of around $1.4 billion that stalls these drugs from reaching the people who need them most.
6. TRAIN
Train health sector personnel from the national to the local level to deliver treatment and keep accurate records
As a part of a five-year integrated NTD control plan, the Kenyan Ministry of Public Health and Sanitation (MoPHS) launched a national School-Based Deworming Program. Phoebe Judy Akinti is a teacher trainer for the Changamwe District Education office where she trains teachers to deworm school-aged children for intestinal worms and schistosomiasis. She ensures that teachers and school directors have appropriate skills and knowledge to treat the children with drugs, supervise for any potential adverse side effects, record treatment data accurately, and report to district education and health officials.
Bihar, India is home to one of the largest school-based deworming programs in the world. The END Fund provided a targeted investment to support Evidence Action’s work with the government, enabling the training of 65,750 teachers and education officials in conducting deworming activities in 2014.
Trained health workers are vital to a successful NTD intervention. Not only do they administer treatment, but they collect data and educate the community about NTDs and how to prevent reinfection.
7. PROMOTE
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Prepare target populations to receive medicines
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Aid social mobilization through media promotions, door-to-door visits, and community health education
Social mobilization tactics like television and radio spots and educational posters displayed in districts across Yemen were instrumental in ensuring successful mass drug administration (MDA) campaigns for intestinal worms and schistosomiasis.
Through the use of mass media, the Yemeni people were informed about the effects of NTDs, the importance of treatment, and plans for ongoing MDA. Despite on-going political and social instability in 2014, over 7 million people were treated through this campaign.
Through different methods of social mobilization, a target population or community will be sensitized to the scheduled treatment interventions. They learn not only where and when the drugs will be distributed, but what diseases are being treated and what the potential benefits of treatment are.
8. MOBILIZE & TREAT
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Equip health facilities with diagnostic equipment
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Treat the target population with mass drug administration (MDA)
A national prevalence survey completed in 2010 found Zimbabwe endemic for schistosomiasis and intestinal worms. In response to this, the Ministry of Health and Child Care (MoHCC) launched the first-ever MDA program in 2012. Since then, the END Fund has supported efforts to implement treatment.
Over 2.6 million children were treated for schistosomiasis and intestinal worms during 2015 MDA activities in 57 districts in Zimbabwe. It was a significant accomplishment for the MoHCC as it reached more individuals with treatment than ever before.
Through partnership with investors, ministries of health, and implementing partners, the END Fund has treated tens of millions of people for the five most prevalent NTDs
12.2M
39.6M
45.8M
9. MONITOR
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Monitor and evaluate the program
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Collect and analyze data
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Make necessary adjustments to implementation
Rwanda was selected for a project to evaluate the current NTD program. The country was remapped for schistosomiasis and intestinal worms using a new, more sensitive type of diagnostic tool, the Circulating Cathodic Antigen (CCA) test, for detection of schistosomiasis. With support from the END Fund, implementing partner the Schistosomiasis Control Initiative (SCI) provided technical assistance, training for personnel, and quality assurance for the project.
20,000 school children were surveyed using both the CCA and the original testing tool, Kato-Katz. Results from this evaluation project will inform future treatment strategy and the setup of sentinel sites where monitoring activities will be conducted to track the declining disease burden.
Monitoring is critical for recognizing improvement opportunities and measuring success that could potentially be scaled up. It allows the END Fund team in partnership with implementing partners, ministries of health, and investors to continue using resources in the the most effective and cost efficient way.
10. SCALE
Scale up health, education, and prevention programs to the national level
The END Fund joined multiple partners in the effort to help build government capacity in Ethiopia to scale-up treatment for intestinal worms and schistosomiasis. Using mapping data, and observing the outcomes of a 2014 mass drug administration (MDA) campaign, the Federal Ministry of Health (FMoH) is working towards a national deworming program for these two diseases that would reach all children at risk.
Scaling up treatment also relies on scaling up investment. The END Fund has been proud to steward a space for the growing community of investors in Ethiopia’s NTD programs so that larger numbers of people at risk are able to receive treatment.
The END Fund, investors, the WHO, and implementing partners work together to support or build a strong foundation for NTD programs for country governments. The ministries of health can then take over and push out the programs on the regional, district, and local community levels through a coordinated national plan.
The END Fund, investors, the WHO, and implementing partners work together to support or build a strong foundation for NTD programs for country governments. The ministries of health can then take over and push out the programs on the regional, district, and local community levels through a coordinated national plan.
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The END Fund would like to thank the generous photographers and organizations whose images and videos have been used with their kind permission. These include: Centre for Neglected Tropical Diseases at the London School of Hygiene and Tropical Medicine (CNTD); Jessica Dimmock; Esther Havens; The MENTOR Initiative; Ministry of Public Health and Population, Republic of Yemen; Jonathan Olinger and Lindsay Branham of Discover the Journey (DTJ); Mo Scarpelli, Rake Films; and Talking Eyes Media.