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