Presentation at The Evidence and Organisations in Development Conference, at the University of Edinburgh’s Centre for Medical Anthropology and the Centre for African Studies.

1. A focus on NTDs in sub-Saharan Africa:
Supporting scale-up of interventions
Russell Stothard & COUNTDOWN consortium
LSTM, UK
The COUNTDOWN project is a research programme funded by
The Research and Evidence Division (RED) of The Department for International Development (DFID).

2. Sustainable Development Goals (SDGs) 2030
Goal 3. Ensure healthy lives and promote well-
being for all at all ages

3. Edinburgh 6-7th October: Evidence & Organisations
• Introducing COUNTDOWN
• Changing NTD landscape: policies with practicalities
• Some examples with discussion points
• Outlook towards 2020 & 2030 targets

4. Introducing COUNTDOWN?
• Implementation research consortium
• Interdisciplinary methods & approaches
• Focused on preventive chemotherapy
- lymphatic filariasis
- onchocerciasis
- schistosomiasis
- soil-transmitted helminthiasis
- trachoma
• Towards health system strengthening

5. Introducing COUNTDOWN?
Liberia GhanaCameroon
MDA Scale-up Theme (MST 1 – 3)
Nigeria
ICST 1
ICST 2
Integrated
Complementary
Strategy Theme
Research uptake & capacity strengthening
MST 1: Evidence synthesis
MST 2: Applied social science
MST 3: Health economics
ICST 1: ‘Hotspots’ and SAEs
lymphatic filariasis & onchocerciasis
ICST 2: Access to MDA and WASH
schistosomiasis & soil-transmitted helminthiasis

6. Introducing COUNTDOWN?
• Website www.countdownonntds.org
• E-communications blog site & twitter account

7. Introducing COUNTDOWN?
• Website www.countdownonntds.org
• E-communications blog site & twitter account

8. • Introducing COUNTDOWN
• Changing NTD landscape: policies with practicalities
• Some examples with discussion points
• Outlook towards 2020 & 2030 targets

9. Changing NTD landscape: policies with practicalities
Community
Global
Regional
National
District

10. Flux of stakeholders & interests
Changing NTD landscape: policies with practicalities
https://www.infontd.org/
An A to Z of agencies
Alliance for Disability-Inclusive Development (ADID) ….WVI - World Vision International
Disease focused (pharmaceutical industry)
http://eliminateschisto.org/
www.who.int/topics/schistosomiasis/

11. Challenges in the provision of MDA, as NTDs are:
• Embedded in complex social/biological systems shaped by ecological/political contexts
• Control vertically focused, ‘outside’ the primary health care system in sub-Saharan Africa
• Promoting community ownership is central but is dynamic sometimes, often with
local complex power structures evolving as programmatic integration ensues
• Programmes need to adapt and reflect the realities of the communities they serve by
voicing opinions/needs of affected communities (NB: control to elimination settings)
Changing NTD landscape: policies with practicalities

12. Changing NTD landscape: policies with practicalities
5-points to consider:
1. A move from a single disease to addressing multiple
NTDs through a coordinated health systems approach
2. Strategic partnerships amongst multiple stakeholders
3. Robust and appropriate data for evidence-based action
4. A strong equity stance and focus upon addressing
poverty and achieving universal health coverage
5. Strong women’s leadership and roles in health

13. • Introducing COUNTDOWN
• Changing NTD landscape: policies with practicalities
• Some examples (schistosomiasis) with discussion points
• Outlook towards 2020 & 2030 targets

14. 1
2
3
Attack points in the lifecycleSome examples with discussion points
Schistosomiasis
250M+ with disease
Urogenital
• FGS/HIV
Intestinal
• Uganda
Access to PZQ
• ?affordable

15. Urogenital - FGS/HIV: cross-sector engagement IN the health system

16. Intestinal – Uganda: inter-sectoral engagement ACROSS the health system
Related-issues
Government
• UPE (coverage)
• UPE (erosion)
NGDO
• WVI
• Leeds University

17. Intestinal – Uganda: inter-sectoral engagement ACROSS the health system
Challenges in large lake settings
- natural or man-made
Infection starts soon after birth
- occupational risk

18. Access to PZQ: SEVERAL bottlenecks to be addressed for universal access
Drugs
donated/purchased/delivery
Deliverers
CDD or teachers or both
Maternal & child health
EPI
Recipients
Pre-SAC
SAC (in-school and out-of-school)
Adults - ?pregnant
Environment
Vectors/sanitation/modificationALB & PZQ drug distribution in Liberia 2012

19. Outlook towards 2020 & 2030 targets

20. Thank You
The COUNTDOWN project is a research programme funded by
The Research and Evidence Division (RED) of The Department for International Development (DFID).
Ghana
Cameroon
Liberia
Nigeria
UK
USA