The document discusses the impact of the Ebola outbreak in Liberia on neglected tropical diseases (NTDs). It notes that before Ebola, Liberia had mass drug administration programs for several NTDs reaching over 80% coverage. However, the Ebola crisis collapsed the fragile health system, with over 180 health workers dying from Ebola. This disrupted NTD programs and mass drug administration in 2014. Moving forward, the document outlines steps needed to rebuild NTD programs, including assessing county readiness, training more health workers, engaging communities, and providing protective equipment as activities resume.

1. The Impact of Ebola on NTDs
Presented by Anthony K. Bettee
Onchocerciasis Coordinator

2. Outline
• Neglected Tropical Disease (NTD) Situation before Ebola
• Overview of Ebola Crisis in Liberia
• Ebola Virus Disease impact on NTDs in Liberia
• Way forward

3. Map of Liberia

4. NTD situation before Ebola

5. Priority Neglected Tropical Diseases in Liberia
•Onchocerciasis
•Lymphatic Filariasis
•Soil Transmitted Helminths
•Schistosomiasis
•Leprosy
•Buruli Ulcer

6. Mapping Status
PCTs # of Endemic IUs Population at risk
Onchocerciasis 15/15 3155572
Lymphatic Filariasis, 13/15 2468231
Shistosomiasis 4/15 421889
Soil Transmitted
Helminthes
15/15 989549
Buruli Ulcer 3/15 1,512,879

7. Neglected Tropical Disease Situation in Liberia

8. Data of Two Mass Drug Administration Rounds
2012 2013
Diseases
Eligible
Population Pop Treated
Therapeutic
Coverage
Eligible
Population Pop Treated
Therapeutic
Coverage
Onchocerciasis 2931633 2384832 81.30% 3155572 2627282 83%
Lymphatic
Filariasis 2300055 2213340 81.10% 2468231 2445275 83%
Schistosomiasis 425922 322253 76% 421889 308742 73%

9. Overview of Ebola Crisis in Liberia

10. Ebola Case and Death Summary by County
County
DAILY EMAIL REPORT
Laboratory2
Confirmed
Cases (Alive
and Dead)
Confirmed
Cases on
Contact List
Cumulative3 cases 23 May-FEBUARY
24th 2015
Cumulative
deaths2
New1 suspected and probable cases
(Alive and Dead)
Total Suspect Probable Total Suspect Probable Confirmed
Bomi 0 0 0 0 0 330 112 79 139 175
Bong 0 0 0 0 0 701 428 33 150 168
Gbarpolu 0 0 0 0 0 35 16 3 16 14
Grand Bassa 0 0 0 0 0 181 56 71 54 81
Grand Cape Mount 0 0 0 0 0 370 224 52 94 241
Grand Gedeh 0 0 0 0 0 11 8 0 3 6
Grand Kru 0 0 0 0 0 36 14 18 4 27
Lofa 3 3 0 0 0 720 142 146 332 447
Margibi 0 0 0 0 0 1327 481 453 392 584
Maryland 0 0 0 0 0 34 28 2 4 28
Montserrado 10 10 0 0 0 5294 2620 869 1796 2248
Nimba 0 0 0 0 0 359 112 131 116 70
River Gee 0 0 0 0 0 37 24 5 8 19
River Cess 0 0 0 0 0 44 10 10 24 27
Sinoe 0 0 0 0 0 64 39 7 18 27
NATIONAL 13 13 0 0 0 9507 4479 1879 3149 4177

11. Number of days since the last confirmed EVD case per county
Moving to maintain zero cases in Liberia

12. Liberia hasn’t had a new confirmed case in 20 days
Liberia
Ebola
Free
Days since last
negative
Days since last
confirmed
Countdown days

13. Overview Continued
• Last known confirmed case (BY) was discharged from Chinese ETU on March
5, 2015
• Liberians and partners are CAUTIOUSLY celebrating victory over EVD, as
Guinea and Sierra Leone (Liberia Neighbours) still in active combat against the
virus
• Efforts are being made to restore normal health services
• Building confidence among health workers remains a huge challenge
• Cross borders collaboration between Liberia, Sierra Leone and Guinea
ongoing

14. Ebola Virus Disease Impact on NTDs
in Liberia

15. Confirmed EVD cases and deaths among health workers

16. Collapse of the Already Fragile Health System
• More than 180 health workers contracted and died from EVD in Liberia
• Some of these staff played a key function in the NTDs intervention at county
level
• Deterioration in and distrust of routine health services
 As EVD mimics other diseases, a lot of health workers unknowingly
contracted and did not survive the disease
 Lack of confidence among health workers returning to service provision
remains a huge challenge
 Some professional health workers are considering changing their
profession due to fear of EVD
• Like all other health services, MDA was disrupted in 2014

17. EVD Impact Continued
• If NTDs program does not get support to conduct immediate MDA especially
for schistosomiasis, thousands of PZQ will expire come June 2015
• Disruption of M&E activities for LF and Schistosomiasis
• Amidst ebola vaccine trial and drugs fear, community members are resisting
some routine health services especially for their children
• Number of CDD that contracted the EVD and died NOT known

18. EVD Impact Continued
• Drug Distributors have relocated to unknown communities from their original
communities
• As a fear of the EVD, some NTDs staff left the country and may not return
• Almost all National level NTDs staff including the Program Director ((Key
person for the COUNTDOWN research) reassigned to fight EVD, it might be
difficult to bring all NTDs staff back to NTD program
• A lot of Liberians have resulted to limited or no international travels
(conferences) due to the Ebola stigma

19. Way Forward
• Conduct assessment in counties to determine level of readiness of County Health Team
and communities
• Building capacity of in country team for all NTDs interventions
• Engagement of stakeholders to advocate restoration of NTDs activities
• Community engagement to alleviate community fear so that they accept MDA and other
NTD interventions
• Identification and training of more health care workers and drug distributors
• Cash incentive for NTD staff is indispensable right now for NTD interventions
• Provision of basic personal protective equipment for Community Drug Distributors and
health workers
• Provision of infection prevention control support for health workers and Community Drug
Distributors as we resume NTDs activities
• Continue with cross border engagement

20. Thanks