1. NTDs and the Health System
Ghana
Nana-Kwadwo Biritwum
2. Introduction
• All countries in WHO/AFRO region are know to be endemic for at least 2
Neglected Tropical Diseases (NTDs)
• Ghana is endemic for 10 NTDs including all 5 PC-NTDs
• Call for elimination of Lymphatic Filariasis and Trachoma by 2020 and
Onchocerciasis by 2025
• Sustained control of Schistosomiasis and Soil Transmitted Helminthiasis
• Strong move towards integration and coordination of NTDs regionally and
within countries (AFR/RC63.R6)
4. Global, Regional and National Commitments
Several documents developed to establish commitment
and guide process
• WHO Resolutions on NTDs
• London Declaration on Uniting to Combat NTDs
• Accra Urgent Call for Action
• Regional Strategy and Regional Strategic Plan for NTDs
• Ghana Master Plan
6. Elimination Strategies
• Mapping of diseases, Mass Drug Administration, monitoring and
evaluation, transmission assessment surveys and surveillance,
certification of elimination process
• Effective in-country health system capable of delivering
interventions is required
• Integrated NTD programme into the health system
8. National Level
• High political priority is given to NTD interventions
• Capacity to plan and coordinate all interventions
• Mobilize and distribute resources
• Supervision, monitoring and evaluation
• Responsible for capacity building at all levels
Management and coordination capacity
Technical and administrative capacity
Laboratory capacity
9. Advantages and achievements
• Wide reach into remote, rural and neglected communities
with health education, medicines and other health
commodities
• Employed to complete mapping of all PC-NTDs in Ghana
• Facilitated impact assessments
• Led in operational research
10. Advantages and Achievements
• About 100 million treatments delivered through community structures
• About 30 million school children dewormed
• 69 of 98 lymphatic filariasis endemic districts have stopped treatment
• Trachoma elimination is achieved
• Operational research to inform TAS guidance completed and PTS ongoing
• Structures for effective collaboration between Ghana Health Service,
Research Institutions, Universities and Support Centres to fill research gaps
11. Challenges of the Health System
• Human resource constraints (quantity and quality)
• NTD prioritization by government and the health system at all levels
• Improving collaboration with other ministries, departments and agencies
• Competition between NTDs and other public health programmes
• Resources for addressing morbidity management and disability prevention
• Capacity needs for effective monitoring and evaluation of NTD interventions
• Addressing poverty with NTD interventions
• Limited technical and managerial capacity below the national level for NTDs
12. Challenges of the Health System
• Existence of various technical gaps that require operational/implementation
research
• Creating a common platform for the use of available community structures for
delivery of NTD and other public health interventions
• Cross-border transmission of lymphatic filariasis and other NTDs
• Collaboration between programme, research institutions and COUNTDOWN
to address research gaps
• Research uptake
13. Challenges of meeting elimination milestones
• Biannual treatments and annual treatment
• Management of Serious Adverse Events
• Persistent non-compliance
• Post-MDA Surveillance strategy and its implementation
• Managing hotspots
• Alternative treatment strategies
• Volunteer and health worker fatigue
14. Conclusions
• COUNTDOWN will help Ghana’s achievement of programme missions, goals
and objectives and 2020 elimination targets
• Assess reliability and integrity of systems and reporting
• Assess effectiveness and efficiencies of technical tools and guidelines
• Ensure compliance with technical tools and guidelines
• Address research gaps
• Important for research uptake and major decision making and policies
• Provide guidance to NTD programmes in Ghana, Africa and globally