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ESPEN: Expanded Special Project for Elimination of NTDs
ESPEN is a special project established in a spirit of partnership between endemic countries in the African region, PC-NTDs partners and WHO. ESPEN provides technical and operational support to endemic countries to accelerate control and elimination of 5 PC-NTDs. ESPEN enables the coordination among MoHs and their stakeholders acting as a bridge and meeting point.
2
ESPEN Priority areas 2018-2020 ESPEN Priority areas 2018-2020
1. Scaling UP: Reaching 100% geographical coverage of PC –NTDs (current coverage 59% in AFRO for the overall 5 PC NTDs).
2. Scaling DOWN: Supporting countries to Stop treatment and achieve WHO Validation as soon as of elimination is reached;
3. Strengthening information systems for evidence based decision and measuring progress towards elimination. Enhancing the NTD Portal : better data for higher impact
4. Improve the utilization of donated medicines to reach those who need them (as part of Dr Moeti’s commitment to the CEO Round Table)
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$15M
14
132M
30M
ESPEN by numbers: First year impact
START UP FUNDING MOBILIZED IN FIRST 12 MONTHS
COUNTRY NTD ELIMINATION ANNUAL WORK PLANS DEVELOPED
DRUG TABLETS RECOVERED THROUGH SUPPLY CHAIN ANALYSIS IN 7 COUNTRIES
PEOPLE newly targeted with MDA in 15 COUNTRIES; 32 countries operational support by ESPEN
41 COUNTRIES SHARING SUBNATIONAL DATA AND MAPS THROUGH THE NTD PORTAL ntd.afro.who.int
SCH
SAC Adults
41
100.3M 88.4M
29 14
49 ND
83 ND
67.9M 13.4M
57 11
PC implementation
Number of countries requiring PC1
Number of people requiring PC
Number of countries implemented and reported
Proportion (%) of districts implemented PC2
Proportion (%) of districts achieving effective coverage3
Number of people treated
Coverage (%)4
Preventive chemotherapy in 2016 – African Region
WHO/ESPEN Data system
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Integrated NTD database
TIPAC
Data collection at country level
Review of the JAP by ESPEN
Regional clearance of the JAP
DA
TA V
ALI
DA
TIO
N
JAP received at WHO/HQ
ESPEN - Data analysis, visualisation and score card
Country submitting JAP
JRSM
JRF
EPIRF
GHO - Data reporting and visualisation
Upload data into NTD portal
DA
TA
VA
LID
AT
ION
10
• 6th RPRG: Recommendation on Schistosomiasis advocacy in the African region
– Recognizing that :
• schistosomiasis is a focal disease,
• district level average prevalence estimates leaves out sections of the population otherwise recommended for treatment in high prevalence regions,
• Adults in high prevalent areas are not being targeted as recommended
• cases of extreme morbidity are still observed in several areas,
…The goal to eliminate morbidity by 2025 may not be on target.
Burkina Faso
Zimbabwe Togo
Consistent high coverage over several years
Schistosomiasis: School Age Children (SAC)
Cameroon
Chad
The Gambia
Comoros
Namibia South Africa
Botswana
Equatorial Guinea Not yet implementing or reporting
Category Country Consistent high coverage; need of Impact assessment surveys for Schisto (and STH )
Burkina Faso Cameroon, Nigeria (some States/LGAs), Togo, Zimbabwe. Malawi, Mali, Mozambique Senegal
Countries in need of scale up (suboptimal coverage) CAR, DRC, Ethiopia, Nigeria, (Some states/LGAs) Benin, Cote D’Ivore, Ghana Guinea, Kenya, Liberia, Mauritania, Madagascar, Niger, Sierra Leone, Zambia. Tanzania Mainland, Uganda (Review denominator)
In need to start their control programmes (no coverage 2004- 2015)
South Africa, South Sudan, Botswana, Equatorial Guinea, Gambia, Chad.
Starting or re- starting: in need of partnerships for technical and financial support
Angola, Congo, Gabon, DRC, Eritrea, Guinea Bissau, South Sudan, Swaziland
Need a survey to update the situation of schisto and develop an elimination agenda
Algeria
Need to verify interruption of transmission Mauritius
Not implementing/ reporting Botswana, Chad, Comoros, Equitorial Guinea, Gambia, Namibia, South Africa.
Summary : Country status for Schistosomiasis preventive chemotherapy (2016)
Activities
Supporting countries to reach 100% geographical coverage Site level data analysis to re-define disease prevalence Refinement mapping of SCH where needed: opportunities to integrate with other mapping surveys (Oncho) PZQ projection based on sub-district level endemicity Building capacity of Programme Managers on the new WHO PM guide on Molluscicides (Snail intermediate host control ) to control morbidity in high prevalent areas Impact assessments in countries with >5 MDA rounds
Country
# IUs Implementing
Geographical coverage
Proportion of IUs requiring PC and achieved effective
coverage
Burundi 21/21 100% 85.71%
Kenya 62/62 100% 24.40%
Malawi 29/29 100% 100%
Mali 47/47 100% 100%
Mozambique 160/160 100% 95.63%
Geographical coverage: Countries implementing to scale
Country # IUs Implementing Geographical coverage IUs not
covered Angola 73/162 45.06 89
Benin 34/76 44.74 42
Cameroon 85/113 75.22 28
Central African Republic 7/8 87.5 1
Chad 0/90 0 90
Congo 3/.6 33.33 4
Democratic Republic of the Congo 108/375 28.8 267
Ethiopia 116/432 26.85 316
Gabon 9/44 20.45 35
Geographical coverage: # of IUs not implementing (1/2)
Country # IUs Implementing Geographical coverage IUs not covered Guinea 6/7 85.71 1
Liberia 5/14 35.71 9
Madagascar 35/105 33.33 70
Nigeria 204/599 34.06 395
Swaziland 53/55 96.36 2
Uganda 76/186 40.86 110
Zambia 38/101 37.62 63
TOTAL 1,522
Geographical coverage: # of IUs not implementing (2/2)
Country # of IU SCH ISUs Map gap
Angola 164 162 2
Central African Republic 17 8 9
Chad 100 90 1
Ethiopia 839 432 48
Nigeria 774 599 50
Total 110
SCH Mapping Gaps
Cameroon Nov 2016 Pemba Sept 2017 Burkina Faso, Sept 2017
Cameroon Tanzania Mainland Cote d’Ivoire
Ethiopia Tanzania Zanzibar Niger
Malawi Uganda Burkina Faso
Mali Zimbabwe Senegal
Niger Ethiopia Cameroon
Nigeria Ghana Togo
The Sudan Mozambique Burundi
Tanzania (Mainland and Zanzibar
Benin
Zambia Rwanda
Zimbabwe
Building capacity Snail control in the African Region
SCH/STH Impact assessments After 5 or 6 years of PC implementation, it is necessary to (re)-evaluate the epidemiological situation. The impact assessment for STH can be conducted simultaneously to a TAS or independently According to the results of the assessment the PC intervention should be re-planned.
Category Country
> 5 rounds of treatment
Benin, Burkina Faso, Cameroon, Nigeria (some States/LGAs), Togo, Senegal , Mali, Burundi, Rwanda, Sierra Leone Ghana, Tanzania Mainland, Uganda Zimbabwe, Malawi, Mozambique, CAR, Ethiopia, Nigeria, (Some states/LGAs) Cote D’Ivoire, Guinea, Kenya, Liberia, Madagascar, Niger, Zambia
SCH / STH : Countries that are conducting or ready for impact assessments
SCH/STH: Morbidity control agenda
WASH Advocacy: Moving from a MDA-focused intervention to intensified / integrated interventions including sanitation, access to clean water, etc.)
Accelerate the scaling up of MDA to reach 100% geographical coverage and at least 75% of SAC
Advocacy: to extend treatment to all populations in need:
Children < 5 years: urgent need of pediatric PZQ
Out of school children and adults
Coordination: partners Matrix
Guidance to countries close to elimination: Algeria, Mauritius, Botswana??
ESPEN NTD Portal : ntd.afro.who.int
The NTD Portal is an open access platform that enables health ministries and stakeholders to share, and exchange program data, in support of their NTD control and elimination goals.
NTD Portal enhancement
Site level maps and data
Historical coverage since reported to WHO
Projections 2017-2020
Master and Annual plans and Budgets
Partners matrix