Opportunities fr from th the BEST Framework to facilitate - - PowerPoint PPT Presentation

Opportunities fr from th the BEST Framework to facilitate Universal Health Coverage for vulnerable populations th through Neglected Tropical Dis iseases in investments

Prepared by:

• Dr. Zineb Bentounsi (Morocco)

Mahnaz Hossain Fariba (Bangladesh)

• Dr. Vitalis F. Feteh (Cameroon)
• Dr. Lilian Ibe (Nigeria)

MSc in International Health and Tropical Medicine Centre for Tropical Medicine and Global Health Nuffield Department of Medicine

The following is part of a training exercise for MSc Students in International Health and Tropical Medicine, University of Oxford

* equal contribution from all co-authors listed by alphabetic order

Outline

• Background
• NTD Fight- Achievements and Challenges
• BEST Framework: Opportunities & Limitations
• Recommendations
• Conclusion

In 2003, decision was made to group those diseases under the label of Neglected Tropical Diseases (NTDs) today official WHO list of NTDs = 20 diseases. London Declaration in 2012 sets the target to eliminate/eradicate NTDs by 2020 & re-awakens intersectoral cooperation. NTDs currently affect over 1.5 billion people in the World’s Poorest Countries NTD disproportionately affect vulnerable populations children, women, refugees, nomadic and indigenous communities

Background

NTD Fight- Achievements

68% drop in sleeping sickness cases between 2011-2016 10 countries have eliminated Lymphatic Filariasis. Onchocerciasis has been eliminated in the Americas Guinness record: total of 1.8 billion treatments were donated Guinea worm disease

• nly remains in 2

countries 5 countries have eliminated Trachoma.

NTD Fight- Challenges

Funding

Additional $300 to $400 million every year until 2020

Conflict & Migration

Syria: Re-surgence of Leshmaniasis

Access to Populations

Geographical & Cultural Barriers

Human Rights

Equity & Non-Discrimination Ethical Considerations

Harmonization of Control Strategies

Monitoring & Evaluation

BEST Framework

Image Credit: http://www.ntd-ngonetwork.org/best-framework

Adopted by Neglected Tropical Disease NGO Network

• 1. Clearer message – stronger

advocacy

• 2. Joint framework – improved

integration

• 3. Comprehensive framework –

rationalised funding and programmes structures

BEST Framework -Behaviour

Physical Behaviours

• Personal Hygiene
• Livestock Handling
• Treatment Seeking Behaviours

Attitudes

• Fighting stigmatisation of NTD patients

Institutional Behaviours

• Collaborate with other sectors that also focus on behavioural

change, e.g the WASH sector

BEST Framework- Envir ironment

• Environmental Sanitation
• Reduce a major reservoir of human infections
• Preventing & Controlling Zoonotic Disease
• utbreaks, epidemics & pandemics
• Integrated Vector Management & Veterinary Public

Health Services Minimize Morbidity & Economic Losses

BEST Framework- Social In Inclusion

Empowering communities

Ensure access to services Inclusive policies

Progressing towards Universal Health Coverage Ensure access to services (including rehabilitation) for women, children, people with disabilities and other targeted population groups Empowering communities affected by NTDs by ensuring their participation in designing programmes. Ensure inclusion of vulnerable populations in NTD interventions.

BEST Framework- Treatment

Hotez P et al (2018) PLoS Negl Trop

Dis 12(5): e0006137

• Variety of methods ranging from Mass

Drug Administration (MDA) of preventive chemotherapy to surgery.

• Incorporating NTD chemotherapy into

already existing health programs like HIV/AIDS or malaria provides another

• pportunity for holistic and sustainable

care.

• Synergy between controlling NTDs and

improving nutrition policies designed to incorporate both will be more cost effective and have better health outcomes.

BEST Framework-Limitations

Behaviour Environment Treatment Social Inclusion

How to effectively monitor and manage data? How to deliver treatment to every NTD patient? How to change culturally embedded practices? How to economically empower NTD patients?

Recommendations

Invest in Community Health Workers

• Improve access to Vulnerable

Population.

• Deliver treatment
• Strengthen data collection and

analysis

• Take care of supply chain

management

• Do health promotions and

intensify community engagement

• Facilitate earlier referrals

Need for Capacity building of CHW

Recommendations

Invest in Information Systems

• Monitoring environmental

data and epidemiology of diseases

• Monitor Mass Drug

Administration

• Facilitate earlier referrals

Image credit: www.sightsaver.org

Conclusion

• Strides have been made in the current global fight against

Neglected Tropical Diseases (NTDs), but NTDs still affect the world’s poorest billion

• Interdisciplinary cooperation from the design of health policies

to their implementation as advocated in the BEST Framework is recommended

• NTD

investment should include holistic health system strengthening and community engagement as means to ensure sustainable Universal Health Coverage