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The Schistosomiasis Control Initiative Summary for 2012/13 and strategic direction for 2014/20

The Schistosomiasis Control Initiative Summary for 2012/13 and strategic direction for 2014/20 Professor Alan Fenwick OBE a.fenwick@imperial.ac.uk. What is involved to upscale to country level we need to:. Mobilise political will

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The Schistosomiasis Control Initiative Summary for 2012/13 and strategic direction for 2014/20

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  1. The Schistosomiasis • Control Initiative • Summary for 2012/13 • and strategic direction for 2014/20 • Professor Alan Fenwick OBE • a.fenwick@imperial.ac.uk

  2. What is involved to upscale to country level we need to: • Mobilise political will • Define disease distribution – collect mapping and base line data • Develop a national plan with strategies at each district level • Define drug needs and order drugs • Develop local advocacy tools • Conduct training for teachers • Deliver the drugs • Monitoring and evaluation

  3. Treating school children is easy

  4. And adults at high risk are offered treatment

  5. Phase One SCI started with funding from Bill and Melinda Gates FoundationMinistries of Health and Education in 6 countries with SCI support delivered over 43 million cumulative Schistosomiasis treatments and over 100 million albendazole (purchased) 50 2002/3 43 m 45 2003/4 40 2004/5 2005/6 35 2006/7 30 Number of Treatments (millions) 26 m 25 20 15 12 m 10 3 m 5 0.1 0 2004/5 2002/3 2003/4 2005/6 2006/7 SCI Treatment Years

  6. Phase Two - Ministries of Health and Education with SCI support and USAID funding Treatments delivered 2007-2010 shown below 50 4 drugs 4 drugs 4 drugs (RTI) 45 >40 m >40 m >40 m 40 35 30 Number of Treatments (millions) 25 20 Pzq and alb 15 6 m Pzq and alb 10 3 m 5 0 Rwanda/ Burundi Yemen Burkina Faso Niger Uganda SCI supported countries

  7. Phase Three – expansion - Ministries of Health and Education with SCI support and DFID funding +++ Treatments delivered in 2012/13 50 75 million treatments to 8 countries planned for 2011 – 2016 funded by DFID Could be doubled with a new award 45 40 35 30 Number of Treatments (millions) 25 20 Pzq/alb 15 10 m 1m/6m 8 m 8 m 10 3 m 1 m 2 m 1 m 5 0 Rwanda/ Burundi Yemen Mozambique Tanzania Niger Malawi Uganda Cote D’Ivoire SCI supported countries

  8. Phase Four 2013-2020 • Consolidate in existing countries • DFID – reach national coverage in all 8 countries • DFID – move towards elimination in Zanzibar, Uganda and Niger • DFID expand into Ethiopia and DRC • Move towards elimination in Rwanda and Burundi (SCORE and ENDFUND and Private) • Expansion of coverage in Yemen • Use donations to move into new countries (Mauritania, Madagascar, Zimbabwe, Senegal)

  9. Phase Four 2013-2020 • A More holistic approach • Maintain and increase income (more proposals, maintaining status with givewell and GWWC) • Strengthen staff (management, new disciplines, more local staff Ethiopia, DRC) • Water and sanitation – what shall we do ? • Behaviour change – is this feasible • Snail control – when and where

  10. Phase Four 2013-2020 • Operational research • Monitor drug efficacy • Improving coverage • Gaining and maintaining control • Possibility of elimination • Water and sanitation • Snail control • Cysticercosis

  11. Director Managing Director PR and fund raising Office Manager SCI ORGANOGRAM Programme Manager UGA (Niger, Mozambique) Director of Monitoring and Evaluation Programme Manager (Yemen and Ethiopia) Finance Manager Programme Manager (Rwanda, Burundi, Senegal) Senior Biostatistician Finance Officer ICOSA Project Manager ICOSA M and E Health Economist Africa Capacity Building Liaison Liverpool CNTD Sub-Contract Mathematical Modeller 3 Programme Managers DFID (8 Countries) Africa country coordinators FINANCE AND ADMINISTRATION UNIT Long and Short Term Technical Assistants RESEARCH UNIT IMPLEMENTATION UNIT

  12. SCI coverage 2003 - 2016 And Yemen With World Bank funds Mauritania Mali Niger Senegal Burkina Faso Ethiopia Cote D’Ivoire and Liberia Uganda DRC Burundi and Rwanda Tanzania Proposed expansion into DRC, Ethiopia Senegal. Mauritania and Zimbabwe Malawi and Mozambique Zambia Zim With support from the Gates Foundation USAID/NTD, Geneva Global and DFID, UK

  13. With the new WHA resolution calling for global schistosomiasis elimination: what is the WHO strategy, the feasibility and what are the major challenges?How does this affect SCI ?

  14. Population requiring preventive chemotherapy ~ 243 million ~ 873 million ~ 1 410 million ~ 127 million ~ 281 million 77.1 Proportion, % 41.8 31.1 13.7 13.3 Soil-transmitted helminthiases Lymphatic filariasis Onchocerciasis Schistosomiasis Trachoma Proportion of PC for schistosomiasis, soil-transmitted helminthiases, lymphatic filariasis, onchocerciasis and trachoma, 2011

  15. Joint drug request, review & reporting mechanism But with pzq there are other sources DFID and USAID WHO ORDER Joint Virtual Review Panel Eisai Merck KGaA GSK J&J Joint Request + Joint Report + Annual work plan DEC PZQ ALB MBD Regional review groups SHIPMENT National Programmes IVM AZI Shipments Applications MDP ITI

  16. Merck KGaA's expanded commitment of praziquantel supply for unlimited period

  17. Likely future praziquantel availability(millions of tablets)

  18. The US Government Launched in 2006 by USAID The Neglected Tropical Diseases Cooperative Agreement - Initially $100 million, and in 2010 a new commitment of $450 million $250 m to “ENVISION”

  19. The British Government £50 million over 5 years for NTD control announced in 2008 A new £200 million 4 year commitment in January 2012

  20. Other donors to/through SCI • The World Bank • The END FUND (Geneva Global and Legatum) • Childrens Investment Fund Foundation (CIFF) • Vitol • The Bill and Melinda Gates Foundation • SCORE (UGA/ BMGF) • Global Network for NTD control (END7) • Private Donors • www.givingwhatwecan.org • www.givewell.org

  21. How much can we reach out to the countries with maximum requirements -the 10 highly endemic AFR countries, 2010

  22. The importance of advocacy

  23. The UK Coalition against Neglected Tropical Diseases (NTDs) is a collaborative partnership between UK organisations actively engaged in the implementation, capacity building and research of neglected tropical disease control at scale

  24. London Centre for NTD Research • Launched on January 30th 2013 • (Sir Roy Anderson) Partners include PCD SCI London School of Hygiene and Tropical Medicine Natural History Museum

  25. Where we can get with existing tools and strategies Where we can get with new tools and strategies Where we are now 2020 Goals Diseases Targeted For Control Diseases Targeted For Elimination Guinea worm Leprosy Lymphatic filariasis Blinding trachoma Sleeping sickness Schistosomiasis River blindness Soil-Transmitted Helminthes Chagas Visceral Leishmaniasis

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