International Conference on NTD Research

This month, COR-NTD and the African Research Network for Neglected Tropical Diseases (ARNTD) hosted the second International Conference on NTD Research (InCORNTD) in Kigali, Rwanda in collaboration with the Ministry of Health. Over 500 researchers, academics, and policymakers met during the three-day conference aimed at bridging the gap between research and implementation, ensuring that knowledge translates into tangible impact in the fight against neglected tropical diseases (NTDs). You can watch highlights on the COR-NTD website and full recordings will be made available later. Thank you to Liesbeth Mieras (from ILEP member NLR) and other ILEP member colleagues for this day-by-day report on topics particularly relevant to ILEP Update readers.

Day One: 20 January

Opening remarks

There were welcomes by Pat Lammie (Director of COR-NTD), who emphasized catalysing new collaboration during the conference, and John Amuasi (Executive Director of ARNTD), who motivated participants to come up with bold ideas to put research into action to tackle NTDs.

Noella Bigirminana, Deputy Director General of the Rwanda Biomedical Centre, emphasized Rwanda’s commitment to eliminating at least four NTDs as a public health problem by 2030. She highlighted the importance of multi-sectoral collaboration and establishing essential services to achieve this ambitious goal, and overcoming the inequity related to NTDs. ‘Rwanda is committed to increasing domestic resources allocated to NTD control interventions. Investing in research is critical for generating evidence-based strategies. I call for strengthened multi-sectoral collaboration through the One Health Approach, which will not only contribute to eliminating NTDs but also help achieve the WHO NTD Roadmap targets, the Sustainable Development Goals, and other continental and global strategic objectives’.

Dr. Mosoka Papa Fallah, Deputy Director of the Africa CDC, underscored the timeliness of the conference, calling for leveraging cutting-edge technology to accelerate the elimination of NTDs. ‘We are in an era of groundbreaking scientific discoveries, from the rapid development of the COVID-19 vaccine in just 12 months to advancements like the recent discovery by Japanese scientists of pathways to regenerate teeth at any age. Yet, despite these incredible achievements, 1.2 billion people in Africa and parts of Asia suffer daily from Neglected Tropical Diseases” Dr Mosoka posed two thought-provoking questions to all concerned actors:

  • Does poverty serve as an invisible magnet that attracts NTDs?
  • Do NTDs persist among the poor because they are poor, disempowered, and faceless?

Through these questions he invited deeper reflection on the structural injustices, weak health systems and societal dynamics that perpetuate the burden of NTDs, including the mental health consequences.

Morning presentations

  1. Health systems integration for schistosomiasis and other NTDs. Presentations focused on integrated ways to implement Mass Drug Administration (MDA) campaigns targeting children, such as MDA combined with mother and child health, including vitamin A distribution.
  2. WHO research and development blueprint. This was mentioned in the October Update where we encouraged readers to sign up to participate, to maximise the number of voices contributing. The deadline has been extended. One of the driving issues is that progress towards the 2030 NTD goals is too slow, and this is related to the fact that there is relatively limited research on NTDs, compared to for example malaria. Questions posed by speaker Anthony Solomon included: Are we doing enough? Do we coordinate and collaborate enough? Are we addressing the right questions?
  3. Post-validation surveillance. Abdel Direny shared PATH’s Landscaping report: Integrated surveillance planning toolkit for NTDs in post–validation or verification settings
  4. iCHORDS encouraged participants to join its Community of Practice which aims to mobilize social and behavioural science into practices that meet the needs of NTD program implementers and partners, to reach the WHO 2030 NTD Roadmap targets. Services include podcasts, knowledge exchange cafes, a mentorship program, quarterly newsletters, blog posts and focus area support.

Visceral Leishmaniasis (VL)

20 million people are at risk of contracting VL; 95% of patients will die if not treated. Targeted vector control (sandflies) is lacking and new breeding sites are emerging. More positively, Bangladesh has achieved elimination of VL as a public health problem, so the challenge is how this can be achieved in East Africa. The solutions to ongoing transmission lie in innovative interdisciplinary control approaches, covering:

  • Early diagnosis and treatment
  • Integrated vector management
  • Effective disease surveillance
  • Advocacy, social mobilisation and partnership
  • Research and development

Contributors to the session included DNDi – Best science for the most neglected which works with partners in low-and middle-income countries to develop treatments for various diseases. These include their Leishmaniasis East Africa Platform (LEAP). WHO has launched a new strategic framework to eliminate VL in East Africa.

The challenges for VL elimination are very similar to the challenges for leprosy control: early detection, early treatment, care, preventive measures, point of care diagnosis, training, awareness, logistics (medication), surveillance, poverty reduction. Diagnosis, treatment and care for people with skin NTDs is a pathway to stronger health systems.

The session identified these requirements for effective surveillance:

  • Systematic collection and analysis of data to monitor disease and inform public action
    • Improve by digitization, training etc
  • Detect outbreaks
  • Monitor trends
  • Promote equitable access
  • Develop policies for prevention, control and elimination
  • Identify new foci (eg consequences of climate change)

Day 2: 21 January

Shape the future for Skin NTD diagnosis – successes and operational challenges

This session was chaired by Kingsley Asiedu (WHO NTDs) and moderated by Liesbeth Mieras (NLR). Rapporteur was Suzan Trienekens (LRI). The full report and slides will be made available in a subsequent ILEP Update.

Sharing and developing practical tools for the integration of NTDs and mental health.

Julian Eaton, CBM Global, talked about the essential care package that is under development by the NNN DMDI (Disease Management, Disability and Inclusion) group. He stressed that treatment and care should aim to not interrupt the income of the patient and to support the patient in their daily life to the extent possible. Research priorities included prevalence and risk factors, and development and evaluation of integrated interventions.

This session continued in a subsequent side meeting. Interventions that were highlighted included:

Follow-up steps were agreed, aimed at making tools easily available and accessible, as well as flexible to enable contextualisation. An online workshop will be organized to get a bigger group together to further discuss: What is good about existing materials? What is missing? What is the best/preferred format so that tools are accessible and useable by health systems?

REDRESS

REDRESS, profiled in the August 2024 Update, is a comprehensive project in Liberia focused on severely stigmatizing skin diseases including leprosy. The very comprehensive combined REDRESS manual was presented by Rosalind McCollum (Liverpool School of Tropical Medicine) and Emerson Rogers (MOH Liberia). The manual includes not only training materials, but also pre-and post-tests and reporting tools. There is an all-condition algorithm (page 112) which is useful as a wall-chart for mid-level Health Workers. It is Liberia-specific in terms of diseases included, but it can be adapted to other contexts as well. There are multiple tools embedded in the manual as annexes, for example the Basic Psychological Support for person affected by NTDs (BPS-N), a diagnostic communication job aid, and mental health indicators within NTD case management.

Day 3: 22 January

Building sustainable financing for NTD programs: tools, challenges and collaborative solutions

The Task Force for Global Health has been working on Pathways to Sustainable NTD Elimination with the aim to empower and equip stakeholders with the tools and strategies needed to sustain the progress made in the elimination and prevention of NTDs, especially Onchocerciasis and Lymphatic Filariasis. By investing in the capabilities of national program managers, this initiative enhances advocacy efforts, bolsters the effectiveness of NTD programs, and positively impacts broader communities.

The tool can be downloaded at the link above in English and French, and Spanish and Portuguese versions will become available. There is an e-course consisting of 5 modules that you can access online. The tool helps to identify actors, including those who would normally not be thought of, to mobilize domestic resources and support the NTD programme, and to identify challenges and opportunities. Experience in Togo showed that the tool enables a full understanding of the messages that need to be drafted, and it can help engaging stakeholders. MoUs with MoH for medication supply and in-country distribution is another example. The tool also helps to understand how to present the return on investment.