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Control of NTDs in Tanzania. A 12 year partnership between CNTD and the Ministry of Health & Social Welfare of the United Republic of Tanzania. Professor Moses Bockarie Director Centre for Neglected Tropical Diseases, LSTM. United Republic of Tanzania. High burden of NTDs. Schistosomiasis
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Control of NTDs in Tanzania A 12 year partnership between CNTD and the Ministry of Health & Social Welfareof the United Republic of Tanzania Professor Moses Bockarie Director Centre for Neglected Tropical Diseases, LSTM
United Republic of Tanzania High burden of NTDs Schistosomiasis Soil transmitted helminths Lymphatic filariasis Onchocerciasis Trachoma Human African Trypanosomiasis Rabies Tick borne Relapsing fevers Echinococcus (hydatid) Taeniosis (cysticercosis) Plague
TANZANIA NTD CONTROL PROGRAMME 44m people 947,300sq km 5 PCT NTDs >10 Case Management NTDs Trachoma mapping incomplete 37.4 million people (87% of the population) are at risk of LF infection
Strategic plan for NTD control An integrated approach to NTD control provides • limited duplication of efforts by different partners • an inter-sectoral approach to planning and implementation • a framework for integrated monitoring and evaluation • maximum use of resources • capacity to ensure sustainability of programmes • empowerment for the communities to own their programmes
Achieving the WHO roadmap targets for NTDs/LF in Tanzania • National plan for LF elimination established in 2000 • WHO Master Plan for NTDs finalised in 2012 • Initiated implementation of MDA for LF elimination in 2000 on Mafia Island • In 2001, 900,000 treated in two LF implementation units (Zanzibar); five rounds of MDA completed by 2006 • LF MDA has been scaled up to 76 out of 132 (70%) implementation units • 11 million people treated for LF in 2011 with a treatment coverage of 76.2% • 6,800 health workers and 68,000 community drug distributors trained • Some previously LF endemic districts may now not need MDA due to other interventions
From LF to NTD implementation • DFID/LFSC funding was the catalyst to launch the National LF Elimination Programme on Mafia Island in 2000 – the first LF MDA in Africa • Upscaling of LF MDA activities to 6 regions with DFID support continued to 2008 • 2009 – a phased NTD integration commenced with many new partners providing additional support
Evidence informed decisions Zanzibar • 2010 MDA ceased after 5 rounds • 2012 TAS indicated recrudescence had occurred • 2013 MDA to resume Mwanza • 2012 TAS indicated that endemicity was below 1% therefore MDA is not required
Current CNTD support • Zanzibar - MDA following TAS • Dar-es-Salaam - LF MDA (in coordination with SCI schistosomiasis/STH MDA) • Further TAS in regions to survey if MDA still needed due to other interventions • Operational research – Urban risk mapping in Dar; Impact of vector control in Mwanza
THANPRESENT CHALLENGESYOU • Delays in reporting from the implementation districts • Rolling out the NTD MIS • to enable timely reporting • for remedial actions • Low support in dealing • with morbidity issues • Reaching full geographical • coverage • Dealing with data and drug logistics
Some final thoughts We, the partners to the National NTD Programme, must: • continue to support the national NTD programme to achieve its targets of elimination and control • continue to build on our long term relationship which mutually builds respect and trust • In the broader scenario - be respectful of the relationships we have with the countries - helping the countries to help themselves - an excellent model for support of Global Health Programmes