Control, elimination, eradication Concepts and terminology

1. Control, elimination, eradicationConcepts and terminology Professor Peter Holmes

2. Control, elimination, eradication - Concepts and terminology

3. Control, elimination, eradication - Concepts and terminology

4. Proposed principles and processes Routine activities and reporting Control Roadmap: 2015 &2020 Validation Elimination as PHP Beyond Roadmap (list of diseases) Verification Elimination Roadmap: 2015 &2020 Certification Eradication

5. Requirements for validation of elimination as PHP Proposal Countries will build up a validation file including (for example): SOPs (essential elements of a country file) WHOGuidelines • Epidemiological surveillance, evidence, • coverage Disease specific guidelines for validation of disease elimination as PHP Definition of the epidemiological target • Sustained preventive measures • Functional detection and treatment systems

6. Validation process Country level • Validation file is build-up by Countries According to recommendations from the disease specific validation SOPs • Validation file shared with WHO WCOs, ROs… HQ? Completion of the file, compliance with specific SOPs • Validation file is reviewed by a WHO disease specific validation group Should validation be repeated over time? Simple letter to countries to acknowledge reception of the info? GHO? WER? STAG country by country? NTD global report? • On the recommendation of the validation group, the national elimination as PHP is acknowledged by WHO Regional or global level When all countries have reached the target, the global elimination as PHP can be endorsed by the specific WHO consultative group and submitted to the NTD STAG

7. Requirements for verification of elimination Countries need to build up and provide a file including (for example): SOPs (essential elements of a country file) • Epidemiological surveillance, evidence, coverage sustained for a number of years WHO Guidelines • Policy about healthy carriers, vectors, reservoirs Disease specific guidelines. Clear definition : Zero case, Interruption of transmission…. • Referral system for identification and treatment • Sustained preventive measures

8. Verification process Country level • Verification file is prepared by Countries According to recommendations from the disease specific verification SOPs (regional or global) • Verification file is submitted to WHO • Verification reviewed by a disease specific verification group As part of STAG? • Verification can request more studies or evidence Country level with support from….? • On the recommendation of the verification group, the elimination is acknowledged by WHO (STAG) Publication in WER, GHO, NTD report, others…… When several countries have reached the target, sub-regional, regional and ultimately global elimination status can be submitted to the NTD STAG

9. Certification of Eradication • Formal process • International Commission for the Certification of Dracunculiasis Eradication • Yaws eradication: to be defined