Professor Alan Fenwick OBE SCI Imperial College London Schistosomiasis and STH control and elimination ICOSA (LF, Oncho and trachoma)

The pharmaceutical industry has increased its contribution to global health GlaxoSmithKline – have already donated over 4 billion tablets of albendazole for lymphatic filariasis and will continue until elimination is achieved (600 million in 2014) In 2010 GSK committed an additional 400 million tablets a year to deworm school aged children in Africa Merck & Co Inc – have reconfirmed their commitment to donate Mectizan for as long as needed for both onchocerciasis and filariasis in Africa – since 1986 Johnson & Johnson – from 2012 donated 200 million tablets mebendazole per year for intestinal worms

The pharmaceutical industry has increased its contribution to global health In 2006 Merck KGaA committed to 20 million praziquantel tablets/year. From 2012 they increased their commitment annually to reach 250 million tabs/yr by 2016 Enough to treat 100 million children per year Novartis is continuing their commitment to MDT for leprosy Pfizer – originally committed to provide azithromycin for trachoma in 1999 In 2014 they reached 60 million In million doses will be shipped EISAI In October 2010, EISAI committed to provide 2 billion tablets of DEC for LF which is used with albendazole outside of Africa

Funding for delivery of these drugs DFID - £50 million in 2008 – increased to £245 million in 2012 USAID $100 million in 2006 – increased to $450 million in 2010 The ENDFUND – has a fund raising target of $100 million The World Bank – supports Yemen Private donors support selected programmes Bill and Melinda Gates Foundation

DFID supported (over 29 million reported to date) Private Investor supported Targeted yet to be supported DFID and Private investor Legacy country (now USAID supported) Niger Mali Burkina Faso Uganda Tanzania Zambia Burundi and Rwanda Malawi Mozambique Liberia Cote D’Ivoire Senegal DRC Ethiopia Mauritania Madagascar Sudan Yemen Zimbabwe Ghana SCI supported countries 2014/15 Total treatments to date over 100 million

New countries (2014/15) Ethiopia DRC Madagascar Sudan The mapping of schistosomiasis and STH in Ethiopia is complete We estimate that 10 million people children need annual treatment for schistosomiasis Over 30 million children need treatment for STH – every year or even tice a year. Mapping of schistosomiasis in DRC is ongoing The first treatment in December 2014 targeted 1 million children Mapping of schistosomiasis in Madagascar is ongoing (finish by July 2015) The first treatment in December 2014 targeted 350,000 children and we will scale up to 1.5 million during 2015 Sudan – treating 4.3 million children this month

CNTD Liverpool CNTD as partner with SCI in ICOSA The ICOSA countries of Liberia, Mozambique, and Zambia are managed by CNTD Liberia work has been on hold due to Ebola Mozambique pzq and albendazole treatment has continued – 3.1 million treated in million planned for 2015 Mapping has been carried out in Zambia

SCI treatment plans – existing funding and our expansion wish list 2 million extra treatments for every £1 million we can raise

Likely future praziquantel availability Millions of tablets USAID DFID40 70 Other Merck Total To treat60m90m100m140m

Where we are now Where we can get with existing tools and strategies 2020 Goals Diseases Targeted For Control/Elimination Schistosomiasis Soil-Transmitted Helminthes Where we can get with new tools and strategies And the new tools are Safe Water and Hygiene

CNTD Liverpool Shrinking the LF map - Ethiopia and DRC The mapping of LF in Ethiopia is complete 112 districts across the country were endemic for the disease 12 million people are exposed to infection. But the CNTD survey result was 60% lower than the current WHO estimate of 30 million. Mapping of LF in DRC is more than 95% complete The number of people at risk seems significantly lower than the 49 million estimated by WHO. According to the reports of 17 African countries, 113,555,882 were treated for LF in 2013 – with albendazole and mectizan or DEC

CNTD Liverpool Review of the LF endemicity status in Gambia Results of LF TAS surveys in the Gambia was reviewed last week by the AFRO Regional Programme Review Group (RPRG) and concluded that MDA for LF will not be required for the Gambia. Gambia is now in line to be removed from the list LF endemic countries. Capacity building for laboratory activities in Sierra Leone aided the diagnostics efforts for Ebola in the country. Technicians trained in Accra Ghana participated in the Ebola laboratory activities. Professor Moses Bockarie was actively involved in discussion about the new entity that will replace APOC in He is a member of the Committee of Sponsoring Agencies (CSA). Transition Task Force (TTF) and the Regional Programme Review Group (RPRG) for NTDs.

APOC The African Programme for Onchocerciasis Control is due to close down and a new programme PENDA Programme for the Elimination of Neglected Diseases in Africa will replace it Onchocerciasis is heading for elimination – blindness has almost disappeared – but how long will this take to reach elimination? According to the reports of 24 countries 100,693,541 persons were treated for onchocerciasis with Mectizan in 2013

Guinea Worm (WHO data) January–October cases compared with 139 cases for the same months in 2013, a decrease of 17% Total number of cases in reported cases, compared with 542 in 2012, a decrease of 73% Endemic countries in endemic countries (Chad, Ethiopia, Mali and South Sudan) compared with 20 in 1990

Zithromax donations

UK Coalition partner activities SIGHTSAVERS: Global number of NTD treatments. In 2013 Sightsavers distributed over 103 million treatments for NTDs targeting Oncho, Trachoma, LF, Schisto and STH Trachoma treatments - 9 million. Oncho treatments have increased to 34.3 million. LF treatments have increased to 44.2 million. STH In 2013 Sightsavers distributed 12.5 million treatments Schisto In 2013 Sightsavers distributed 3.4 million in MALARIA CONSORTIUM Malaria Consortium is exploring innovative approaches to ensure community engagement in NTD control in Mozambique

Russell Stothard (Director) (CNTD Liverool) Rachael Thomson, Sally Theobald and Mark Taylor Programme of implementation research to inform the effective and sustainable scaling-up of integrated Neglected Tropical Disease (NTD) control initiatives

Rationale for research themes and approaches Our IR themes and approaches take forward the current needs and priorities of our embedded country partners, and also reflect calls for action at the international level. Louis Tchuem-Tchuente – NTDs (SCH/STH) Nana Biritwum – NTDs (LF) Karsor Kollie – NTDs Margaret Gyapong – Social sciences Sam Wanji - LF and ONCH scale-up in Nigeria

What are the expected results? 1: Form a vibrant multidisciplinary IR consortium engaged with national NTD programmes and international stakeholders 2: Provide rigorous and generalizable evidence to improve and support scale-up of integrated MDA programmes 3: Develop knowledge management strategy and multi-sectoral platforms for cross-talk and dialogue, ensuring open access knowledge products 4: Increase research capacity and integrate multi-sectoral evidence for optimisation of NTD control programmes Our results are framed in four outputs:

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