According to the World Health Organization, “Fifteen neglected tropical diseases (NTDs) continue to be public health problems in 28 countries and areas in the Western Pacific Region.” Operational Research (OR) has played a crucial role in the success of programs aiming to overcome NTDs, from defining the initial control and elimination strategies to more recent efforts to improve and validate new tools for monitoring and evaluation after elimination. The Coalition for Operational Research on Neglected Tropical Diseases (COR-NTD) supports these operational research efforts by conducting research to optimize strategies and convening NTD experts to discuss what steps and research are needed next to progress.
On August 31, 2023, COR-NTD co-hosted the Inaugural Coalition for Operational Research on Neglected Tropical Diseases Meeting for the Pacific Islands with the University of Queensland and the Australasian College of Tropical Medicine in Sydney, Australia. While COR-NTD meetings have occurred in other parts of the globe, it is often challenging for members of the Western Pacific to participate due to travel and time zone restraints. This was the first in-person meeting in the region.
“The meeting provided an excellent opportunity for first time COR-NTD participants from the Pacific Islands to present from the podium, share their expertise and experiences in NTD elimination, voice their concerns and challenges, and engage in discussions about opportunities to optimize the success of elimination programs,” said Prof Colleen Lau, The University of Queensland.
More than 120 participants attended from 21 countries, 15 of those Pacific Island countries. The meeting was sponsored by the Bill & Melinda Gates Foundation, the United States Agency for International Development, The University of Queensland, ACE-NTDs, James Cook University, and Murdoch Children’s Research Institute.
“The goal of the meeting was to bring together these countries not only to discuss and learn about neglected tropical diseases endemic in their countries but also to collaborate on the next steps to help control or maintain the elimination of these diseases,” said Pat Lammie, Director, COR-NTD Secretariat.
During the inaugural gathering, Lau articulated the choice to concentrate on specific NTDs, namely, lymphatic filariasis (LF) and scabies. The gathering was characterized by a keen awareness of the critical challenges besetting numerous Pacific nations within the realm of NTD elimination.
“We decided to focus on a few NTDs-lymphatic filariasis and scabies-for this first meeting,” said Lau. “Many countries in the Pacific are facing operational challenges related to LF elimination. For countries that have not yet reached elimination status, there are challenges related to MDA coverage, resurgence, and better surveillance strategies to identify hotspots. For countries that have been validated as having eliminated LF as a public health problem, there are questions related to post-validation surveillance strategies.”
“Control and elimination of scabies are of high priority for many Pacific Islands also,” she continued. “Not only can scabies cause debilitating itching, it is also associated with bacterial skin infections and rheumatic fever.”
Eight of the Pacific Island countries and territories endemic to lymphatic filariasis achieved the elimination of lymphatic filariasis as a public health problem since 2016. Still, there has been no LF surveillance for most of these countries since achieving validation. Scabies is recognized as a significant public health problem across the Pacific. In many prevalence surveys conducted across the region, scabies prevalence typically exceeds the 10% threshold WHO defined as a provisional target for beginning MDA.
Using the COR-NTD meeting style, which includes presentations and in-depth breakout session discussions, participants' interests ranged from starting a control program to post-validation surveillance methods to ensure that diseases don’t return.
“The COR-NTD meeting provided an excellent opportunity for meaningful interactions with the key partners in the region to prioritize research needs and action areas to control and eliminate NTDs in the Pacific. The meeting was a great success from many different perspectives,” said Dr. Kazim Sanikullah, WHO Western Pacific Regional Office.
Feedback from all participants has been positive. Anonymous survey comments remarked on how the COR-NTD Pacific meeting proved to be a highly valuable and well-received event, mirroring the quality of the COR-NTD annual meeting. It effectively addressed the unique challenges of Pacific Islands while fostering valuable discussions and connections among attendees. Participants hope this successful initiative will continue annually, promoting collaboration and knowledge sharing among Pacific partners. Input also suggested focusing on additional diseases for future meetings and some challenges countries face with MDA implementation.“The experience was good. It could have included a [future] session more contextual to PIC. Here, the NTD program faces drug availability challenges, and the cost of MDA is high due to the difficult terrain.”
In addition to bringing together researchers and implementers from countries, the meeting also engaged several donors.
Joe Shott, Health Scientist in the NTD Division, USAID, had several key takeaways from the meeting. “We need commercialization partners for these technologies. The tools we have work, but it’s all in how they are standardized and rolled-out to programs thoughtfully. He also commended the new partnership with The University of Queensland, acknowledging and thanking them for investing in this regional meeting and the research itself in the region.
Dr. Jordan Tappero, Deputy Director of Neglected Tropical Diseases for the Gates Foundation, commented on the event and where they are looking to invest for the future. “It's impressive to see what these island communities have accomplished over the years in LF. We’re really approaching the need in so many of the settings for post-validation surveillance. There needs to be intense operational research around those platforms to ensure they make sense and teach us how to protect the gains [in elimination].”
“The meeting was a successful first step. NTD experts from the Pacific Islands were able to network, catalyze new partnerships, and discuss how others are translating research into impact in their countries and how it may be applied to other settings,” concluded Lammie.
If you would like to read more about the outcomes of this meeting, Breakout Session reports of the discussion details will be shared in October. Please check back to www.cor-ntd.org or subscribe to our newsletter.