On Sunday 28 January 2018 at the 30th African Union summit, the African Leaders Malaria Alliance (ALMA) added neglected tropical diseases (NTDs) to its annual scorecard on disease progress. The scorecard is personally reviewed by African heads of state every year, putting NTDs alongside malaria and maternal and child health as top health priorities for the continent. By adding NTDs to the scorecard, African leaders are making a public commitment to hold themselves accountable for progress on these diseases.

“Improving the health, education and productivity of our poorest citizens by eliminating NTDs can put Africa on the path to prosperity and universal health coverage”

His Excellency, Prime Minister of Ethiopia, Hailemariam Desalegn

We collaborated with the World Health Organization on this NTD progress index for the ALMA scorecard. The index provides an overview of a country’s progress in reaching people in need of mass treatment. Country-specific recommendations on how they can improve their coverage were included and these will be monitored every 3 months to track progress and identify bottlenecks.

NTD mass treatment coverage index for African countries

Country by country

How the index is calculated

The index is an average of coverage across the diseases endemic in your country that are amenable to mass treatment, calculated using the geometric mean.

By using the geometric mean for the index, it prevents high coverage of one disease compensating for very low coverage of other diseases. This provides countries with a sense of how well they are delivering integrated treatment across diseases.

The methodology used is comparable to WHO’s proposal for a Universal Health Coverage (UHC) index. It can, therefore, help to monitor equity in progress towards UHC, making sure that the least well-off are prioritised at every step.

Progress in Africa

40 million more people were reached with preventive treatment for at least one NTD in 2016 than in 2015 Over 50% countries improved their mass treatment coverage index between 2015 and 2016 Togo was certified by the World Health Organization as eliminating lymphatic filariasis

While most data points to progress, the scorecard shows areas that need improvement. Nearly two-thirds of countries have an NTD coverage index of less than 50%. The percentage of affected countries implementing disease-specific interventions ranges from 92% for trachoma to just 72% for schistosomiasis, suggesting that there is still much more to do.

Recommendations

To overcome these challenges and defeat these NTDs, we have provided countries and the African Union with a set of recommendations. Country-specific recommendations are available in the country profiles.

African Union recommendations

40% of the global NTD burden is in Africa. However, out of the 17 countries that have been validated as having eliminated one of the five diseases, only two are from Africa (Morocco [trachoma, 2016] and Togo [lymphatic filariasis, 2017]).

The World Health Organization has set a target of eliminating at least one NTD in 30 additional countries by 2023. This presents the African Union with an opportunity to take the lead on delivering this goal and support the broader SDGs.

To achieve elimination of NTDs in Africa, we encourage the African Union to:

  • Establish a task force on NTDs at the African Union
  • Set up a fund for neglected tropical diseases at the Africa Union
  • Regularly monitor and report on progress on neglected tropical diseases
  • Recognise and celebrate countries as they achieve elimination goals
  • Support the Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN) established by WHO AFRO region for the elimination of these five diseases