WORKING GROUP ON CAPACITY STRENGTHENING FOR NTDS

Prof. David Molyneux

OUTLINE OF PRESENTATION

Overall Objectives of Working Group on Capacity Strengthening 2012 Recommendations: Progress & Challenges Second Report of WG CS, 9 – 10 January 2014

Four key outcomes Other highlights

Key issues Regional needs & priorities Country needs & priorities

Recommendations WG CS work plan 2014 Recommendation for STAG endorsement

OBJECTIVES OF THE WG-CAPACITY STRENGTHENING (CS)

1. Identify existing CS efforts 2. Recognize gaps in CS efforts and prioritize short-term and long-

term needs 3. Advise, standardize and support the implementation of training

curricula to strengthen managerial and technical capacity for NTD control

4. Harmonize partners’ efforts and increase their contribution to fill identifiable gaps, qualify monitoring and assess CS products.

2012 STAG RECOMMENDATIONS: CHALLENGES EXPERIENCED

1. Prioritize capacity strengthening in order to achieve the Roadmap’s goals. Challenges for resource allocation scale-up coverage vs. scale-down, both

very resource intense with 2015 milestone.

2. Harmonize partners’ activities towards capacity strengthening and Roadmap’s goals.

Efforts made with RTI/ENVISION, Sight Savers, Children Without Worms, Save the Children, Deworm the World etc.

3. Focus capacity strengthening on ‘mega countries’ to reduce the implementation deficit at all levels, especially at including district level; large volume of work.

350 million implementation preventive chemotherapy deficit in ~2,200 districts in five countries (Ethiopia, DR Congo, Nigeria, Tanzania, Indonesia)

Example: Nigeria (123 million deficit) accounts approx. 35% of PC global deficit, which is also approx. 45% of AFRO PC deficit

4. Utilize most appropriate available technologies (eLearning and NTD app)

Financial and legal impediments

5. Maintain the CS momentum through ongoing technical focus, e.g. monitoring and evaluation, transmission assessment surveys, and managerial and advocacy skills.

Low capacity for most Regional offices' engagement Partners leading field activities, not WHO country offices

6. Examine needs for CS beyond PC – for integrated vector management, intensified disease management and neglected zoonotic diseases during 2013–14

Inventory is ongoing

2012 STAG RECOMMENDATIONS: CHALLENGES EXPERIENCED

SECOND REPORT OF WG CS, 9 – 10 JANUARY 2014

FOUR Key achievements/outcomes1. Meeting on development and roll-out of a standardized

district level management NTD training course, July 2013 Input from AFRO, APOC, AMRO, NTD partners, EPI-WHO/UNICEF Ongoing development of course: 10 modules, for 3 day training Inventory of Regional office CS priorities (see Report) Inventory of "mega countries" CS priorities (2-page summary)

2. Developed simplified protocol for training needs assessments Used for Opinion Survey of programme managers in AFRO Implemented by FMOH/WHO Nigeria Detailed reports available

AFRO National Programme Managers training needs survey

State level NTD Programme managers training needs assessment

A SAMPLE OF RESULTS FROM NTD-CS TRAINING NEEDS ASSESSMENTS

Triggered partners to collaborate and coordinate support for training of State level Programme managers in Nigeria

TRAINING OF STATE LEVEL NTD PROGRAMME MANAGERS NIGERIA, 3 – 8 FEBRUARY 2014

1) All 36 States and FCT sent a State level NTD programme manager and M&E officer/Data manager to attend the training. 2) Four NTD programme zonal coordinators, NTD disease focal points at FMOH and their respective data managers were also trained.• In total more than 120 individuals trained• More than 220 kgs of guidelines distributed.

Financial & logistical support through;• RTI/ENVISION• Sight Savers

3. Strengthening Laboratory network for NTDs Undertook a scoping study Q4 of 2013 (AFRO ongoing until end of April 2014) 162 identified labs; only 22 Reponses (13%)

SECOND REPORT OF WG CS, 9 – 10 JANUARY 2014

Key findings: • 50% of the laboratories employ fewer than 10 staff. • More than 70% employ scientists and researchers • nearly one-third of the laboratories lack key human resources. • Each of the 17 NTDs was covered by at least one laboratory • Majority of laboratories (77%) covered two or more NTDs.• Only three laboratories (14%) fulfilled all three RRL criteria (training, QA and external interactions).

4. The NTD TOOLBOX – β version a virtual repository of operational guidelines,

documents, photographs and videos that allows easy, fast and user-friendly searching for protocols, guides, manuals and training courses, among others.

500+ items included WHO/NTD operational guidelines, training documents,

videos WHO/TDR guidelines WHO/Regional offices operational guidelines Some NTD partners:

Target audience programme managers personnel at national & subnational levels

Off-line: DVD format Online: WHO Website, (Apps – pending WHO legal) Specific acknowledgement:

AMRO/PAHO vital collaboration & contribution to this work

SECOND REPORT OF WG CS, 9 – 10 JANUARY 2014

Accessible TODAY via the WHO/NTD Department website:http://www.who.int/neglected_diseases/ntdtoolbox

OTHER HIGHLIGHTS REPORTED

Several ongoing NTD-CS and training activities other units: IDM prioritizes treatment monitoring and drug

resistance surveillance, proper drug administration and surveillance, evaluation and use of diagnostic tests

NZD strategy requires intersectoral collaboration and capacity across different disciplines

VEM emphasize the need for entomological surveillance and monitoring for insecticide resistance.

Long-term training courses – Diploma in applied parasitology and entomology (Malaysia); Master’s degree programs (Benin, Pakistan, Sudan, India, UK)

Short-term courses – IVM workshops; dengue workshops (Cuba, Singapore)

Area-specific courses – management of public health pesticides (e.g. Cape Town University)

The WHO Integrated Management of Adult Illness (IMAI) District Clinician Manual (DCM), which includes NTDs Neglected tropical diseases modules could be added to

clinicians case management training at district levels WHO/NTD needs to support country adaptation processes

(ongoing)

Several training initiatives by NTD partners RTI/ENVISION - Grants management training, Media

training, job aides, support for implementation of technical training workshops

Sight Savers - integral role in the Global Trachoma Mapping Project (GTMP), technical assistance in drug supply chain management, health systems planning and management

OTHER HIGHLIGHTS REPORTED

Involving TDR Research Training Centers as regional hubs to identify and support training needs• taking in consideration local/regional health priorities • by embedding Implementation /Operational Research within routine

disease control programmes

Examples: Introduction of good health research practices to strengthen capacities:

national reference laboratories and peripheral laboratories to detect antimicrobial resistant strains;

monitor drugs safety and efficacy in the target populations Integrated case management for vector borne diseases including

improved case detection and management, provision of bed-nets…

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WHO/TDR input: Example of potential collaboration with national NTD programmes

REGIONAL AND COUNTRY NTD-CS PRIORITIES

Regional levels – Table 1 (see WG CS 2014report, pages 5 & 6) Human resource constrained Diverse technical focus: Example - WPRO/Pacific vs. AFRO Scope & complexity of humanitarian emergencies: EMRO, WPRO (Typhoons)

Country levels - Mega countries priorities (see 2 page summary)FIVE specific and clear needs for: 1. Advocacy & Sensitization at all levels2. Trainings, especially at district and peripheral levels: need for specific technical tools;

field guides, integration & coordination aides3. Additional finances: national master NTD plan funding gaps especially for training &

medicines delivery4. Human resources; high staff turnover, dormant or no coordination committees at national

& district levels, incentives for peripheral health workers, incentives to retain current NTD staff

5. Context-specific strategies for hard-to-reach populations: large distances, difficult terrain (islands, dense forests), humanitarian & complex emergencies affected populations.

Examples: DR Congo, (Nigeria), Indonesia, (South Sudan),

WG-CS 2014 RECOMMENDATIONS

1. Compile a comprehensive inventory of existing NTD training courses & resources for all NTDs

make this available to public encourage all NTD stakeholders to participate

2. Support implementation of WG CS Work plan 2014 Training courses and workshops: regional adaptation in response to regional priorities,

country adaptation of IMAI guidelines etc. Strengthen network and capacity of training centres: KEMRI, NOGUCHI, others Implement Phase II of laboratory strengthening activities

3. Promote eLearning platforms and tools Field-test and evaluate use of NTD toolbox Regularly update toolbox library

4. Harmonize field-guides, job aides and training materials in use5. All the above are directly dependent on effective mobilization of

sufficient resources for Capacity Strengthening for NTD programmes

RECOMMENDATION FOR NTD STAG ENDORSEMENT

1. Call for sufficient mobilization of human and financial resources for Capacity Strengthening for NTD programmesI. Acknowledge the vast scope and scale of capacity strengthening activities

that need to be implemented in order to achieve the NTD roadmap goalsII. Provide dedicated NTD staff and required financial resources to empower

WHO's coordination and leadership role in CS activities at; WHO/NTD department, HQ WHO Regional offices WHO Country offices – particularly for the high-burden priority countries

III. Draft a comprehensive strategy for Capacity strengthening in support of NTD roadmap goals, and beyond;

CS resource mapping by all NTD stakeholders Scheduling of CS activities by type, in support of national NTD programmes Include CS evaluation plan against NTD roadmap timelines Pro-active engagement of the academic sector for longer term capacities

FAVOURABLE POLICY ENVIRONMENT-PLATFORM FOR POST 2015

World Health Assembly Resolution following Executive Board Resolution-first on NTDs-WHA 66.12

Regional Resolution from the WHO/AFRO Region, Brazzaville September, 2013

Cameron et al Post 2015 Development Report include NTDs on Health targets with HIV, TB and malaria

THANK YOU