On October 8, 2020, Dr. Soro Kountelegona, Chief of Staff of the Ministry of Health of Côte d’Ivoire, did something that represents a milestone in the fight against neglected tropical diseases (NTDs) in West Africa. He convened a high-level meeting of representatives of various ministries in the Government of Côte d’Ivoire’s cabinet and presented a draft of the 2021–2023 national neglected tropical diseases sustainability plan to the cabinet as well as international and other national stakeholders for political validation, endorsement, and adoption.
In attendance were representatives from the Ministries of Education, Agriculture, Environment, Animal and Fishery Resources as well as multiple Ministry of Public Health and Hygiene programs and directorates, including malaria and nutrition, among others). Among the international stakeholders in attendance were USAID/Côte d’Ivoire; the World Health Organization/Côte d’Ivoire; and the United Nations Food and Agriculture Organization/Côte d’Ivoire.
Why an NTD sustainability plan?
The NTD sustainability plan is an initiative of the country’s Neglected Tropical Diseases Program (NTDP), founded in 2016 within Côte d'Ivoire’s Ministry of Health. In 2019, Côte d’Ivoire’s NTDP started developing a plan to sustain the gains that the country has made in the fight against NTDs, with support from USAID’s Act to End NTDs | West Program, led by FHI 360 and partners Deloitte Consulting and Helen Keller International. The plan aims to ensure that NTD activities are included in Côte d’Ivoire’s national policies, strategic planning, and health financing. It also envisions adding NTD indicators into health sector performance monitoring.
Minister of Public Health and Hygiene Dr. Eugène Aka Aouélé has expressed the Government’s support for the plan. “The political will that was exerted through development of Côte d’Ivoire’s NTD sustainability plan will be supported with government financing. This effort, which engaged stakeholders across different sectors—including education, nutrition, hygiene, agriculture, water, and sanitation—and mobilized strong community participation, demonstrates a key step towards sustainability of NTD achievements,” he said.
Because many stakeholders have a role to play in sustaining NTD control, including multiple sectors of the government as well as the private sector, having a politically validated NTD sustainability plan can help to align efforts and avoid missteps. Without a plan, national budget processes may neglect to allocate resources to fund activities necessary to end NTDs, for example, or the water and sanitation sector may develop infrastructure improvement priorities without considering the implications of water and sanitation on NTD prevalence.
Sustaining Côte d’Ivoire’s progress on NTDs
Under the leadership of the NTDP, Côte d’Ivoire has begun to see encouraging results from the implementation of mass NTD treatments, case management, and other strategies. For example, the number of school-age children treated for soil-transmitted helminthiases almost tripled between fiscal year 2016 and fiscal year 2019, increasing from 794,397 to 2,205,220 over the space of just four years.
Sustaining these results over the medium- and long-term has been a concern, however, Dr. Kountelegona noted. “When NTD elimination and control goals are achieved, the major challenge will be to sustain the gains," he said.
Although international donors have supported NTD programs for many years, Côte d’Ivoire’s NTDP knows that such support may not last. Thus, the NTDP is actively taking steps to reduce program reliance on outside donors, and the 2021–2023 national NTD sustainability plan is an important tool for securing political commitment at the highest levels of the government for NTD program sustainability.
Meant to be an actionable roadmap, the sustainability plan will guide the country toward integrating NTD activities into financial planning and operations across government sectors. The plan includes a detailed list of interventions and activities to achieve this integration. For example, ensuring that deworming and morbidity management services are provided through existing and emerging community and health facility platforms is on Côte d’Ivoire’s list of NTD activities that are slated for integration into health sector operations. Likewise, introducing NTD data and indicators into national information systems and databases will facilitate the inclusion of NTD activities in financial planning across government sectors. As such short-term objectives are achieved, partners will assist the NTDP in addressing long-term priorities on the path to NTD sustainability.
Next steps for sustainability
Côte d’Ivoire’s achievement in obtaining the political endorsement of the national 2021–2023 NTD sustainability plan demonstrates the country’s commitment to sustainable solutions for the fight against NTDs. Having obtained political endorsement, the Côte d’Ivoire NTDP’s next step is to disseminate the plan to the regional and district levels of the health sector as well as to other relevant sectors and to begin integrating priority NTD activities into the operational plans of each sector at every level.
Dr. Kountelegona called on stakeholders from every sector to support this process at the October 8th meeting. “Sustainability requires a multisectoral approach and integration of interventions at all levels of the health pyramid,” he said. “it is also important to involve civil society, religious leaders, NGOs, women's associations, and others to mobilize, disseminate and implement the strategy.”
USAID’s Dr. Lowenthal congratulated the Government and partners for the results achieved to date in the fight against NTDs in Côte d’Ivoire, which attest to both their collaboration and commitment, she said. “The decisive leadership demonstrated by the national authorities at the highest levels of Government will not only help to stop the chain of [NTD] transmission, but also and above all, will improve the well-being of all Ivoirians.”