Health workers distribute medicines during a mass drug administration campaign in 2020. The campaign was aided by new standard operating procedures for NTD drug management, developed with support from PATH and ADP. Photo: National Program for NTD Control.
“You cannot think of development without your health,” says Dr Ndeye Astou Badiane, a public health specialist with PATH in Senegal.
Like many countries, neglected tropical diseases (NTDs) are holding back Senegal and its people from reaching their full potential.
NTDs are a group of communicable diseases that affect more than 1 billion people around the world. They often affect the most vulnerable communities, with harmful consequences for not only health but also social and economic development.
“Even though prevalence is lower than with malaria, TB or HIV, for example, these are diseases that prevent people from working, from going to school, from having a quality life,” explains Dr Badiane. “This is why we are really striving to help create a Senegal that is free of NTDs.”
Some of the most problematic NTDs in Senegal are trachoma, lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiasis, leprosy, rabies, dracunculiasis, leishmaniasis and dengue.
To aid the national response, PATH collaborated with the National Program for NTD Control of the Ministry of Health and Social Action, the World Health Organization (WHO), FHI 360, Sightsavers and other technical partners, to jointly develop a Manual of standard operating procedures for NTDs drug management during mass drug administration in Senegal. The initiative is part of PATH’s role in the UNDP-led Access and Delivery Partnership (ADP).
“These SOPs will be crucial tools to improve the overall management of medicines used in mass drug administration activities for NTDs,” says Dr Badiane. “They will contribute to creating a highly effective and efficient supply chain and ensure that medicines are both available when and where needed, and are of high quality.”
Mass drug administrations (MDAs) are essential for effectively controlling NTDs, and involve providing treatment to an entire population (within a specified area), regardless of whether they are infected with the target disease or not. By doing this on a regular basis, it can effectively curb transmission throughout the population.
However, MDAs are complicated operations and need strict protocols in place to run efficiently and achieve their goals. The new SOPs cover a total of 12 operational areas, including medicines transportation, stocking, waste management and pharmacovigilance. For each step, required actions, responsibilities, operating modes and deadlines are specified.
The SOPs are intended for use by personnel from the National Program for NTD Control working on logistics and programmatic functions at each level of the health system including at the National Supply Pharmacy, Direction of Pharmacy and Medicine as well as individual health workers and pharmacists at the operational level.
The manual was piloted, and proved to be crucial, during an MDA campaign in 2020 targeting schistosomiasis, lymphatic filariasis, onchocerciasis and helminthiasis in 47 districts. It helped improve efficiency and availability of medicines in health facilities during the campaign, and also contributed to reaching targets for therapeutic coverage in all affected health districts throughout the country.
By following the procedures outlined in the SOPs, it is expected that over time there will be significant savings and reductions in medicines wastage – which is increasingly essential in the resource-scarce COVID-19 environment.
“These SOPs have enabled us to considerably reduce medicines wastage compared to previous years. In addition, we saved time and financial resources dedicated to transportation and distribution because of the increased efficiencies and better planning,” said Dr Boubacar Diop, Pharmacist and Head of Procurement and Stock, Directorate of Disease Control. “It’s really essential that we invest in improving our medicine supply chain management – medicines are crucial, and without them there is no campaign.”
The new SOPs for NTD drug management during MDAs was developed in response to specific recommendations from WHO, and is in accordance with the Ministry of Health and Social Action Strategic Plan 2018–2029, as well as the WHO Roadmap for neglected tropical diseases 2021–2030.
This year, plans are in place to develop a related training guide for personnel on how to use the various management tools included in the manual, and a five-year medicines procurement plan that will help to strengthen resource planning and identify resource mobilization needs.
Given the positive reaction thus far to the new SOPs manual, PATH and partners at ADP are exploring the possibility of replicating this approach in other countries of the region.