Our NTD experience will be invaluable for COVID vaccine rollout

Restarting the distribution of neglected tropical disease (NTD) preventative treatments in Africa can teach us a lot about the rollout of a COVID-19 vaccine.

The battle to deliver vaccines for COVID-19 around the world is on. We’ve only just begun, but the true complexity of the task ahead as well as the consequences of not reaching everyone, or ‘leaving no-one behind’ – so familiar to those working to tackle NTDs – has taken on a new relevance.

‘Leave no-one behind’ – reaching everyone, everywhere no matter how remote – is vital to fighting NTDs because by their nature they tend to affect the most marginalised and isolated communities. For decades, those working in NTDs have had to hone their skills at reaching out to communities which traditionally have been neglected – not just as a moral imperative but an epidemiological one.

An estimated 1.7 billion people around the world are affected by an NTD, a group of 20 plus diseases which – while easily treatable and preventable – can cause debilitating levels of pain and disability and can stop people from going to school or being able to work.

The campaign to prevent, treat and eliminate NTDs has been a decades-long exercise in organisation, cooperation, monitoring, and mitigation. It has also given us robust links to communities who themselves are working to control and eliminate NTDs. It has taught us a lot about how to treat and prevent infectious bacterial diseases which spread through environmental and human contact, as well as how to meet the challenge of reaching everyone.

Most recently, it has also taught us how to mitigate the risks of working in the middle of a pandemic. And we’ve done it! Despite the challenges of COVID-19 over the past year we have forged ahead. We have supported the delivery of over 35 million antibiotic treatments across 11 countries in west and central Africa, with millions more treatments due to be delivered over the next few months. We have also supported COVID-19 preventative messaging with a behaviour change campaign which reached millions of people across Africa.

Lessons learned

Some of the lessons we have learned, which may become invaluable as the vaccine is rolled out, include:

Governments must be in the driving seat. If programmes are to be successful and sustainable, they need to be supported and often delivered by each country’s ministry of health. Before a programme starts, we ensure that the country can support supply chains for the safe delivery of antibiotic or antiparasitic treatments and surgical equipment to communities at risk.

Co-operation is central. No one organisation can deliver medical treatment on the scale needed to eliminate disease on their own. Supporting governments, as well as collaborating with partners, multilateral organisations, drug companies, other NGOs and researchers, has been essential to tackling NTDs.

Excellence in organisation is the cornerstone of any treatment distribution. Delivering treatments internationally, across vast geographic expanses and remote areas, requires systematic processes and a microscopic attention to detail. The human logistics of drug distribution take on even greater complexity at ground level. Delivery in the community also involves managers, various cadres of public health workers, volunteers, data experts, village leaders and more. Many of these groups need to be trained in developing and implementing policies, processes, and the quality control checks required to successfully deliver billions of treatments each year.

Working with communities is vital. Getting buy-in from the communities to which we are distributing is essential for successfully rolling out any medical treatment. Over decades, NTD programmes have involved the mobilisation of millions of community health workers – many of them volunteers – to deliver treatment. Most of these health workers live and work in the same community, which is crucial for gaining the trust of its members.