Control & elimination

Commitment to NTD control has increased in recent years, including periodic deworming campaigns with safe, cheap drugs.

International commitment to NTD control

Recent years have witnessed an unprecedented commitment to the control of neglected tropical diseases, with a specific emphasis on the integration of mass drug administration (MDA) programmes.  The main commitments include:

  • In January 2012, the World Health Organization published a roadmap for implementation detailing its vision for control, elimination and eradication of NTDs, including a series of global, regional and country goals to be reached by 2020.

  • On the same month, global health organizations, donors and pharmaceutical industry leaders endorsed the London Declaration on Neglected Tropical Diseases.
  • NTD endemic countries have developed multi-year integrated NTD plans and have begun to allocate funds to NTD control.
  • In January 2013, WHO published its second report on NTDs, which outlined the progress made towards the 2020 goals.
  • In May 2013, the World Health Assembly adopted a comprehensive resolution on all 17 neglected tropical diseases (WHA66.12)

Worm control

Worms can be effectively controlled by periodic chemotherapy (deworming) with safe, cheap and single-dose drugs. Treatment should ideally be implemented alongside improvements in sanitation and health education. Deworming can improve children's growth and benefit their learning by increasing primary school attendance. Even though re-infection may occur after treatment, the risk of developing chronic or severe disease is greatly diminished and even reversed when treatment is initiated in childhood.

For STH and schistosomiasis, the World Health Organization (WHO) identifies three key groups for mass treatment: school-aged children, pre-school children and pregnant women. In communities where infection is common, all individuals at risk of infection should be offered treatment. 

School-based deworming

School-aged children typically have the highest intensity of worm infection of any age group, with significant consequences for their health and development. However, much of this morbidity can be rapidly reversed by treatment. School-aged children are therefore key targets for mass treatment, or deworming.

The most cost-effective way to deliver deworming regularly to such children is through schools. These offer a readily available, extensive and sustained infrastructure with a skilled workforce that is in close contact with the community.

Community directed treatment

Treatment for LF and onchocerciasis is typically implemented through community structures, using community drug distributors. The success of the African Programme for Onchocerciasis Control (APOC), the first NTD programme to benefit from a substantial drug donation, has been attributed largely to its public private partnership model, and the use of community volunteers to deliver treatments. The same approach is successfully used by LF control programmes. 

  • Drugs for STH

    The main drugs recommended by WHO for treatment of STH are albendazole and mebendazole. They are administered as a single tablet to all children, regardless of size or age. One pill can cost as little as US$0.02.

    GlaxoSmithKline has committed to donating 400 million doses of albendazole every year until 2020 whilst Johnson & Johnson is donating 200 million doses of mebendazole per year.

  • Drugs for schistosomiasis

    The drug of choice to treat schistosomiasis is praziquantel, which is on average US$0.20 per treatment for a school-aged child. Praziquantel is given as a single dose, but the number of pills has to be adjusted to the size of the child. The preferred method for adjustment in schoolchildren is an inexpensive 'dose-pole' that uses the height of the child to estimate the dosage.

  • Drugs for LF

    The main strategy for reducing LF transmission is annual MDA of entire populations at risk of infection for at least five years. Vector (mosquito) control is also sometimes effective.

    Two pharmaceutical companies, GlaxoSmithKline and Merck, made a pledge to donate albendazole and ivermectin, respectively, to help eliminate LF. GSK's commitment is a donation of 1 billion albendazole tablets every year until 2020, while Merck has pledged to donate as much ivermectin as necessary to eliminate LF as a public health problem.

     In 1997, WHO classified LF as eradicable or potentially eradicable.