NTD News 2021

ISSUE NO. 14 | JANUARY TO DECEMBER 2021 Malaria and neglected tropical diseases WHO Western Pacific Regional Office Email: wpromvp@.who.int NTD News NEGLECTED TROPICAL DISEASES NEWSLETTER An MDA campaign against schistosomiasis was conducted in the Khong and Moulapamok districts of Champasack province in November and December 2021. Efforts to provide essential health services were continued to ensure the performance of the comprehensive health system during the COVID-19 pandemic. Health centre staff strictly observed COVID-19 precautions for infection, transmission and hygiene in providing deworming medicine during household visits, a different approach from last year’s mass gathering deworming campaign. 2 Western Pacific Region Neglected Tropical Diseases Western Pacific Region Neglected Tropical Diseases 1 NEWS FROM MEMBER COUNTRIES Cambodia Provinces endemic for schistosomiasis are Kratie and Stung Treng along the Mekong River. Around 100 000 people live in these endemic provinces and are at risk of infection. Regular mass preventive chemotherapy is the cornerstone of schistosomiasis control in Cambodia. With the implementation of mass drug administration (MDA) since 1995, the prevalence of schistosomiasis in four sentinel site villages has dropped dramatically from 80% in 1995 to less than 1% by 2020. In October 2021, teams visited 18 sentinel and spot- check villages in Kratie and Stung Treng provinces to assess infection status and conduct MDA for Schistosoma mekongi and soil-transmitted helminthiasis. The prevalence of schistosomiasis and soil-transmitted helminthiasis in these selected villages was very low, with one case from the four sentinel site villages in Kratie infected with S. mekongi. However, there were 11 new sentinel villages in Kratie province where S. mekongi was found. Fiji Fiji continues its efforts against neglected tropical diseases (NTDs). Nationwide activities for trachoma, lymphatic filariasis (LF) and scabies were conducted in 2021. Lymphatic filariasis morbidity equipment is ready to be shipped to Kiribati in partnership collaboration with WHO, Japan International Cooperation Agency (Junko Otaki of JICA Fiji office) and the Ministry of Health. (Credit: Fiji Ministry of Health) Infection status assessments and mass drug administration for Schistosoma mekongi and soil-transmitted helminthiasis were conducted in 18 sentinel and spot-check villages in Kratie and Stung Treng provinces in October 2021. (Credit: Cambodia Ministry of Health) MDA and health education in schistosomi- Community screening for trachoma in partnership with Project HEAVEN (Credit: Fiji Ministry of Health) Online skin consultation with stakeholders of the World Scabies Program, WHO, Fiji Ministry of Health and dermatology experts in October 2021 (Credit: Fiji Ministry of Health) Storage container sent to Fiji from WHO to address MDA storage and shipping needs (Credit: Fiji Ministry of Health) French Polynesia In February 2021, the French Polynesia Ministry of Health conducted the Transmission Assessment Survey (TAS) 3 among children aged 6 and 7 years in urban areas of Tahiti. Of the 1188 children who participated in the survey, only two tested positive with the Filariasis Test Strip. Windward urban Tahiti passed TAS 3 in March 2021. TAS 2 in a Windward urban area (Tahiti Nui), French Polynesia, March 2021 (Credit: French Polynesia Ministry of Health) 2 Western Pacific Region Neglected Tropical Diseases 3Western Pacific Region Neglected Tropical Diseases The French Polynesia Ministry of Health implemented an MDA campaign against LF using a combination of diethylcarbamazine and albendazole in October and November 2021. The campaign was conducted in two units (the island of Huahine and three islands of the Southern Marquesas: Hiva Oa, Fatu Hiva and Tahuata). The Ministry of Health is pleased to announce the MDA campaign’s success with a coverage of 92% for the population of Huahine and 70% for Southern Marquesians. Lymphatic filariasis MDA campaign ambassadors in Huahine, October - November 2021 (Credit: French Polynesia Ministry of Health) From November 2021 to February 2022, the Ministry of Health conducted TAS 3 in rural zones of Tahiti Nui and Tahiti Iti, and in the rest of French Polynesia (Moorea, Northern Marquesas archipelago, Australs, Tuamotu- Gambier). Data analysis is ongoing, and results will be shared once finalized. TAS 3 in Ua Pou, Northern Marquesas, November 2021 (Credit: French Polynesia Ministry of Health) Lao People’s Democratic Republic The Ministry of Health integrated the newly finalized health education package on rabies prevention and control into the teaching curriculum in Xayabouly province. In March 2021, a team from the ministries of health, education and sport, and agriculture conducted a monitoring visit to assess the pilot integration of rabies lessons into the teaching curriculum in primary and secondary schools. The assessment team tested 313 students on their knowledge and understanding of rabies prevention. It noted a positive result; 92.0% of students had knowledge of rabies prevention compared to 58.7% before integrating the health education package on rabies prevention and control. Monitoring visit in Xayabouly province, Lao People’s Democratic Republic, March 2021 (Credit: Lao People’s Democratic Republic Ministry of Health) In April 2021, the Ministry of Health and the Food and Drug Department conducted a meeting in Vangvieng, Vientiane province to revise the school deworming implementation programme guidelines. After careful planning and a review of the guidelines, they agreed the Food and Drug Department would take responsibility for packing and delivering medicine from the provincial to the district level, facilitating the efficient distribution of deworming drugs to different schools. Monitoring visit in Xayabouly province, Lao People’s Democratic Republic, March 2021 (Credit: Lao People’s Democratic Republic Ministry of Health) 4 Western Pacific Region Neglected Tropical Diseases Western Pacific Region Neglected Tropical Diseases Development of guidelines on using the rabies vaccine in humans, August 2021 (Credit: Lao People’s Democratic Republic Ministry of Health) TAS 3, November 2021 (Credit: Lao People’s Democratic Republic Ministry of Health) Schistosomiasis deworming in Khong and Moulapamok districts of Champasack province, November and December 2021 (Credit: Lao People’s Democratic Republic Ministry of Health) The Ministry of Health conducted TAS 3 for LF in November 2021. A total of 1532 samples were collected from students in grades 1 and 2. No positive Filariasis Test Strip results were identified during the survey in Attapeu province. An MDA campaign against schistosomiasis was conducted in the Khong and Moulapamok districts of Champasack province in November and December 2021. Efforts to provide essential health services were continued to ensure the performance of the comprehensive health system during the COVID-19 pandemic. Health centre staff strictly observed COVID-19 precautions for infection, transmission and hygiene in providing deworming medicine during household visits, a different approach from last year’s mass gathering deworming campaign. Malaysia The Ministry of Health conducted Pre-Transmission Assessment Survey (Pre-TAS) and TAS 1 activities in the Debak subdistrict in April and July 2021, respectively. Both surveys, with 1009 slides and 311 samples, had no positive results. Nauru In July 2019, the Ministry of Health’s national trachoma prevalence survey confirmed the endemicity of trachoma in the country. The survey prompted a series of activities for trachoma elimination, such as the Trachoma Survey Refresher Training on 29–31 March, facilitated by The Fred Hollows Foundation Australia and WHO, followed by a nationwide MDA campaign in August 2021. Quarterly NTD meetings were held in March and June 2021. The meetings were chaired by the director of the Department of Communicable Disease Control and attended by the NTD task force. The meetings aimed to identify priority activities that could be undertaken during the COVID-19 pandemic, such as: (1) training of school health task force from all provinces before restarting school deworming activity in October 2021; (2) conducting the final transmission assessment survey in Attapeu province; and (3) conducting an MDA campaign against schistosomiasis. In August 2021, the Department of Communicable Disease Control organized a meeting in Thalath, Vientiane province to develop the rabies vaccine guidelines. Participants included representatives of the National Immunization Programme, selected district hospitals and central hospitals. The meeting was chaired by the deputy director of the Department of Communicable Disease Control. The next step will be to design the cover and get approval from the director of the Department of Communicable Disease Control/Department of Hygiene and Health Promotion. 4 Western Pacific Region Neglected Tropical Diseases 5Western Pacific Region Neglected Tropical Diseases Philippines Despite the ongoing COVID-19 response activities within the Philippines, the country remains steadfast in addressing NTDs. As to not waste the initial efforts and the continuing release of issuances, such as the establishment of the Dengue Centers of Excellence, the conduct of dengue mortality review training, monitoring and evaluation tool, and the lead country for the conduct of the 2021 Association of Southeast Asian Nations (ASEAN) Dengue Day Forum and LF elimination activities. In 2018, the Department of Health, in collaboration with WHO, conducted a capacity-building mission with the primary aim of reducing the dengue case fatality rate. One of the recommendations was to establish Dengue Centers of Excellence (COEs) in tertiary hospitals. Within five years, the COEs aim to improve dengue clinical management and reduce the dengue case fatality rate below 0.1%, which will turn into better health service delivery. The COEs aim to improve the management of dengue in terms of absorptive capacity, equipment and human resources. Ultimately, each COE is expected to transition into a facility capable of conducting research, generating evidence-based best practices, recommending policies, proposing clinical health advocacies, and providing capacity-building and technical support for its health facility referral network. Trachoma Survey Refresher Training, March 2021 (Credit: Nauru Ministry of Health) Administrative Order No. 2021-0009 - Guidelines for the Establishment of Dengue Centers of Excellence (COEs) in Tertiary Hospitals Recorders test during the virtual training for trachoma, 31 March 2021 (Credit: Nauru Ministry of Health) Trachoma MDA campaign, August 2021 (Credit: Nauru Ministry of Health) 6 Western Pacific Region Neglected Tropical Diseases6 Western Pacific Region Neglected Tropical Diseases On 22 and 29 April 2021 and 21-22 July 2021, the National Aedes-borne Viral Diseases Prevention and Control Program (NAVDPCP), in collaboration with the University of the Philippines – Philippine General Hospital, conducted the Virtual Training on the Conduct of Dengue Death Review among Hospitals in the Philippines-Health System Operation. The training emphasizes the implementation of early case detection and referral systems for patients, managing severe cases with appropriate treatment, reorienting health services to cope with dengue outbreaks, and training health personnel at all health system levels. Mortality from dengue is highly preventable by implementing timely and appropriate clinical management, which involves early clinical and laboratory diagnosis, intravenous rehydration, staff training, and hospital reorganization. In addition, to achieve expertise in the clinical management capacity of dengue nationwide, the continuation of the training mentioned above is necessary. The training components consist of a Self- Study Module on Data Extraction in Dengue Mortality Review and the Standard Operating Procedures for Analysis of the Dengue Mortality Review. Participants ranged from Infectious Disease Cluster heads, NAVDPCP coordinators, Regional Epidemiology and Surveillance Unit coordinators, medical officers, medical technologists, nurses, dengue point persons, and infectious disease officers. Virtual training for dengue mortality review, 29 April 2021;8:00-5:00, via Zoom (Credit: Philippines Department of Health) Draft training modules for dengue mortality reviews done in collaboration with the University of the Philippines – Philippine General Hospital Relative to Administrative Order No. 2021-0009, the NAVDPCP developed a corresponding assessment tool to monitor and evaluate the status of the implementation of the guidelines. The timeline for monitoring and evaluating based on the phase of development is as follows: The guide will determine any gaps and challenges encountered during its five-year implementation to identify the appropriate ways forward. The Disease Prevention and Control Bureau, through the Infectious Disease Division, conducted a series of monitoring and evaluation (M&E) activities with the selected level III hospitals (Phase I). Phase I includes the enhancement of service delivery components and the development of a training centre to assess the current status of the implementation of the Administrative Order. These activities provide an avenue for identifying technical and financial support needed for the phased developments and discussing the ways forward for the identified gaps and challenges. In several level III hospitals – San Lazaro Hospital, Philippine Children’s Medical Center, National Children’s Hospital, Southern Philippines Medical Center, Vicente Sotto Memorial Medical Center, Jose B. Lingad Memorial Regional Hospital, and the University of the Philippines – Philippine General Hospital – the M&E activities were conducted from August to December 2021. 6 Western Pacific Region Neglected Tropical Diseases6 Western Pacific Region Neglected Tropical Diseases 7Western Pacific Region Neglected Tropical Diseases Annually, the Philippines hosts the Association of South- east Asian Nations (ASEAN) Dengue Day Forum on 15 June. The theme for this year’s ASEAN Dengue Day Forum was “ASEAN Unite Against Dengue Amidst the COVID-19 Pandemic”. The theme coincided with the ASEAN Member States’ desire to maintain the minimum public health standards and avoid increased transmis- sion of dengue during the COVID-19 pandemic. The Forum served as the platform for sharing knowledge and best practices developed during the pan- demic and how the strategies have shifted to address both dengue and COVID-19, including clinical or public health interventions and vector control management. Representatives from WHO were invited to speak on the “global and regional trends and development in dengue prevention and control.” Conduct of the ASEAN Dengue Day Forum, 15 June 2021; 8:00-12:00, via Zoom (Credit: Philippines Department of Health) Virtual conduct of Phase I monitoring and evaluation of selected level III hospitals, via Zoom (Credit: Philippines Department of Health) In early January 2021, Zamboanga del Norte conducted a routine province-wide deworming activity. The Depart- ment Memorandum Interim Guidelines on the Delivery of Routine Lymphatic Filariasis Mass Drug Administration under the National Filariasis Elimination Program (NFEP) ensured the safe and effective delivery of routine ser- vices during the pandemic. Zamboanga del Norte was able to deworm 777 770 individuals from the 789 906 targets with a coverage of 98.46%. On 7 April 2021, a virtual Pre-TAS and TAS 1 orientation was held for the eight municipalities and one city of Sultan Kudarat. The orientation informed participants of the importance of Pre-TAS and TAS 1 in attaining and sustaining a filariasis-free area. The orientation also provided training on the Filariasis Test Strip (FTS) procedure. Sultan Kudarat municipal health officer, city health officer, public health nurse, Rural Health Unit (RHU) medical technologist, RHU midwife, and barangay health workers attended the orientation. Despite the connection difficulties and problems in the remote areas, the participants were able to find locations with decent internet connectivity, ensuring non-disruption in the orientation and training. The National Program, the regional LF coordinators, partners from the Research Triangle Institute (Act to End East), and the WHO Country Office in the Philippines facilitated the meeting. The participants were informed with programme updates and 8 Western Pacific Region Neglected Tropical Diseases8 Western Pacific Region Neglected Tropical Diseases a short epidemiology principle of TAS and community preparation. The lecture on conducting Pre-TAS and TAS 1 was followed by a demonstration and return demonstration on the FTS procedure among the medical technologies participants. Synchronously, in their respective municipalities and areas, demonstrations of the FTS procedure were carried out online, ensuring medical technologists were ready and capable of performing quality FTS procedures in the surveys. Filariasis Test Strip training with return demonstration for medical technologists, 7 April 2021; 8:00-12:00, via Zoom (Credit: Philippines Department of Health) The online orientation and training were successful, as evident in the passing of Sultan Kudarat 8+1 Pre-TAS activity. The Pre-TAS was held from the last week of April until the first week of May in the three municipalities as sentinel and spot-check sites. The programme issuance of the Department Circular for the Delivery of Routine Services under the National Filariasis Elimination Program (NFEP) during the COVID-19 pandemic provided guidance on conducting and delivering community surveys in accordance with existing infection prevention and control measures against COVID-19. After passing the Pre-TAS and qualifying for TAS 1, Sultan Kudarat optimistically continued the planning and re-orientation the same month. The different municipality’s LF coordinators gave lists of the number of children aged 6 to 7 years old from the selected barangays identified by the survey sample builder. All preparations and necessary logistics are in place for the TAS 1 activity, with everyone looking forward to passing the survey. Online training on the use of ivermectin, diethylcarbamazine and albendazole (IDA) was offered for the municipalities of Kalamansig, Lebak and Palimbang of Sultan Kudarat on 17 June 2021. The regional and provincial LF coordinators attended the online training and orientation, as well as municipal health officers, public health nurses, RHU medical technologists, midwives, and barangay health workers. The training and orientation provided by the Department of Health Central Office provided a venue to discuss the pathophysiology of LF with municipal and barangay coordinators; to recall and explain the different diagnostic techniques for the medical technologist in the three municipalities; and to focus on properly administering preventive chemotherapy to the community and preparation according to the principles of social mobilization for the triple-drug therapy from a Health Promotion Officer. The participants also discussed a Coverage Supervision Tool to monitor and evaluate coverage of MDA. A follow-up training and orientation will be conducted before the actual conduct of the MDA with IDA. The municipalities selected to pilot the IDA will be prepared with information, education and communication (IEC) materials such as flipcharts and billboards to better prepare the community before the actual conduct of the MDA. Sultan Kudarat is ready for the two rounds of IDA MDA and is looking forward to passing TAS 1. IDA online training and orientation, 17 June 2021, via Zoom (Credit: Philippines Department of Health) On 11 March 2021, the Commission on Higher Education (CHED) Chairman J Prospero E De Vera III and the Depart- ment of Health Secretary Francisco T Duque III signed a joint memorandum of agreement that was witnessed by CHED Commissioner Lilian De Las Llagas and Disease Prevention and Control Bureau Medical Officer Leda Hernandez. The Department of Health and CHED joined forces to integrate instruction on NTDs into the pre-service cur- ricula of colleges and universities, thus educating the Philippines’ future health workforce. Courses such as Medicine, Nursing, Medical Technology, Midwifery, and Physical Therapy will teach the latest information on NTDs in the Philippines. Through internships, future health professionals will be given a basic understanding of the NTDs of public health importance. The curriculum, at the same time, will prepare them for the actual situa- tion in the communities they will be working. 8 Western Pacific Region Neglected Tropical Diseases8 Western Pacific Region Neglected Tropical Diseases 9Western Pacific Region Neglected Tropical Diseases A memorandum of agreement to integrate instruction on neglected tropical diseases into the pre-service curriculum of medicine, nursing, midwifery, medical technology, and physical therapy was signed between Department of Health Secretary Francisco T Duque III and CHED Chairman J Prospero E De Vera III on 11 March 2021. (Credit: CHED Philippines) The 2nd Association of South East Asian Nations Lym- phatic Filariasis Virtual Forum was celebrated on 14 July 2021 with the theme: “Ending the Neglect Amidst Dis- ruption, Reset, and Integration – A Community Seizing Opportunity to Meet the LF Goals in the ASEAN by 2030”. The event strengthened the regional response to accel- erate progress toward eliminating lymphatic filariasis by 2025 through advocacy and resource mobilization. It also aimed to update ASEAN member countries on the global and regional status of NTDs, aligned with Sustainable Development Goal 3.3. It was also an avenue to share experiences from communities on lymphatic filariasis elimination responses, which is an NTD in the ASEAN region. 2nd ASEAN Lymphatic Filariasis Forum Banner, 14 July 2021 The National Leprosy Control Program continues its efforts to attain zero disease, zero transmission, zero disability, and zero stigmas towards a leprosy-free Philippines by 2030. On 27 July 2021, the National Leprosy Control Program held a virtual orientation on clinical practice guidelines, clinical pathways and research priorities in collaboration with the Philippine Dermatological Society. Representatives and coordinators from the 17 regions, eight sanitaria, and selected medical centres were in attendance. The objective of the orientation was to enhance the participants’ knowledge of the leprosy clinical practice guidelines and clinical pathways to provide quality leprosy services in various health facilities. A virtual orientation on the modified leprosy elimination campaign (MLEC), leprosy alert response and network system (LEARNS), and post-exposure prophylaxis single-dose rifampicin (PEP-SDR) was prepared in collaboration with WHO through their technical and financial assistance. In partnership with the Culion Foundation, Inc, the virtual orientation took place for Bohol, Nueva Ecija and Pangasinan on 11, 13 and 18 August 2021, respectively. The objectives of the orientation were (1) to discuss with the provincial and municipal front-line health workers of the selected provinces the conduct of the systematic screening of all household contacts of at least 80% of the index cases registered in the past five years in selected provinces; (2) to provide post-exposure prophylaxis to eligible population; and (3) to train the front-line health workers and supervisors by engaging them during the systematic screening campaign. The National Leprosy Control Program, in collaboration with the RITM - Department of Dermatology, conducted a webinar on “Zooming Together Towards a World Without Leprosy” on 28 September 2021. More than 600 participants from the various regions, provinces, cities and municipalities, including partners and other stakeholders, attended the online event. Increasing the knowledge of health workers on providing health services for implementing leprosy control programmes will be of utmost importance in their capability. The Integrated Helminth Control Program (IHCP) conducted a consultation meeting with the 16 Centers for Health Development and the Ministry of Health of Bangsamoro Autonomous Region in Muslim Mindanao (BARMM) on 3 August 2021. The meeting participants discussed and addressed some inevitable gaps and challenges encountered during the initial implementa- tion of Department Memorandum No. 2020-0260 titled, 10 Western Pacific Region Neglected Tropical Diseases “Interim Guidelines on IHCP and Schistosomiasis Control and Elimination Program (SCEP) during the COVID-19 Pandemic”, and its supplemental guidelines, Department Circular No. 2020-0302 titled, “Delivery of Routine Deworming Services under the IHCP during the COVID-19 Pandemic” in 2020 and 2021. Consultation meeting on the conduct of the Integrated Helminth Control Program’s MDA campaign, 3 August 2021; 8:00–12:00, via WebEx Virtual Meeting Platform (Credit: Philippines Department of Health) After a previous meeting with the Knowledge Management and Information Technology Service (KMITS), the Disease Prevention and Control Program, through the IHCP, SCEP and National Filariasis Elimination Program (NFEP), conducted a consultation meeting with the 16 Centers for Health Development and the Ministry of Health BARMM to review and discuss the following: 1) draft integrated guidelines on the implementation of an NTD management information system for schistosomiasis, soil-transmitted helminthiasis and lymphatic filariasis; 2) updates on the NTD management information system provided by KMITS; 3) a consultation meeting on the draft integrated issuances on NTDs. The current direction of the Disease Prevention and Control Program to integrate activities of the various programmes of the Bureau prompted the IHCP, SCEP and NFEP to start integrating policies and issuances with common themes or strategies. The integration efforts resulted in the issuance of two guidelines: 1) Mass Drug Administration for Soil-Transmitted Helminthiasis and Lymphatic Filariasis in Selected At-Risk Groups; and 2) Guidelines on the Adjusted Frequency of Mass Drug Administration under the Preventive Chemotherapy Strategy for Schistosomiasis and Soil-transmitted Helminthiases in the Philippines. Tuvalu The Ministry of Health plans to implement LF MDA activities using triple drug therapy and new weighing scales in collaboration with JICA. New weighing scales for lymphatic filariasis MDA activities with JICA (Credit: Tuvalu Ministry of Health) Vanuatu On 29 January 2021, the national NTD programme presented an NTD health talk via the national public service broadcaster, Vanuatu Broadcasting and Television Corporation (VBTC), as an activity to raise awareness on World NTD Day 2021. The national NTD programme, working with the Shefa provincial NTD focal point, used the media platform to raise NTD awareness and demonstrate hand and face washing activities. In early 2021, the national and provincial NTD pro- grammes implemented provincial health zone NTD training in Sanma, Tafea and Penama provinces. Several health zones completed their NTD workshops, while others faced challenges. Training and activities were suspended in because of the COVID-19 vaccine roll-out in Penama province, the COVID-19 lockdown in Tafea province, and the provincial election in Eromanga. The national NTD programme plans to complete the NTD training in these provinces once the COVID-19 vaccine roll-out is complete and public health programme activities are allowed. The NTD training in Malampa and Torba provinces will be completed in 2022. 10 Western Pacific Region Neglected Tropical Diseases 11Western Pacific Region Neglected Tropical Diseases NTD MDA awareness-raising conducted by NTD teams (Credit: Vanuatu Ministry of Health) The national NTD programme implemented several activities, including NTD screening, case investigation, focal treatment (which includes MDA in Tafea, Sanma and Shefa provinces), survey training, and biannual deworming treatment in schools and communities. The first deworming treatment took place from January to June 2021, with coverage of 2178 for yaws focal treatment, 2234 for scabies, and 73 618 for total deworming treatment. During the activity, the national NTD programme reported 31 confirmed cases of yaws in Sanma province (1), Tafea province (9) and Shefa province (21), and 2234 cases of scabies in Tafea (1733), Shefa (361), Sanma (94) province, Malampa (22), Penama (16), and Torba province (8). The second round of deworming treatment was carried out from July to December 2021, with 20 390 treatments recorded. The national NTD programme is waiting to receive deworming data from several health facilities in each province. So far, seven additional confirmed cases of yaws, six from Shefa province and one from Penama province, and 41 cases of scabies have been reported. After data from all provinces are collected and analysed for the final coverage, the Ministry of Health will produce the final report. Health workers performing NTD MDA activities in a village on Tanna Island (Credit: Vanuatu Ministry of Health) In November 2021, the province of Tafea completed a mass treatment of 2178 people for yaws. The success of the MDA campaign was due to careful planning, including a seven-day awareness-raising operation. Operationally, the MDA campaign took 15 days with a total of 17 MDA teams and 68 team members. The national NTD programme conducted NTD health edu- cation training for community leaders in Efate, Santo and Tanna Island in selected areas, except in the Black Sand community, which has yet to conduct the training. Health education activities took place in selected communities for 12 weeks, from September to November 2021. The NTD programme initially planned nine implementation sites. However, only seven areas implemented health education activities (two areas in Sanma province, namely Olboe and Natawa, two areas in Shefa province, namely Black Sand and Eratap, and three areas in Tafea province, namely Imafin, Lowital and Itonga). The national NTD programme also carried out NTD survey training in a selected cluster in Tafea province. The two NTD survey teams planned to cover 33 villages, but only 17 (51.5%) villages were surveyed. The teams visited 251 households and screened 1362 people. Of them, 0.4% were suspected of having yaws, with 0.1% DPP test conducted and sore swabs were collected. Another 109 people (8.0%) were suspected of having severe skin diseases; 146 stool samples (10.7%) and 243 (17.8%) dried blood spot samples were collected from the total number of people screened. Both teams surveyed 14 villages on Tanna Island. While they both visited Futuna Island and Aneityum Island, they could only survey only one village per island because of a fuel shortage on Aneityum Island. Without road access, the team could not travel to other villages as they would have had to walk with all the equipment in bad weather during their visit. In conjunction with the health education, deworming, MDA, case investigation and focal treatment activities, a soap distribution activity was held at the community level. The Ministry of Health and the NTD team distributed 7839 bars of soap, including 545 bars during the deworming and yaws treatment activities in Shefa province, and 7294 bars during the MDA activities. The national NTD programme is pleased to share that they completed most of their planned 2021 activities despite the COVID-19 pandemic, poor weather and road conditions, funding delays and lack of NTD MDA materials. 12 Western Pacific Region Neglected Tropical Diseases The launching of NTD MDA on Tanna Island was observed by the Minister of Health and his delegation, the Tanna chiefs and the NTD teams. (Credit: Vanuatu Ministry of Health) Viet Nam The Ministry of Health implemented its first round of deworming activities from April to May 2020 in 21 provinces with the participation of 2 264 178 primary children (97.9% coverage). In addition, 1 268 103 children aged 24–60 months in 21 provinces received the deworming tablet and vitamin A from April to June. Due to the COVID-19 pandemic, the other 11 provinces could not organize MDA campaigns. Between March and September 2020, Viet Nam reported two suspected cases of dracunculiasis for the first time. Both cases were confirmed not as D. medinensis (targeted for global eradication) but as a species of zoonotic origin, most likely transmitted to humans through the ingestion of infested fish or reptiles. The Malaria and Neglected Tropical Diseases (MTD) unit of the WHO Regional Office for the Western Pacific coordinated with headquarters and the WHO Country Office to provide technical support for case investigation, laboratory analysis of species, and control interventions. With the emergence of dracunculiasis cases, the Viet Nam Ministry of Health organized two courses on diagnosis, treatment and reporting for dracunculiasis for 140 participants in Phu Tho and Yen Bai provinces in January 2021. The Ministry of Health also organized a dracunculiasis survey to be conducted by 228 commune health staff in Phu Tho province and 173 commune health staff in Yen Bai province. Commune health staff from Yen Bai province removes a dracunculus species from a patient in Thach Kiet commune, Tan Son district, Phu Tho province. (Credit: Viet Nam Ministry of Health)