Meeting Report
The 15th Meeting of the Western Pacific Regional Programme Review Group on Neglected Tropical Diseases
20-22 July 2015 Davao City, Philippines
WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR THE WESTERN PACIFIC RS/2015/GE/75(PHL)
English only
REPORT
THE 15TH MEETING OF THE WESTERN PACIFIC REGIONAL PROGRAMME REVIEW GROUP ON NEGLECTED TROPICAL DISEASES
Convened by: WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR THE WESTERN PACIFIC Davao City, Philippines 20-22 July 2015
Not for sale Printed and distributed by: World Health Organization Regional Office for the Western Pacific Manila, Philippines January 2016
NOTE
The views expressed in this report are those of the participants of the 15th meeting of the Western Pacific Regional Programme Review Group on Neglected Tropical Diseases and do not necessarily reflect the policies of the conveners.
This report has been prepared by the World Health Organization Regional Office for the Western Pacific for Member States in the Region and for those who participated in the 15th meeting of the Western Pacific Regional Programme Review Group on Neglected Tropical Diseases in Davao City, Philippines from 20 to 22 July 2015.
CONTENTS
1. INTRODUCTION ............................................................................................................................................. 1 1.1 Meeting organization ................................................................................................................................... 1 1.2 Meeting objectives ........................................................................................................................................ 1 2. PROCEEDINGS ................................................................................................................................................ 1 2.1 Opening session ........................................................................................................................................... 1 2.2 Actions taken on the recommendations of the Regional Programme Review Group Meeting – 2014 ........ 1 2.3 Global updates from the Strategic and Technical Advisory Group for NTDs (STAG) and its Working Groups recommendations ................................................................................................................................... 2 2.4 Updates from the RPRG Working Groups .................................................................................................. 2 2.5 Country reports on progress and review of drug applications ..................................................................... 2 2.6 Country dossiers for elimination of LF as a public health problem ............................................................. 6 2.7 Strengthening data management and reporting in the Region ..................................................................... 9 2.8 RPRG Working Groups: priorities and action plans 2015-2016.................................................................. 9 3. CONCLUSIONS AND RECOMMENDATIONS ............................................................................................ 9 3.1 Conclusions ................................................................................................................................................. 9 3.2 Recommendations...................................................................................................................................... 10 ANNEXES ........................................................................................................................................................... 19
Annex 1. List of participants Annex 2. Meeting programme
Keywords: Regional health planning / Neglected diseases / Schistosomiasis / Elephantiasis, Filarial
SUMMARY The 15th meeting of the Western Pacific Regional Programme Review Group (RPRG) on Neglected Tropical Diseases (NTD) was held from 20 to 22 July 2015 in Davao City, Philippines. In addition to RPRG members, selected national NTD programme managers and representatives of stakeholder institutions participated in the meeting. In his opening remarks, the Regional Director for the Western Pacific, WHO, acknowledged the important role of RPRG in providing technical expertise to the Regions’ NTD control and elimination programmes and highlighted a growing attention to NTDs in the Asia Pacific in recent years. The key highlights of the actions taken following the 14th RPRG meetings included submission of dossiers for review by RPRG for provisional validation of LF elimination as a public health problem by three additional countries to WHO (Cambodia, Cook Islands and Marshall Islands), recommencement of MDA rounds in Papua New Guinea in 2014 and continuation in 2015, and a surge of activities in joint multi-sectoral initiative between Cambodia and Lao PDR and the similar initiative in Philippines for elimination of schistosomiasis. The meeting continued with review of the progress of NTD elimination and control activities and the Joint Application Packages for requesting donation of medicines in all relevant endemic countries in the Region. The Working Group on Advocacy and Inter-Sectoral Collaboration progressed with is advocacy efforts in the form of letters to the health ministers in the Region and ASEAN to encourage reaising NTDs during upcoming high level meetings and highlighted various opportunities to continue such efforts in 2016 such as G7. The RPRG acknowledged the new generic framework for the control, elimination and eradication of NTDs endorsed by the STAG for the validation of elimination as a public health problem and the need to establish a regional reviewing authority, the Regional Dossier Review Group (RDRG), appointed by the Western pacific Regional Director, to review dossiers when submitted by the Member States. This procedure will apply to the dossiers submitted to the RPRG meeting in 2015 and thereafter. The RPRG conducted provisional review of the three draft dossiers submitted by Cambodia, Cook Islands and Vanuatu on elimination of LF as a public health problem and invited Cambodia to official submit the dossier to WHO for review after adding information on the results of transmission assessment survey for B. malayi being conducted, Cook Islands to submit the dossier as it is, and recommended Marshall Islands revise the dossier with elaboration of implementation of the programme further with support of WHO. Noting significant challenges in scaling up NTD interventions in the Papua New Guinea and potentially important role of vector control in accelerating interruption of LF transmission and in the surveillance phase, creation of subgroup in the RPRG to join forces on PNG support and vector control was discussed. The RPRG also proposed to increase an emphasis on strongyloidiasis and FBT control in the Working Group on Asia.
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1. INTRODUCTION
1.1 Meeting organization The 15th meeting of the Western Pacific Regional Programme Review Group (RPRG) on Neglected Tropical Diseases (NTD) was held from 20 to 22 July 2015 in Davao City, Philippines. In addition to RPRG members, selected national NTD programme managers and representatives of stakeholder institutions participated in the meeting. 1.2 Meeting objectives The objectives of the meeting were: 1) to review the progress towards control and elimination of NTDs in the Western Pacific Region, analyse key challenges and propose concrete steps, especially the scaling up of investment and interventions on NTDs, and intersectoral collaboration, specifically water, sanitation and hygiene; and
2) to advise WHO on the request of medicines and diagnostic supplies.
2. PROCEEDINGS
2.1 Opening session Dr Eva Christophel delivered the opening speech on behalf of Dr Shin Young-Soo, the Regional Director of the WHO Regional Office for the Western Pacific. The Regional Director highlighted significant progress being made towards the goals set in the Regional Action Plan for NTD (2012-2016). He acknowledged the important role of RPRG in reviewing and approving the request for donated medicines and appreciated the pharmaceutical donors for their generous donations. He also noted a growing attention to NTDs in the Asia Pacific, including the lead taken by Philippines to adding NTDs in ASEAN’s agenda, and called for continuous and increasing advocacy efforts to meet regional and global NTD goals. He conveyed special thanks to RPRG for their commitment in volunteering their time and work in guiding WHO and countries of the Region in the fight against NTDs. 2.2 Actions taken on the recommendations of the Regional Programme Review Group Meeting – 2014 The key highlights of the actions taken and progress made on the recommendations of the 14th RPRG meetings included submission of dossiers for review by RPRG for provisional validation of LF elimination as a public health problem by three additional countries to WHO (Cambodia, Cook Islands and Marshall Islands), recommencement of MDA rounds in Papua New Guinea in 2014 and 2015, a surge of activities in joint multisectoral initiative between Cambodia and Lao PDR and the similar initiative in Philippines for elimination of schistosomiasis, reported possible elimination of blinding trachoma as a public health problem in Cambodia, China and Viet Nam, continuation of case
-2detection and treatment of all contacts since initiation of total community treatment in 2013 for yaws in Vanuatu, and organization of the Western Pacific Regional Training on Integrated Neglected Tropical Diseases (NTD) Programme Management in Manila, Philippines in 19–23 January 2015 to strengthen management of PC interventions and severe adverse events. Country-specific progress was discussed in the country report session.
2.3 Global updates from the Strategic and Technical Advisory Group for NTDs (STAG) and its Working Groups recommendations The RPRG noted various recommendations endorsed by the NTD STAG and its Working Groups in May 2015 to facilitate management of these key components in countries, including endorsement of the generic framework for the process and principles for confirming eradication, elimination and elimination as a public health problem of NTDs. Also the availability of donor subsidy of Alere Filariasis Test Strip (FTS) and endorsement of same for use in the Global Programme to Eliminate Lymphatic Filariasis was highlighted. The strips are available free of charge through WHO for use in transmission assessment surveys (TAS) to detect W. bancrofti antigen.
2.4 Updates from the RPRG Working Groups The Working Group on Advocacy and Inter-Sectoral Collaboration progressed with its advocacy efforts in the form of letters, co-signed by the chair of the RPRG and that of the Working Group, addressed to the health ministers in the Region and ASEAN to encourage health leaders to raise NTDs during upcoming high-level meetings, funding by the Global Network for Neglected Tropical Diseases in Pacific for LF hydrocelectomy, and planned publication of success story over 15 years of the Pacific Programme to Eliminate Lymphatic Filariasis (PacELF). Resent publication of Acta Tropica Special Issues highlighted progress in research, control and elimination of helminth infections in Asia.
2.5 Country reports on progress and review of drug applications 2.5.1 Cambodia Cambodia passed TAS 3 in December 2014, developed the dossier to document elimination of LF as a public health problem with support of RTI and provisionally submitted to WHO for review by the RPRG. Sentinel site surveys conducted in July-September 2014 for STH found prevalence of as high as 40% (for hookworm), despite more than 5 years of deworming against SAC and pre-SAC with over 80% reported national coverage. High-coverage MDA for schistosomiasis targeting the entire population in endemic villages continued in 2014, resulting in prevalence of 0 to 3.16%. The concept note for the multi-sectoral initiative to complement PC intervention with water, sanitation and hygiene (WASH) and animal health interventions was being developed jointly with Lao PDR. Mobilizing resources and medicines to deworm WCBA against STH and for all population against strongyloidiasis and FBT remains to be a major challenge despite their high burden. To accelerate elimination of schistosomiasis, the RPRG encouraged continuation of MDA in high-risk population complemented by the multi-sectoral interventions. The RPRG also emphasized the need of more sensitive diagnostic tool to continue monitoring and evaluation (M&E) of Schistosoma mekongi in such low-prevalence areas. The Joint Request for Selected PC Medicines (JRSM) for 2016 was reviewed and endorsed.
2.5.2 Lao PDR Lao PDR completed the fifth round of LF MDA covering the entire Attapeu province, considered still endemic in February 2014 with 88.3% reported national coverage. Sentinel and spot-check site surveys conducted in October 2014 detected up to 1.33% antigenaemia prevalence, thus one more
-3MDA round was conducted in February 2015. Another round is planned in February 2016 before moving to pre-TAS survey. The second round of two MDA recommended during the 13th RPRG meeting for Sekong province were also completed in February 2015. Four suspected LF-related lymphoedema cases were reported in Savannakhet province. A house-to-house rapid questionnaire survey and physical examination confirmed that cases were not related to LF. Deworming against STH for SAC and pre-SAC continued in October 2014 with 86.9% and 85.0% reported national coverage, respectively. However, the prevalence examined in 2014 in four provinces remained as high as 68.7% (particularly hookworm). MDA against schistosomiasis targeting the entire at-risk population have continued in 2014 with above 70% reported national coverage. The sentinel prevalence surveys conducted in August 2014 showed 0 to 9.9% prevalence, and the prevalence of heavy intensity infection was below 1% in all sites. The concept note for the multi-sectoral initiative to complement PC intervention with WASH and animal health interventions was being developed jointly with Cambodia and implementation started in pilot endemic villages. PC intervention against FBT was implemented only in a part of endemic areas due to lack of funding despite their high burden (prevalence of above 70%). The RPRG encouraged continuation of multisectoral interventions to complement MDA to accelerate elimination of schistosomiasis. The RPRG also recommended establishing a system to conduct standardized investigation whenever suspected LF cases are reported. The JRSM for 2016 was reviewed and endorsed.
2.5.3 Viet Nam Viet Nam passed TAS 3 in March-May 2015. The LF elimination dossier is being drafted with support of USAID/ENVISION and WHO. STH deworming targeting pre-SAC, SAC and WCBA continued in 2014. The national coverage for SAC was 76.9% but that for pre-SAC and WCBA remained below 40%. Analysis of STH prevalence in 2012-2014 indicated reduction among SAC (11.4% in 2015) and WCBA (23.2% in 2014), highlighting the need to scale-up deworming among pre-SAC. PC intervention against FBT covered only a part of endemic provinces in 2014 due to lack of funding. The RPRG highlighted its concern on weak political commitment for sustaining STH and FBT control and recommended enhanced efforts to scale up and sustain control activities. The JRSM for 2016 was reviewed and endorsed.
2.5.4 Malaysia Technical assistance was provided by WHO to evaluate the progress of the national LF programmes in June 2015. By the end of 2014, 99 out of 116 IUs reportedly passed TAS 1 and progressed or is in preparation for TAS 2. However, challenges are realized in stopping MDA in some areas where nocturnally sub-periodic B. malayi is prevalent even after over 7 rounds of MDA with effective coverage. Concern was also raised on aborigine population who might have been consistently noncompliant to MDA. Potential presence of animal reservoir of B. malayi was also indicated. Further, there is a high influx of immigrants from other endemic countries such as India, Indonesia, Myanmar, Nepal and Philippines. Migrants have been tested and treated if positive, but not necessarily covering all migrants. Updating of the list of lymphoedema cases in each state and training of 10% of primary health care staff in each IU to provide health services for lymphoedema cases is planned in 2016. The RPRG recommended implementation of coverage survey to identify the issues with noncompliant population and operational research to clarify the role of animal reservoir in transmission of LF in the areas of persistent transmission.
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2.5.5 Brunei Darussalam Technical assistance was provided by WHO to evaluate the progress of the national LF programmes in July 2015. Two rounds of MDA were conducted in 2013 and 2014 in 3 IUs considered endemic, as par the recommendation by the RPRG in 2012. Since one district failed to achieve 65% coverage, the third round of MDA is planned later in 2015 in all three IUs, followed by pre-TAS survey in 2016. The country is inquiring for possible exemption of TAS 2 and TAS 3 since the recommendation by RPRG in 2012 was a precautionary measures where districts indeed have met the threshold to be classified as non-endemic. The RPRG recommended to conduct pre-TAS surveys and submit the results to the RPRG through WHO for further advice, while operational research could be conducted to see the level of antibody in the areas.
2.5.6 Philippines Out of 44 LF-endemic provinces, 27 provinces have passed TAS and stopped MDA by the end of 2014. The remaining 17 IUs continued MDA in 2015, 11 of which also plan mid-term sentinel site surveys and 6 plan TAS 1. Deworming against STH has been conducted covering both SAC and preSAC in all 81 provinces. However, national coverage for SAC was less than 50% in 2014. To ensure coordination and address inconsistency of reporting unit between the Department of Health and Department of Education to improve treatment coverage, the country plans to shift from decentralized implementation of deworming campaigns at provincial level to the nationwide school deworming day to treat all school-aged children in all provinces in a single day in a year twice, staring in July 2015. National parasite survey is reportedly being conducted in 2015. Schistosomiasis is reportedly transmitted in 2,230 focal villages in 190 municipalities and 15 cities in 28 provinces. PC intervention targeting all people at 5-65 years of age in all endemic villages continued in 2014 but national coverage was 62.8%. The programme is developing a communication strategy to address noncompliance and improve coverage. To further reduce transmission, multi-sectoral cooperation with the Bureau of Animal Industry in the Ministry of Agriculture and the Environmental Office in the Department of Health to complement PC intervention with WASH and animal health intervention has also been initiated. The RPRG acknowledged various measures put in place to improve timely reporting, to increase treatment coverage and to accelerate elimination of schistosomiasis and encouraged further progress of such measures. The JRSM for 2016 was reviewed and endorsed.
2.5.7 China China is currently formulating a new strategy to accelerate interruption of transmission of schistosomiasis by 2025, which reinforces rebuilding of improved sanitation facilities, encouraging replacement of use of bovine with use of agricultural machinery, isolation of animal grazing areas, centralized disinfection of fishermen’s stools, and strengthening reference laboratory network for rigorous surveillance of human, bovine and snail infections, in addition to selective treatment. PC intervention for STH has been implemented since 1990s, but currently deworming against SAC is implemented only in some provinces with high prevalence. One sentinel site has been designated in each province to monitor STH prevalence. There are also five designated sentinel surveillance site for FBT and 3 for taeniasis/cysticercosis in the country. An increasing trend of clonorchiasis prevalence has been observed recently. The RPRG acknowledged China’s leading role in building evidence to control and interrupt NTDs in the Region. The RPRG encouraged China to submit the joint reporting form on PC intervention
-5against STH, schistosomiasis and FBT as well as the outcomes of the ongoing national parasite surveys so as to reflect its significant progress in the global report. The RPRG also invited China to share its experience on echinococcosis control and explore its potential support for Mongolia.
2.5.8 Pacific island countries and territories An overall declining trend of LF transmission has been observed, with increase number of countries reaching the surveillance phase nationwide (American Samoa, Kiribati, Tonga, Wallis and Futuna) or partially (Fiji, French Polynesia) or further, developing or submitting dossiers for elimination of LF as a public health problem (Cook Islands, Marshall Islands, Niue, Palau, Vanuatu). American Samoa has so far reportedly passed TAS 3 but a concern was raised on the its sample size, which did not meet the recommended size. Fiji, French Polynesia, FSM, Samoa and Tuvalu are expected to conduct hopefully final MDA and implement pre-TAS surveys in 2015-2016. In New Caledonia where the nationwide survey in 2013 reported less than 1% antigenaemia prevalence, a confirmatory survey in a previously highly endemic area (Loyalty Islands), has been planned in 2016. Attention on LF morbidity management and disability prevention is being increased in the Pacific, and morbidity registers are being updated in Fiji, French Polynesia, Vanuatu and Kiribati. With support of the Global Network for NTD and WHO, hydrocelectomy project to address surgical backlog is planned at the end of 2015 in Fiji, Kiribati and Vanuatu. STH deworming against SAC was implemented in all countries requiring PC intervention except for Tonga in 2014 but national coverage in Vanuatu, Solomon Islands, Marshall Islands and Kiribati was below 75% and thus needs to be further improved. Vanuatu raised difficulty in obtaining data of treatment delivered by other partners/stakeholders as one of the reasons of low coverage. Delay in implementation of deworming in Tonga despite having received donated albendazole was reported. For elimination of trachoma, one round of country wide MDA was completed in Solomon Islands in 2014/15, where 19 out of 21 districts achieved over 80% reported coverage. Baseline mapping was completed in Fiji, Kiribati and Vanuatu. These countries are planning to start MDA in 2016, while Nauru remains to be mapped. Vanuatu continued case detection and treatment of cases and their contacts for yaws in 2014 following total community treatment conducted in 2013 in Tafea the highest endemic province. The RPRG emphasized the need for scaling up and sustaining PC intervention against STH in the Pacific, noting that sanitation coverage target in the Millennium Development Goal has been achieved by only half of the Pacific Island countries and open defecation is still widely practiced in some countries. A concern on persistent transmission of LF was raised in areas other than the urban areas of the Winward Islands in French Polynesia despite over 10 rounds of MDA implemented so far. The RPRG recommended French Polynesia to carefully analyse outcomes of pre-TAS surveys planned to be conducted at the end of 2015. RPRG emphasized that the directly observed treatment strategy should be maintained to ensure a high coverage of MDA. The RPRG recommended American Samoa to implement one more TAS in 2017, ensuring achievement of the targeted sample size, to confirm interruption of transmission. The RPRG urged continuous advocacy efforts to position NTDs within the current Universal Health Coverage and Healthy Islands drive to ensure sustaining the the necessary interventions against NTDs to achieve regional and global targets. The JRSMs for 2016 were reviewed and endorsed for Fiji, French Polynesia, FSM, Kiribati, Marshall Islands, Samoa, Solomon Islands, Tuvalu and Vanuatu.
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2.5.9 Papua New Guinea Papua New Guinea restarted MDA in New Ireland province in 2014 as per the MDA roll-out plan 2014-2021 and continued in 2015 achieving a reported above 80% coverage. Considering high LLIN coverage being achieved in the past decade, Papua New Guinea plans to conduct reassessment of original baseline prevalence in 4 provinces at the end of 2015 which might potentially lead to reclassification of endemicity status in some areas. STH prevalence data is patchy, apart from some publications indicating over 60% prevalence in most of the areas in the country. No specific control activities against STH have been implemented. The trachoma preliminary exploratory survey was conducted in September 2014, which found localized active infection but very low number of the blinding form of trachoma. The survey recommended implementation of full population based prevalence survey in selected provinces. As for yaws, an international multi-center drug trial to test impact of drug dosage of azithromycin for trachoma (20mg/kg body weight) on yaws is planned to commence at the end of 2015. Relatively low political commitment on NTDs in PNG compared to other competing public health issues was highlighted, resulting in lack of skilled manpower and financial resources to support implementation of activities at all levels. While re-assessment of LF prevalence in some areas might be warranted, there are many other areas that are known to be highly endemic. The RPRG supported Papua New Guinea’s plan to expand LF MDA in 2016 and 2017, including sentinel site surveys in West Sepik and east New Britain. Wastage of significant number of donated medicines in the past has been highlighted, and the RPRG urged Papua New Guinea to review drug inventory before donation of further drugs is approved for 2016. The RPRG also recommended Papua New Guinea to develop concrete and realistic business plan with budget estimate to initiate MDA in new areas to assist mobilization of political commitment and necessary resources.
2.5.10 Review and approval process of drug applications in the Western Pacific Region The 13th RPRG meeting recommended the virtual review process of joint report and joint drug request by the RPRG, facilitated by WPRO. However, several issues were highlighted by the WHO Headquarters with current practice where drug applications virtually reviewed by the RPRG are still endorsed at the face-to-face meeting once a year. This delays shipment of WHO-donated medicines for countries that are planning PC interventions before the RPRG meeting. This also appears to increase last-minute submission of drug applications before the RPRG meeting. Further, a concern was raised on possible hampering of timely processing of applications for donation of LF diagnostics for TAS, which is expected to start in late 2015. The RPRG emphasized that the process should not delay progress of activities in countries, and urged the Secretariat to improve the current practice, including virtual review and approval of drug applications.
2.6 Country dossiers for elimination of LF as a public health problem 2.6.1 Process of review and validation of the country dossiers in the Western Pacific Region In April 2015, the NTD Strategic and Technical Advisory Group (STAG) endorsed a generic framework for the validation process of the eradication, elimination and control of NTDs. Under this framework, a process of validation will be used for formal confirmation of elimination as a public health problem, and validation of such status is to be determined by an ad-hoc regional reviewing authority.
-7Noting the current Terms of Reference of the RPRG which includes advising WHO on applications by countries for verification of elimination of NTDs but insufficient number of experts on each specific disease in the RPRG, for example for blinding trachoma, it was concluded that in the Western Pacific Region, a sub-group of the RPRG with additional experts added on specific diseases on an adhoc basis should be appointed by the Regional Director as the Regional Dossier Review Group (RDRG). The RPRG also concluded that the new process should not be applied to the dossiers already submitted prior to endorsement of the generic framework by the NTD-STAG. It was agreed that the original reviewers of these dossiers should submit the summary review report of each dossier to the Regional Director that can be further submitted to the WHO Director General for official acknowledgement of the status of elimination as a PHP. 2.6.2 Provisional review of the country dossiers (Cambodia, Cook Islands and Vanuatu) The three countries – Cambodia, Cook Islands and Vanuatu – submitted draft dossiers on elimination of LF as a public health problem for provisional review by the RPRG. The dossiers were reviewed by assigned RPRG members, who presented their review outcome as summarized below: 2.6.2.1 Cambodia In 2001, extensive study was conducted using night blood examination for Wuchereria bancrofti and Brugia malayi and ICT test for W. bancrofti in north-east four provinces where transmission of chronic LF cases were historically reported. The study found less than 1% microfilaremia prevalence and less than 1% antigenaemia prevalence in all except for one province (Rattanakiri, 1.1% microfilaremia, 1.9% antigenaemia). The national programme adopted a conservative approach and implemented MDA in two provinces where microfilaria positive cases were detected, with effective coverage from 2005 to 2009. MDA was terminated after passing TAS 1 in 2010. Surveillance continued with TAS 2 in 2013 and TAS 3 in 2015 with all tested children antigen negative. In order to confirm interruption of B. malayi transmission in the endemic province, the programme decided to conduct assessment of B. malayi infection among children using Brugia Rapid test in July 2015. The RPRG acknowledged that the dossier is well written and included all necessary information. The RPRG requested Cambodia to add the results of TAS 3 that is being conducted currently in Rattanakiri, considered endemic for B. malayi as well, in the dossier and officially submit to WHO for review. 2.6.1.2 Cook Islands The country was endemic with W. bancrofti transmitted mainly by Aedes polynesiensis. Baseline survey (‘A-survey’) was conducted in 1999 in all inhabited islands. Antigenaemia prevalence ranged from 0.0% to 20.0%. MDA was initiated in 2000 and continued annually until 2006 except for 2005 with effective coverage. Sentinel site survey conducted in 2005 in three Evaluation Units (EUs) found above 1% antigenaemia prevalence in two EUs (Southern Group and Northern Group), where one more round of MDA was conducted while the other EU (Rarotonga) conducted test and treat in 2006. TAS 1 was conducted in 2007 with no positive individuals. Since then, neither intervention nor survey was conducted until 2013 when TAS 3 was implemented detecting only one positive. Risk for reinfection is considered minimal due to geographical isolation of the country, progressive modernization, dengue vector control efforts under way, and tourists generally not coming from endemic areas. The RPRG acknowledged that the dossier included all information and provides strong evidence on effective implementation of intervention measures and interruption of transmission. The RPRG recommended that Cook Islands officially submit the dossier to WHO for further processing.
-82.6.1.3 Marshall Islands The country was endemic with W. bancrofti transmitted mainly by Culex quinquefasciatus. Mapping was conducted in 2001, which found the prevalence of 0.1%. Surveys were again conducted between 2002 and 2004 in several atolls using ICT cards, finding that the only two atolls (Mejit and Ailuk) are endemic (44.2% Ag positive in Meijit and 29.0% Ag positive in Ailuk in 2002). Annual rounds of MDA were conducted between 2002 and 2006. Effective coverage was achieved in the first two rounds but coverage data is not available for the other rounds. Mid-term survey (‘B-survey’) conducted in 2005 showed Ag prevalence of up to 46.6%. However, C-survey conducted between 2007 and 2008 found only one positive out of 1,132 individuals. In 2013 TAS was conducted only using high school children for logistic reasons, which found no positives. TAS was repeated in 2014 testing 565 people of all age groups, finding no positives. The country receives around 5,000 visitors every year mostly from North America and other Pacific countries. The RPRG concluded that the dossier is still incomplete in parts and should be further revised. It recommended conducting an additional LF prevalence survey in Mejit and Ailuk covering the entire population in order to better understand the current status in these areas previously reported as highly endemic. The RPRG recommended Marshall Islands to revise and re-submit the dossier with the additional information, including from the proposed prevelance survey. 2.6.4 Challenges identified with development of LF country dossiers Challenges and issues encountered by the national programmes and experts providing technical assistance for development of country dossiers were highlighted. These included lack of information on process to confirm non-endemicity status, inadequate information on migrants, sentinel site selection, LF morbidity burden and availability and quality of services for patients with LF morbidity. Also highlighted were the absence of guidance on post-validation surveillance and ignorance by countries of the need for morbidity related data in the dossier. General lack of documentation of data and process information, resulting in reliance on institutional memory of people, was also highlighted. The RPRG concluded with the need for building capacity on data management at national and subnational level to ensure proper documentation of data and avoid inconsistency of data held at national and subnational level and also for providing guidance and training for countries on development of the dossiers in addition to the dossier template. WHO Integrated NTD Database was suggested as one option to improve data management practice in countries. RPRG also acknowledged the ongoing collaboration project between James Cook University, Nagasaki University and WHO, financially supported by USAID via Task Force for Global Health to develop a non-exhaustive inventory of documents and publications on LF elimination in the Pacific and assist countries locate information when developing a dossier. WHO is developing the LF Morbidity Management and Disability Prevention Toolkit, which includes tools for burden assessment and health facility inspection. RPRG urged WHO to make this toolkit available to assist compilation of data on LF burden and service availability to be included in the dossiers. 2.6.5 Upcoming country support need for dossier development The following countries are expected to start (or have started) development of dossiers on elimination of LF as a public health problem for submission to WHO in 2016-2017, thus potentially requiring technical assistance: Viet Nam, Tonga, New Caledonia (after confirmatory survey in Loyalty Islands), and Wallis and Futuna. Viet Nam has been supported by RTI under USAID’s ENVISION.
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2.7 Strengthening data management and reporting in the Region National programmes generally face lack of capacity and work force to properly compile and manage NTD-related data and to analyse and utilize such data to improve efficiency and effectiveness of the programmes. Decentralized governance and presence of multiple partners/stakeholders involved in delivery of NTD interventions could also be barriers against timeliness and completeness of data reporting. However, progress has been made in some countries. The notable example is signing a joint memorandum between ministries of health and education and shifting from decentralized delivery of deworming interventions to a nationwide one-day deworming campaign in the Philippines. RPRG emphasized the need by country programmes to give high priority to gather, store, clean and process all the original data as well as data from various other sources, including drug inventory, to improve programme implementation, facilitate dossier preparation, and contribute to global reporting. WHO and partners are urged to support capacity building on data management at national and subnational level.
2.8 RPRG Working Groups: priorities and action plans 2015-2016 The planned activities of the Working Group on Advocacy and Inter-Sectoral Collaboration in the coming year include regular sharing country updates on NTD interventions to Regional Committee Members, and advocating on NTDs in various high-level meetings at global level such as G7. RPRG suggested exploring additional means to disseminate the NTD Newsletter as an advocacy material using social media. Noting significant challenges in scaling up NTD interventions in the Papua New Guinea and potentially important role of vector control in accelerating interruption of LF transmission and in the surveillance phase, RPRG agreed (i) to convert the Working Group on Pacific to the PNG Support Group and (ii) to include vector control in the Working Group on Research and Capacity Building. It was also suggested to jointly establish a working group with SEARO on Brugia species, persistent transmission of which has been observed in Malaysia. RPRG also proposed to increase an emphasis on strongyloidiasis and FBT control in the Working Group on Asia.
3. CONCLUSIONS AND RECOMMENDATIONS 3.1 Conclusions RPRG noted the significant progress on elimination of LF and trachoma in the Region, and acknowledged the surge of intersectoral collaboration with the WASH and animal health sectors for elimination of schistosomiasis. Progress on yaws elimination is slow but being made. However, progress in PC scale-up against STH is insufficient, and FBT control even regressed rather than progressed. Control and elimination of NTD remains high in the public health agenda in the Region. Opportunities should be explored to position NTD attractively in Universal Health Coverage and Healthy Islands Concept in the Pacific.
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3.2 Recommendations 3.2.1 Recommendations for Member States Cambodia 1) Despite reported low prevalence of schistosomiasis being achieved, Cambodia should continue PC interventions in high-risk populations. 2) Cambodia is encouraged to continue pursuing inter-sectoral collaboration with WASH and animal health sector, and intensify collaboration with Lao PDR to accelerate elimination of Mekong schistosomiasis. 3) The RPRG concluded that the provisionally submitted LF dossier is well written and included all necessary information. Only the results of TAS 3 that is being conducted currently in Rattanakiri considered to be endemic for B. malayi as well as for W. bancrofti needs to be included in the dossier. Cambodia should be invited to revise the provisional dossier accordingly and officially submit to WHO for review. Lao PDR 1) Lao PDR needs to consider establishing a system to implement standardized investigation for any suspected LF cases reported. 2) Lao PDR is encouraged to continue pursuing inter-sectoral collaboration with WASH and animal health sector, and intensify collaboration with Cambodia to accelerate elimination of Mekong schistosomiasis. Viet Nam 1) Viet Nam to be invited to complete and submit to WHO the dossier on elimination of LF as a public health problem. 2) Viet Nam is urged to make enhanced efforts to scale up and sustain control activities for STH and FBT. Brunei Darussalam 1) Brunei Darussalam is encouraged to implement a third round of MDA for LF in all endemic IUs and conduct pre-TAS surveys to determine eligibility to proceed with TAS 1 (Brugia only). Brunei should report the results to WHO for the RPRG to determine the next course of action, including a possible exemption of TAS 2 and 3. Malaysia 1) Malaysia is encouraged to analyse the reasons carefully for persistence of LF infection despite implementation of 7-9 rounds of ‘effective’ MDA by implementing coverage survey to identify the issues with non-compliant population and operational research to clarify the role of animal reservoir in transmission of LF in such areas, while continuing to implement MDA with directly observed treatment as the core strategy. Philippines 1) Philippines is encouraged to proceed with planned LF TAS and report results to WHO for expert review by the RPRG.
- 11 2) Philippines is encouraged to continue strengthening inter-sectoral collaboration with WASH and animal health sector and also inter-country collaboration to accelerate elimination of schistosomiasis. China 1) China is encouraged to submit joint reporting forms on the implementation of PC and outcomes of the ongoing national helminth survey against schistosomiasis, STH and FBTs so as to reflect its significant progress in the global report. 2) China is invited to share experiences on echinococcosis control and explore potential support for Mongolia. Cook Islands 1) The RPRG concluded that the LF dossier included all information. It provides strong evidence on effective implementation of intervention measures and interruption of transmission. Cook Islands are invited to officially submit the dossier to WHO for further processing. Marshall Islands 1) The RPRG concluded that the dossier is still incomplete in parts. The dossier should be further elaborated and include details to understand better the implementation of the programme. Monitoring and evaluation should be dealt with in much greater detail to understand the evidence for interruption of transmission. Marshall Islands are encouraged to revise the dossier with support of WHO and officially submit to WHO for review. Vanuatu 1) Vanuatu is encouraged to make enhanced efforts to ensure sharing of reports on deworming against STH conducted by other implementing partners (i.e. UNICEF) that are involved in delivery of interventions in the country, and also ensure this data is included in national reporting. American Samoa 1) American Samoa is encouraged to conduct a further LF TAS in 2017 and submit the results to the RPRG via WHO for expert review. Fiji 1) The RPRG acknowledged Fiji’s progress on increasing its focus on providing morbidity management and disability prevention for LF, notably the LF hydrocelectomy project led by local surgeons, and encouraged further expansion of care for lymphoedema cases. Samoa 1) Samoa is encouraged to conduct LF sentinel and spot-check assessments after the 2015 MDA round to determine whether to proceed with the repeat TAS in North West Upulu (NWU). The plan for TAS2 in the other EUs that have passed TAS1 in 2013 may be postponed to synchronize with the repeat TAS in NWU.
- 12 French Polynesia 1) French Polynesia is encouraged to implement the planned pre-TAS survey in all the areas other than Winward urban areas that passed TAS1 in 2015 and report the results to WHO for expert review by the RPRG, while continuing with the directly observed treatment strategy for LF MDA. Tonga 1) Tonga is invited to complete and submit to WHO the dossier of elimination of LF as a public health problem. The current template and guidelines for dossier preparation should be used and technical assistance may be requested from WHO for preparing the dossier. 2) With donated albendazole having already arrived, Tonga is urged to commence STH deworming of school-aged children without delay. Papua New Guinea 1) The RPRG supports Papua New Guineas plan to expand LF MDA in 2016 and 2017, including LF surveys (sentinel sites) in West Sepik and East New Britain. 2) Papua New Guinea is urged to review drug inventory and inform WHO before further drugs are approved. 3) Papua New Guinea is encouraged to develop a short costed action/business plan to mobilise necessary resources to support scaling up the NTD activities. 3.2.2 Recommendations for WHO 1) RPRG acknowledged the new generic framework for the control, elimination and eradication of NTDs endorsed by the STAG for the validation of elimination as a public health problem and the need to establish a regional reviewing authority, the Regional Dossier Review Group (RDRG). The RDRG should be appointed by the WP Regional Director. The RDRG will communicate its official recommendation to WHO via RPRG after review. The Regional Director will send the dossier and its official recommendation to WHO Director General. This procedure will apply to the dossiers submitted to the RPRG meeting in 2015 and thereafter. 2) The three previously reviewed LF dossiers, which RD has already sent to DG (Niue, Palau and Vanuatu), will not fall under the new procedures. A summary report of the previous deliberations of the RPRG should be written to support the submission to DG. 3) WHO is requested to support capacity building on data management at national and subnational level to ensure that NTD personnel at all levels, particularly at district level, are able to use the data to analyze and improve the programme. Data management practices and tools currently in place should be examined in each country and the best approach identified. WHO’s Integrated NTD Database might be an option for countries with high burden and multiple NTDs. 4) WHO is requested to facilitate virtual review of the joint application package by the RPRG members assigned per country by WPRO in consultation with the RPRG Chair. The WPRO secretariat should pre-review the country submission, prepare the country situation summary and send to the assigned reviewer/s via email. The reviewer should send the outcome of the review via email to WPRO. The LF TAS Eligibility and Planning Form should be also reviewed by a sub-group of LF experts in the RPRG.
- 13 5) WHO is requested to make enhanced efforts to make a more sensitive diagnostic tool to evaluate progress in the low-transmission areas of schistosomiasis available to the national programmes. 6) WHO is requested to develop guidance on post-elimination LF surveillance to the countries being validated as having achieved elimination of LF as a public health proble. 7) WHO is requested to consider possible establishment of multiple submission deadlines of drug request in a year in consultation with other ROs and drug donors and report back to the RPRG. 8) WHO is requested to make the LF Morbidity Management Disability Prevention Toolkit available to Member States. 9) WHO is requested to enhance inter-regional communication particularly between WPRO and SEARO to share experience and learn from each other, especially interruption of transmission of Brugia malayi.
ANNEX 1
The 15th Meeting of the Western Pacific Regional Programme Review Group on Neglected Tropical Diseases
Marco Polo Hotel, Davao City, Philippines 20-22 July 2015 AGENDA Meeting objectives: 1. 2. To review progress towards control and elimination of NTDs in the Western Pacific Region, analyze key challenges and propose concrete steps, especially the scaling up of investment and interventions on NTDs, and intersectoral collaboration, specifically water, sanitation and hygiene; and To advise WHO on the request of preventive chemotherapy medicines and diagnostic supplies.
Day 1 – 20 July 2015, Monday
08:00 – 08:30 08:30 – 09:00
Registration 1. Opening session - MC: Dr Rabindra Abeyasinghe Opening speech Dr Eva-Maria Christophel on behalf of Dr Shin Young-soo, WHO Regional Director for the Western Pacific Dr Zhou Xiao-Nong Dr Eva-Maria Christophel, WHO WPRO
Welcome remarks on behalf of the RPRG Objectives of the meeting 09:00 – 09:30 Group photo Coffee/tea break
09:30 – 10:00 10:00 – 10:30 10:30 – 10:50
2. Global and regional updates – Moderator: Dr Zhou Xiao-Nong 2.1. Actions taken on the 2014 RPRG recommendations Dr Eva-Maria Christophel 2.2. Global updates on NTD-STAG and its WGs recommendations Discussion 2.3. Updates from the RPRG Working Groups Dr Gautam Biswas
10:50 – 11:00 11:00 – 11:10 11:10 – 11:20 11:20 – 11:30 11:30 – 12:00 12:00 – 13:00
• • • •
Asia Pacific Advocacy Capacity building and research
Dr Tai-Soon Yong Dr Patricia Graves Ambassador Michael Marine Dr Juerg Utzinger
Discussion Lunch break 3. Country reports on progress and review of drug applications – Moderator: Dr Tai-Soon Yong (country presentation 10 min + review of drug request 5 min + discussion 15 min)
13:00 – 13:30 13:30 – 14:00
• Cambodia • Lao PDR
Dr Virak Khieu Reviewer: Dr Hiroshi Ohmae Dr Rattanaxay Phetsouvanh Reviewer: Dr CP Ramachandran Dr Vicente Belizario/ Dr Alex Hildebrand Dr Rattanaxay Phetsouvanh Dr Sinuon Muth
14:00 – 15:05
Progress with intersectoral collaboration for NTDs in Cambodia, Lao PDR and the Philippines Introduction (5 min) WASH and schistosomiasis (30 min) Lao PDR Cambodia Discussion WASH, animal health, schistosomiasis and STH (15 min) Philippines Discussion Fit for School impact evaluation (15 min) Discussion
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Dr Leda Hernandez/Dr Winston Palasi
15:05 – 15:30 15:30 – 16:00 16:00 – 16:30
Dr Juan Alfonso Leonardia
Coffee break • Viet Nam • Malaysia and Brunei Darussalam Dr Nguyen Thu Huong Reviewer: Dr Tai-Soon Yong Dr Kapa Ramaiah Reviewer: Dr CP Ramachandran Dr Leda Hernandez Reviewer: Dr Pat Lammie Dr Zhou Xiao-Nong
16:30 – 17:00 17:00 – 17:30 18:00 – 19:30
• Philippines • China Reception
Day 2 – 21 July 2015, Tuesday 3. Country reports on progress and review of drug applications (continued) – Moderator: Dr Juerg Utzinger Dr Padmasiri Eswara / • Pacific island countries and territories Dr Hervé Bossin (presentation 20 min + review of drug requests 30 Reviewers: min + discussion 20 min) Dr Ottesen (Fiji), Dr Zhou Xiao-Nong (Marshall Islands), Dr Bossin (FSM), Dr Lammie (Samoa), Dr Sinuon (Solomon Islands), Dr Utzinger (Vanuatu), Dr Graves (FP, Kiribati, Tonga), • Papua New Guinea Mr Leo Makita (presentation 15 min + review of drug request 5 min Reviewer: Dr Eric Ottesen + discussion 15 min) Discussion on approval process of drug applications: during RPRG meeting versus virtual
08:00 – 09:10
09:10 – 09:45
09:45 – 10:00
Introduction: Dr Niño Dayanghirang
10:00 – 10:30
Coffee/ tea break 4. Country dossiers for elimination of LF as a public health problem – Moderator: Dr Patricia Graves (presentation 10 min + discussion 10 min)
10:30 – 10:50 10:50 – 11:10 11:10 – 11:30 11:30 – 11:35 11:35 – 11:40 11:40 – 12:00 12:00 – 12:30 12:30
• Cambodia • Cook Islands • Marshall Islands Experience, issues and challenges with development of LF country dossiers (5 min) Update on upcoming country support need for dossier development (5 min) Update on ad-hoc dossier review group and process Lunch break Departure for field visit 5. Field visit
Reviewers: Dr Pat Lammie, Dr Patricia Graves Reviewers: Dr Eric Ottesen, Dr Pat Lammie Reviewers: Dr Patricia Graves, Dr Eric Ottesen Dr Kapa Ramaiah Dr Niño Dayanghirang Dr Jonathan King/ Dr Aya Yajima
13:00 – 13:30 15:30 – 16:30
i. The Department of Health Inter-Regional Collaboration Center for Malaria and Other Vectorborne and Parasitic Diseases" ii. STH and schistosomiasis endemic community, including school visit o Presentation from Regional NTD Coordinator, including Q&A o Preparations for the National Deworming Day (July 29)
o Visit to the warehouse of the Rural Health Unit 18:30 19:30 – 21:30 Return to Marco Polo Hotel Evening round table: (light dinner will be served) 1. Echinococcosis surveillance and control: Experiences from the Region – Moderator: Dr Zhou Xiao-Nong (presentations 10 min each + discussion 30 min) Dr Natasha Murray • New Zealand • China • Mongolia 2. • Dr Zhou Xiao-Nong/ Dr Wu Wei Ping Dr Aya Yajima/ WHO Mongolia
Vector control and surveillance for LF in the Pacific – Moderator: Dr Rabindra Abeyasinghe (presentations 10 min each + discussion 30 min) Dr Hervé Bossin Challenges of effective A. polynesiensis control in French Polynesia, and pilot studies on vector control Latest xenomonitoring results from American Samoa, Samoa and French Polynesia Review of LLIN and IRS effects on LF- data and modelling Dr Patricia Graves Dr Patricia Graves
•
•
Day 3 – 22 July 2015, Wednesday 07:30 – 08:30 8:30 – 08:50 Breakfast session: Operational researches on NTD in the Region : Updates and priorities – Moderator: Dr Juerg Utzinger 6. Strengthening data management and reporting in the Region – Moderator: Dr Zhou Xiao-Nong (presentation 10 min + discussion 10 min) Dr Aya Yajima/ Dr Niño Dayanghirang
08:50 – 09:10 09:10 – 09:30 09:30 – 10:00 10:00 – 10:20 10:20 – 10:40 10:40 – 11:40 11:40 – 12:10 12:10 – 12:30 12:30 – 13:30
7. RPRG Working Groups: Priorities and action plans 2015-2016 – Moderator: Dr Zhou Xiao-Nong (presentations 10 min + discussion 10 min) Dr Tai-Soon Yong • Asia Dr Patricia Graves • Pacific Coffee/ tea break • Advocacy • Capacity building and research 8. Remarks from the partners 9. Conclusions and recommendations of the meeting 10. Closing session Lunch break Ambassador Michael Marine Dr Juerg Utzinger Partners Dr Eva-Maria Christophel RPRG, WHO
ANNEX 2
LIST OF PARTICIPANTS
Dr Hervé Bossin, Research Scientist, Medical Entomologist, Emerging Infectious Diseases, Institut Louis Malardé, Rue Des Poilus Tahitiens, 98713 Papeete, Tahiti, French Polynesia Tel. No.: +689 533156, Email: hbossin@ilm.pf Dr Patricia Graves, Associate Professor, Faculty of Medicine, Health and Molecular Sciences, School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook UniversityWHO Collaboration Centre, P.O. Box 1811, Cairns, Queensland, Australia Tel. No.: +61 424096571, Email: patricia.graves@jcu.edu.au Dr Patrick Lammie, Senior Scientist, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, Georgia, United States of America Tel. No.: +1 404 718 4135, Email: pjl1@cdc.gov Mr Michael Marine, Ambassador (Ret.), Chief Executive Officer, Global Network for Neglected Tropical Diseases, Vaccine Development, and Vaccine Advocacy and Education, Sabin Vaccine Institute, 2000 Pennsylvania Avenue, NW, Suite 7100, Washington D.C., United States of America Tel. No.: +1 202 842 5025, Email: michael.marine@sabin.org Dr Hiroshi Omae, Visiting Senior Researcher, Department of Parasitology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan Tel. No.: +81 90 15379861, Email: h-ohmae@nih.go.jp; rsa40370@nifty.com Dr Eric Ottesen, Director, Neglected Tropical Diseases Support Center, The Task Force for Global Health, 325 Swanton Way, Decatur, Georgia 30030, United States of America Tel. No.: +1 404 687 5604, Email: eottesen@taskforce.org
Professor Dato Dr C. P. Ramachandran, Professor Emeritus Universiti Sains Malaysia Council Member, Academy of Sciences Malaysia, Belvedere Condominium, 1/63, Jalan Tunku, Bukit Tunku, 50480-Kuala Lumpur, Malaysia, Tel. No.: +60 3 2698 7275 Email: ramacp@hotmail.com Dr Muth Sinuon, Programme Manager of Helminthiasis, National Center for Parasitology, Entomology, and Malaria Control, Ministry of Health, No. 372 Monivong Boulevard, Phnom Penh, Cambodia, Tel. No.: +855 12 926 266, Email: sinuonm@cnm.gov.kh Dr Juerg Utzinger, Head, Ecosystem Health Sciences Unit, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box CH-4002, Basel, Switzerland Tel. No.: +41 61 284 8129, Email: juerg.utzinger@unibas.ch Professor Tai-Soon Yong, Director, Department of Environmental Medical Biology, Institute of Tropical Medicine, Yonsei University College of Medicine, Seoul 120-752, Republic of Korea Tel. No.: +82 2 22281841 / +82 10 68883121, Email: tsyong212@yuhs.ac Prof Zhou Xiao-Nong, Director, National Institute of Parasitic Diseases, Chinese Center for Disease Control , 207, Rui Jin Er Road, Shanghai 200025, People's Republic of China Tel. No.: +8621 6474 6458, Email: zhouxn1@chinacdc.cn
Dr Vicente Belizario, Jr, Undersecretary, Department of Health, Building 14, 3rd Floor, San Lazaro Compound, Sta. Cruz, Manila, Philippines, Email: vbelizar@yahoo.com Dr Leda Hernandez, Division Chief, Infectious Disease Office, Department of Health Building 14, 3rd Floor, San Lazaro Compound, Sta. Cruz, Manila, Philippines Tel. No.: +632 651 7800 local 2354, Email: dr_leda@edsamail.com.ph Dr Rattanaxay Phetsouvanh, Deputy Director, Department of Communicable Diseases Control, Ministry of Health, Vientiane, Lao People’s Democratic Republic Tel. No.: +856 21 264324/25, Email: rattanaxay@gmail.com Mr Leo Makita, Manager, Malaria and Vector Borne Diseases Program, Disease Control, Division of Public Health, Department of Health, Waigani, Papua New Guinea Tel. No.: +675 70673352/675 3013774, Email: leo.makita@gmail.com Dr Virak Khieu, Head, Helminth Unit, National Center for Malaria Control, Parasitology and Entomology, 477, Corner St 92, Trapeang Svay Village, Sangkat Phnom Penh Thmey, Khan Sensok, Phnom Penh, Cambodia, Tel. No.: +855 12 677 244, Email: Virak.khieu@gmail.com Dr Nguyen Thu Huong, Deputy Head, Parasitology Department, Head, Helminthic Treatment Unit of Clinical Department, Member, National Neglected Tropical Diseases Control Group Ministry of Health, 245 Luong The Vinh, Tu Liem District, Ha Noi, Viet Nam Tel. No.: +84 4 38540302, Email: huongnimpe@gmail.com Dr Winston Palasi, Program Manager, National Schistosomiasis Control and Elimination Department of Health, San Lazaro Compound, Sta Cruz, Manila, Philippines Email: winstonpalasi@gmail.com Dr Takayuki Hida, Director, Global Access Strategies, 4-6-10 Koishikawa, Bunkyo-ku, Tokyo 112-8088, Japan, Tel. No.: +81 3 3817 3700, Email: t-hida@hhc.eisai.co.jp Mr James Johnson, Project Director, END Neglected Tropical Diseases in Asia, Asia Pacific Regional Office, 130-132 Sindhorn Building, 19th Floor, Tower 3, Wireless Road, Lumpini, Pathumwan, Bangkok 10330, Thailand, Tel. No.: +662 263 5261, Email: jamjohnson@fhi360.org Mr Robert Bergquist, Editor-in-Chief, Geospatial Health Journal, International Society of Geospatial Health, University of Naples Federico II, Naples, Italy Tel. No.: +39 081 253 1111, Email: robert.bergquist@outlook.com Dr Juan Alfonso Leonardia, Regional Programme Coordinator, Regional Fit for School Programme, Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, Büro Manila/Office Manila, 7/F PDCP Bank Centre, cor. V.A. Rufino and L.P. Leviste Streets, Salcedo Village, 1227 Makati City, Philippines, Tel. No: +632 651 5131 Email: juan.leonardia@giz.de Dr Mark Bradley, Director, Global De-worming, Global Health Programs, 980 Great West Road, Brentford, Middlesex, TW8 9GS, United Kingdom, Tel. No.: +44 0 2080475521 Email: mark.h.bradley@gsk.com
Ms Tijana Duric, Director, Supply Planning and Finances, Global Health Programs 980 Great West Road, Brentford, Middlesex, TW8 9GS, United Kingdom Tel. No.: +44 0 208044904, Email: Tijana.X.Duric@gsk.com Ms Komal Ram, Regional Project Manager, International Agency for the Prevention of Blindness, Victoria 3053, Australia, Email: kram@iapb.org Dr Zee Leung, Program Officer, Agriculture and Environment, International Development Research Centre, 150 Kent Street, Ottawa, Ontario, Canada, Tel. No.: +1 613 696 2325 Email: zleung@idrc.ca Dr Peter Wood, Adjunct Research Fellow, College of Marine and Environmental Sciences, James Cook University, 1 James Cook Dr, Townsville City, Queensland 4811, Australia Tel. No.: +61 7 42321789, Email: peter.wood@jcu.edu.au Dr Kaname Kanai, Executive Technical Advisor to the Director-General, Human Development Department, Japan International Cooperation Agency, Nibancho Center Building 5-25, Niban-cho, Chiyoda-ku, Tokyo 102-8012, Japan Tel. No.: +813 5226 8305, Email: Kanai.Kaname@jica.go.jp Mr William Lin, Director, Worldwide Corporate Contributions, Johnson and Johnson, No 1 Johnson and Johnson Plaza, New Brunswick, New Jersey 08933, United States of America Tel. No.: +1 732 524 0400, Email: wlin@corus.jnj.com Dr Kazuyo Ichimori, Professor, Nagasaki Center for Elimination of Lymphatic Filariasis and Neglected Tropical Diseases, 1-14 Bunkyo-machi, Nagasaki City, Nagasaki Perfecture Japan, Email: ichimorikazuyo@gmail.com Ms Lyn Capistrano, Executive Director, Philippine Center for Water and Sanitation, 267 Ermin Garcia Street, Cubao, Quezon City, Philippines, Email: pcwsitnf@gmail.com / capistranolyn@gmail.com Engr Apol Jimenez, Deputy Director and Wash Engineer, Philippine Center for Water and Sanitation, 267 Ermin Garcia Street, Cubao, Quezon City, Philippines, Email: pcwsitnf@gmail.com Dr Arve Lee Willingham, Director, One Health Center for Zoonoses and Tropical Veterinary Medicine, Professor of One Health, 630 US Highway 1, North Brunswick, New Jersey 08902 United States of America, Tel. No.: +1 732 898 0144, Email: awillingham@rossvet.edu.kn Ms Molly Brady, NTD Advisor, RTI International, 701 13th Street, NW, Suite 750 Washington DC 20005, United States of America, Tel. No.: +1 202 728 2080 Email: mbrady@rti.org Dr Rob Henry, Senior Public Health Advisor, Neglected Tropical Diseases Program 1300 Pennsylvania Avenue NW, Washington D.C. 20523, United States of America Tel. No.: +1 202 712 1000, Email: rhenry@usaid.gov
Dr Kimberly Won, Health Scientist, Center for Global Health, Division of Parasitic Diseases and Malaria, 1600 Clifton Road, MS D-65, Atlanta, Georgia, United States of America Tel. No.: +1 404 718 4137, Email: kwon@cdc.gov Dr Kapa Ramaiah, Consultant, 12 Bhaktavatsalam Street, Tagore Nagar, Lawspet Podicherry, India, Email: ramaiahk@yahoo.com Dr Gautam Biswas, Coordinator, HQ/NTD Control of Neglected Tropical Diseases, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland, Tel. No.: +41 22 791 3850, Email: biswasg@who.int Dr Jonathan King, Scientist, Lymphatic Filariasis Elimination, Preventive Chemotherapy and Transmission Control, Department of Control of Neglected Tropical Diseases, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland, Tel. No.: +41 22 79 11423, Email: kingj@who.int Dr Aya Yajima, Technical Officer, Preventive Chemotherapy and Transmission Control, Department of Control of Neglected Tropical Diseases, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland, Tel. No.: +41 22 7913554, Email: yajimaa@.who.int Dr Eva Maria Christophel, Coordinator, Malaria, Other Vectorborne and Parasitic Diseases, World Health Organization, Manila, Philippines, Tel. No.: +632 528 9723, Email: christophele@wpro.who.int Dr Rabindra Abeyasinghe, Technical Officer (Regional Entomologist), Malaria, Other Vectorborne and Parasitic Diseases, World Health Organization, Manila, Philippines, Tel. No.: +632 528 9725, Email: abeyasingher@wpro.who.int Dr Niño Dal Dayanghirang, Consultant, Neglected Tropical Diseases, Malaria, Other Vectorborne and Parasitic Diseases, World Health Organization, Manila, Philippines, Tel. No.: +632 528 9759, Email: dayanghirangn@wpro.who.int Dr Wu Wei-Ping, Volunteer from the National Institute of Parasitic Diseases, (NIPD), Shanghai, China, Tel. No.: +632 528 9417, Email: wuw@hotmail.com Dr Natasha Murray, Volunteer, Division of Communicable Diseases, World Health Organization, Manila, Philippines, Tel. No.: +632 528 9760, Email: murrayn@wpro.who.int Dr Andreas Mueller, Technical Officer (Blindness Prevention), Noncommunicable Diseases and Health Promotion, World Health Organization, Manila, Philippines, Tel. No.: +632 528 9885, Email: muellera@wpro.who.int Mr Alexander von Hildebrand, Technical Officer, Environmental Health, World Health Organization, Manila, Philippines, Tel. No.: +63 2 528 9854, Email: hildebrandal@wpro.who.int
Dr Thiphavanh Chanthapaseuth, National Programme Officer, Neglected Tropical Diseases, World Health Organization, 125 Saphanthong Road, Unit 5, Ban Saphangthongtai, Sisattanak District, Vientiane Capital, Lao PDR, Tel. No.: +856 21 353902, Email: chanthapaseutht@wpro.who.int Dr James Kiawali Wangi, National Programme Officer, Neglected Tropical Diseases, World Health Organization, 4th Floor, AOPI Centre, Waigani Drive, Port Moresby, Papua New Guinea, Tel. No.: +675 3257827, Email: wangij@wpro.who.int Dr Zhang Zaixing, Scientist, Malaria, and Other Vectorborne and Parasitic Diseases, World Health Organization, Ground Floor, Building 3, Department of Health, San Lazaro Compound, Sta Cruz, Manila, Philippines, Tel. No.: +632 528 9061, Email: zhangz@wpro.who.int Dr Padmasiri Eswara Aratchige, Technical Officer (Neglected Tropical Diseases), World Health Organization, Level 4 Provident Plaza One, Downtown Boulevard, 33 Ellery Street, Suva, Fiji, Tel. No.: +632 528 9754, Email: aratchigep@wpro.who.int
Dr Eva Maria Christophel, Coordinator, Malaria, Other Vectorborne and Parasitic Diseases, World Health Organization, Manila, Philippines, Tel: +632 528 9723, Email: christophele@wpro.who.int Dr Rabindra Abeyasinghe, Technical Officer (Regional Entomologist), Malaria, Other Vectorborne and Parasitic Diseases, World Health Organization, Manila, Philippines, Tel: +632 528 9725, Email: abeyasingher@wpro.who.int Dr Niño Dal Dayanghirang, Consultant, Neglected Tropical Diseases, Malaria, Other Vectorborne and Parasitic Diseases, World Health Organization, Manila, Philippines, Tel: +632 528 9759, Email: dayanghirangn@wpro.who.int Dr Wu Wei-Ping, Volunteer from the National Institute of Parasitic Diseases, (NIPD), Shanghai, China, Tel: +632 528 9417, Email: wuw@hotmail.com Dr Natasha Murray, Volunteer, Division of Communicable Diseases, World Health Organization, Manila, Philippines, Tel: +632 528 9760, Email: murrayn@wpro.who.int Dr Andreas Mueller, Technical Officer (Blindness Prevention), Noncommunicable Diseases and Health Promotion, World Health Organization, Manila, Philippines, Tel: +632 528 9885, Email: muellera@wpro.who.int Mr Alexander von Hildebrand, Technical Officer, Environmental Health, World Health Organization, Manila, Philippines, Tel: +63 2 528 9854, Email: hildebrandal@wpro.who.int Dr Thiphavanh Chanthapaseuth, National Programme Officer, Neglected Tropical Diseases, World Health Organization, 125 Saphanthong Road, Unit 5, Ban Saphangthongtai, Sisattanak District, Vientiane Capital, the Lao People's Democratic Republic, Tel: +856 21 353902, Email: chanthapaseutht@wpro.who.int Dr James Kiawali Wangi, National Programme Officer, Neglected Tropical Diseases, World Health Organization, 4th Floor, AOPI Centre, Waigani Drive, Port Moresby, Papua New Guinea, Tel: +675 3257827, Email: wangij@wpro.who.int Dr Zhang Zaixing, Scientist, Malaria, and Other Vectorborne and Parasitic Diseases, World Health Organization, Ground Floor, Building 3, Department of Health, San Lazaro Compound, Sta. Cruz, Manila, Philippines, Tel: +632 528 9061, Email: zhangz@wpro.who.int Dr Padmasiri Eswara Aratchige, Technical Officer (Neglected Tropical Diseases), World Health Organization, Level 4 Provident Plaza One, Downtown Boulevard, 33 Ellery Street, Suva, Fiji, Tel: +632 528 9754, Email: aratchigep@wpro.who.int
www.wpro.who.int