ISSUE NO. 08 | JULY TO DECEMBER 2018 Malaria, other vectorborne and parasitic diseases WHO Western Pacific Regional Office Email: wpromvp@.who.int NTD News NEGLECTED TROPICAL DISEASES NEWSLETTER Palau, Wallis and Futuna (France) and Viet Nam have eliminated Lymphatic Filariasis as a Public Health Problem After over a decade of efforts, Palau, Wallis and Futuna (France) and Viet Nam have eliminated lymphatic filariasis as a public health problem. Dr Tedros Adhanom Ghebreyesus, WHO Director-General and Dr Shin Young-soo, WHO Regional Director for the Western Pacific Region, congratulated representatives from the three countries and territories for this historical achievement during the sixty-ninth session of the WHO Regional Committee for the Western Pacific 2018 in Manila, Philippines. 2 Western Pacific Region Neglected Tropical Diseases Western Pacific Region Neglected Tropical Diseases 1 NEWS FROM MEMBER COUNTRIES Cambodia In February and March 2018, the National Helminth Control Programme, working under the Ministry of Health and in collaboration with the University of Yamanashi, Japan, conducted screening for cholangiocarcinoma among the O. viverrini-infected cases, along with health education and mass drug administration (MDA) against O. viverrini, in high-prevalence villages in Prey Veng and Kampong Cham provinces. The results are being analysed. From May to June 2018, the National Helminth Control Programme, working jointly with the local health authorities, namely the Provincial Health Department, District Health Department, local health centres, village health volunteers and village chiefs, and with the support of WHO, carried out a schistosomiasis monitoring survey. Using the Kato-Katz method, followed by a preventive chemotherapy campaign for schistosomiasis and soil-transmitted helminthiasis using praziquantel and mebendazole, the Programme intervened in 45 villages, including sentinel and spot-check villages, in Kratie and Stung Treng provinces. In June 2018, the National Helminth Control Programme, in cooperation with the Ministry of Rural Development and with WHO support, continued the community-led initiative to eliminate schistosomiasis with water, sanitation and hygiene interventions (CL-SWASH) in four schistosomiasis-endemic villages in Kratie province. The CL-SWASH aimed to empower the communities to take control of eliminating schistosomiasis by understanding the linkage between schistosomiasis and sanitation, and taking action by building latrines and improving hygienic behaviour. In May 2018, the National Helminth Control Programme, working with the Korean Association for Health Promotion (KAHP), investigated the burden of intestinal trematode infection in schoolchildren and residents in Preah Vihear and Stung Treng provinces. China The National Institute of Parasitic Diseases under the Chinese Center for Disease Control and Prevention (China CDC) held the Fourth Symposium on Surveillance-Response Systems Leading to Tropical Disease Elimination in Shanghai, China, from 25 to 26 June 2018. Nearly 300 participants from more than 50 research institutions in 40 countries around the world joined the meeting, including representatives from the National Health Commission, Shanghai Municipal Commission of Health and Family Planning, WHO and the Swiss Tropical and Public Health Institute. Parallel sessions were held on malaria, schistosomiasis, other helminthiases and cestodes, and on optimization of surveillance and early warning systems for imported parasitic diseases. Cholangiocarcinoma screening, health education and MDA in opisthorchiasis-endemic villages in Prey Veng and Kampong Cham provinces, Cambodia, February- March 2018 Investigation of the burden of intestinal trematode infection in schoolchildren and residents in Preah Vihear and Stung Treng provinces, Cambodia, May 2018 MDA and stool examination activities in schistosomiasis-endemic villages in Kratie and Stung Treng provinces Cambodia, May-June 2018 Training of community members, household survey and presentation of the results of household survey by the Community CL-SWASH Team in Kratie province, Cambodia, June 2018 © V. Khieu © M . S in uo n © V . K hi eu © K. Miyamoto 2 Western Pacific Region Neglected Tropical Diseases 3Western Pacific Region Neglected Tropical Diseases Kiribati The Kiribati Ministry of Health continued to implement the third TAS in the remaining outer islands (Abaiang and Maiana) of the Gilbert Islands in May-June 2018. So far 5218 people have been tested using immunochromatographic tests (ICT) or the filariasis test strip (FTS) and no positive cases have been detected. The last island, Banaba, will be reached in August- September 2018 subject to availability of transport. The Kiribati Ministry of Health continued deworming preschool- aged and school-aged children and women of child-bearing age twice a year. The first round of deworming was completed by March 2018. Data on treatment coverage is awaited. The Kiribati Ministry of Health implemented the second round of MDA for elimination of trachoma in all the outer islands in May-June 2018. The MDA in South Tarawa is ongoing. The Lao People’s Democratic Republic A meeting to evaluate implementation of the Community-led initiative to eliminate Schistosomiasis with Water, Sanitation and Hygiene (CL-SWASH) after its launch in 2016 was held by the National Center for Environmental Health and Water Supply (Namsaat) working under the Ministry of Health, in Pakse, Champasak province, from 9 to 10 January 2018. The objective of this meeting was to review the achievements and challenges in implementing CL-SWASH in 24 villages since November 2016. Participants included the Department of Communicable Disease Control (DCDC), the Centre for Malariology, Parasitology and Entomology (CMPE), Namsaat, Champasak Provincial Health Department, the provincial malaria station, provincial Namsaat, district governor, and representatives from 10 villages where CL-SWASH has been implemented. The report is being compiled. Fiji The 14th round of MDA in Fiji was conducted in the Eastern division and Taveuni subdivision. The 4th targeted round on Malolo Island, following the failed transmission assessment survey (TAS) in 2015, was also completed in April-May 2018. The lymphatic filariasis (LF) program also utilised the Coverage Supervision Tool which showed over 85% reported coverage for treatment through direct observed treatment strategy among those surveyed. The Seoul National University team gave a training course on soil-transmitted helminthiases laboratory diagnosis from 14 to 23 May at the National Parasitology Laboratory. The course covered both the Kato Katz and Formalin Ethyl Concentration (sedimentation) techniques. In 2017, the villages on Rotuma and Gau islands were randomised to receive ivermectin, diethylcarbamazine citrate and albendazole (IDA) treatment, or DA, in a 2:1 ratio. Half of the IDA villages received an additional dose of ivermectin after completion of the safety monitoring period in order to evaluate the efficacy of one versus two doses of ivermectin on community prevalence of scabies and soil transmitted helminths (STH) at 12 months. The long-term effect of the different treatment arms on community prevalence of the three infections will be reviewed at 12 months with repeat testing of all community members. The second phase of data collection to evaluate these secondary outcomes of effectiveness is scheduled to occur between July and November 2018. French Polynesia French Polynesia conducted MDA for elimination of LF in March and April 2018 in the south Marquesas and Leeward islands. School-based MDA and house-to-house MDA by volunteers to ensure directly observed treatment led to over 85% treatment coverage in both islands. In October and November 2018, the second school-based TAS will be conducted in Tahiti rural area and Moorea in the Windward islands, the Tuamotus, and the Austral and north Marquesas islands. A two-day training course for outreach teams from the health and education sectors in preparation for implementation of integrated MDA for schistosomiasis and STH, using a combination of praziquantel and mebendazole in six pilot sentinel villages, was carried out from 13 to 14 February 2018. The training was followed by implementation of MDA from 15 to 17 February 2018. Fourth Symposium on Surveillance-Response Systems Leading to Tropical Disease Elimination, Shanghai, China, 25-26 June 2018 School-based MDA for elimination of lymphatic filariasis, French Polynesia, March-April 2018 Evaluation meeting of CL-WASH in Pakse, Champasak province 9-10 January 2018 Health education activity for school children during the integrated MDA for schistosomiasis and soil-transmitted helminthiases in Champasak province, 15 – 17 February 2018 © W H O © W H O © W H O © E. Lecalvez 4 Western Pacific Region Neglected Tropical Diseases Western Pacific Region Neglected Tropical Diseases From 27 to 29 March 2018, the Ministry of Health held a LF dossier development workshop in Vientiane, the purpose being to start developing the LF elimination dossier. The workshop was attended by DCDC and CMPE with the support of WHO, FHI 360 and the Research Triangle Institute (RTI) International. The group collected and reviewed documentation and data right from the start of the LF programme in 2002 through to the implementation of the TAS1 survey in September 2018 and discussed how to complete the dossier development. The schistosomiasis infection survey in potential animal reservoirs, including goat, dog, pig, buffalo, and cow, was initiated in June 2018 and is expected to continue to August 2018 in seven sentinel villages in Champasak province. The survey was led by the Institut Pasteur du Laos in collaboration with the Ministry of Agriculture and Forestry and with the support of WHO. or communities, and paramilitary and military personnel, were reached. The meetings were held in Manila on 21 June and 10 July 2018. This was in addition to the preschool- and school- aged children (1-4 years old 5-18 years old respectively) who are currently being targeted by the programme. To improve the MDA campaign coverage and monitor implementation of MDA activities, the IHCP conducted a Training of Trainers (TOT) for regional level coordinators on the Coverage Supervisory Tool (CST) in Iloilo City on 22-25 May 2018. The trained regional coordinators will roll out the CST at the provincial and municipality level, involving Local Government Units (LGU) and Department of Education (DepEd) partners who are the service delivery points for deworming. It is expected that the roll-out training will be completed by the fourth quarter of 2018, in time to be used in the next MDA round in January 2019 and onwards. The Department of Health, through the NTD Program, continued its implementation of the NTD Management Information System (MIS) project in three cities in the National Capital Region and three provinces in Region 7 covering both the communities and schools. Evaluation of pilot implementation of the NTD-MIS continued up to July 2018 by triangulating and comparing reported deworming coverage from three sources, namely: the NTD-MIS, programme reports from facilities, and results of coverage surveys at community level. Results showed that the NTD-MIS does better in Region 7 than in the National Capital Region. Program implementation reviews and on-site monitoring visits will continue to identify specific issues and challenges encountered at each implementing unit in order to determine steps to address them. The Disease Prevention Control Bureau (DPCB) and Regional Office 8 of DOH forged a Memorandum of Agreement (MOA) with the Bureau of Animal Industry (BAI) and Regional Agricultural Office 8 of the Department of Agriculture (DA). Under this agreement, the DA-BAI and Regional Agriculture Office 8 will lead the implementation of a demonstration project on the control and prevention of animal schistosomiasis under the “One Health Approach” in one of the endemic provinces in Region 8. Results of this project will be the basis of the formulation of a national policy by DA in control and prevention of animal schistosomiasis in the country. It is expected that the project will start in the third quarter of 2018. A series of intersectoral meetings between DCDC in the Ministry of Health and the Department of Livestock and Fisheries (DLF) in the Ministry of Agriculture and Forestry were held in May 2018 to discuss development of a proposal for joint control of taeniasis and cysticercosis in selected pilot areas in Savannaket province with the support of WHO and the World Organisation for Animal Health (OIE). The proposal is currently being drafted. Malaysia The tenth round of enhanced MDA for elimination of LF was conducted in Lawas, Sarawak from 16 April to 24 May 2018. Drugs were administered with directly observed treatment according to body weight. A total of 16 258 eligible population received a single dose of diethylcarbamazine citrate (DEC) and albendazole with 92.14% MDA coverage. Philippines The Integrated Helminth Control Program (IHCP) of the Philippine Department of Health (DOH) organized a consultation to initiate the formulation of policies and guidelines to expand the deworming target group to pregnant women and women of reproductive age, and ensure that hard- to-reach at-risk groups such as selected indigenous peoples Collection of blood and faecal samples from potential animal reservoirs to assess schistosomiasis infection in Champasak province, June-August 2018 NTD-MIS training in Cagayan de Oro City (Region 10), 22-23 March 2018 © P .M . A lp ay © W H O 4 Western Pacific Region Neglected Tropical Diseases 5Western Pacific Region Neglected Tropical Diseases Samoa In January 2018, the Ministry of Health of Samoa finalized and endorsed the national action plan to eliminate LF in Samoa 2018-2024. The Ministry of Health of Samoa organized a series of national LF elimination steering committee meetings and consultations with stakeholders, including church leaders, school principals and community leaders between April and June 2018, to seek their engagement and support for the upcoming nationwide MDA campaign scheduled in August 2018. Monitoring visit on use of NTD MIS in municipal health office in Corella, Bohol, 3-6 April 2018 Consultations with church leaders, school principals, community leaders and health workers on the upcoming MDA campaign, April-June 2018 The Ministry of Health of Samoa, with support of WHO, organized a meeting with the Department of Health in American Samoa in Apia, on 6 June 2018, to coordinate micro- plans and synchronize implementation of the upcoming MDA campaign in both countries. A coordination meeting between Samoa and American Samoa to synchronize MDA plans for elimination of lymphatic filariasis, Apia, Samoa, 6 June 2018 Solomon Islands The Ministry of Health and Medical Services (MHMS), in collaboration with the Ministry of Education and with WHO support, assisted three new provinces (Malaita, Western, and Isabel) to prepare for initiating school-based deworming against STHs in 2019. This included developing strategic scaling-up plans for 2019-2020 to be included in their 2019 Annual Operational Plan. Up to 2018, only two provinces (Honiara and Guadalcanal) have engaged in STH school-based deworming. The program will continue engaging the remaining provinces to prepare their scaling-up strategic plan for 2020 and onward. Consultation with health promoting school team in preparation for the implementation of the deworming program in Western Province, Solomon Islands Following the recommendations of the WHO Expert Consultation to Accelerate Elimination of Trachoma in the Pacific, held in Melbourne, Australia, on 17-19 January 2018, MHMS carried out a trachoma ancillary survey in Solomon Islands with support of WHO, the Fred Hollows Foundation, and the London School of Hygiene & Tropical Medicine, in June-July 2018. Refresher training for the survey team was undertaken in Honiara, followed by examination of children aged 10-14 in two clusters, confirmation by WHO experts of all diagnoses by the designated MHMS field grader, and review of the quality of photographs of the limbus and conjunctiva taken by a specialist photographer. Dried blood spots were collected in exemplary manner. Laboratory analysis of the collected samples is continuing. The survey was completed and the findings will determine whether an additional intervention is required or not. Teacher training where the NTD Coordinator was invited to share the basic roles of teachers on Deworming Day in Malaita Province, Solomon Islands © R . S ey ha © R . S ey ha © H . L ep ai ta i © H . L ep ai ta i © P .M . A lp ay 6 Western Pacific Region Neglected Tropical Diseases6 Western Pacific Region Neglected Tropical Diseases Vanuatu Deworming against STHs was implemented throughout January-June 2018. The submission of treatment reports from health facilities, particularly remote ones, is still continuing. Yaws case investigation and focal treatment continued in Tafea, Sanma and Shefa provinces over the period of January to June 2018. Based on reports or rumours within provinces, 20 cases were investigated within the three provinces for confirmed or suspected cases of yaws. A total of 531 children aged below 15 have been tested, of which 20 were confirmed positives, while 274 people were treated with azithromycin during the focal treatment. Community health education workshops were organized in 17 villages including eight at high risk for trachoma and nine at high risk for yaws. The workshop involved a weekly health talk over 12 consecutive weeks. Subjects included prevention of NTDs, and soap distribution to encourage communities to participate in health promotion activities. A total of 1826 scabies cases were reported through the HIS reporting system, whereas 23 scabies cases were diagnosed and treated as part of NTD surveillance integrated with activities on World Malaria Day in selected communities in Sanma and Shefa provinces. Viet Nam On 9-11 May 2018, the Vietnam National Institute of Ophthalmology (VNIO) organized a trachoma elimination workshop in Hanoi. Experts from the VNIO, the Ministry of Health, WHO, the Fred Hollows Foundation and RTI International attended the workshop and assisted with updating a plan to help Vietnam eliminate trachoma as a public health problem. The group reviewed historical data on Vietnam’s trachoma elimination efforts, identified districts that require further evidence of trachoma status, and agreed upon next steps and a timeline for the country to reach elimination. 2 REGIONAL NEWS The Expert Consultation on the Elimination of Trachoma in the Pacific was held on 17–19 January 2018 at the Centre for Eye Research Australia, University of Melbourne, Australia, to review the outcomes of the post-intervention impact surveys in Solomon Islands and Vanuatu and discuss immediate and medium-term actions and priorities to accelerate elimination of trachoma as a public health problem from the Pacific. Consultation participants acknowledged progress made in the Pacific, including the contribution of trachoma elimination activities to strengthen local health systems and research capacity in the area of eye health and recommended a series of country-specific programmatic actions to accelerate elimination of trachoma in the Pacific. Community health education workshops in Espiritu Santo, Sanma province on World Malaria Day, 23-27 April 2018 Integrated deworming and yaws surveillance in Sanma and Shefa provinces, May 2018 National NTD Planning Meeting at Mangaliliu village, Port Vila, March 2018 Group photo of the Expert Consultation on the Elimination of Trachoma in the Pacific in Melbourne, Australia, on 17–19 January 2018 © W H O © F . T al eo © F . T al eo © F . T al eo 6 Western Pacific Region Neglected Tropical Diseases6 Western Pacific Region Neglected Tropical Diseases 7Western Pacific Region Neglected Tropical Diseases The Programme Managers Meeting on Neglected Tropical Diseases in the Pacific was held in Nadi, Fiji on 20-22 February 2018. The meeting was attended by 26 participants from 16 countries in the Pacific, 3 temporary advisors and representatives from 5 partner agencies. The meeting discussed the draft Regional Framework for Control and Elimination of NTDs, new WHO tools and guidelines, various country experience and challenges and regional priorities and support needed to accelerate elimination and control of NTDs in the Pacific. The particular focus was on the new WHO recommendation on triple drug therapy for elimination of LF, post-validation surveillance, morbidity management and disability prevention associated with LF, strengthening data reporting and control of scabies. The Programme Managers Meeting on Neglected Tropical Diseases in the Asia sub-Region was held in Manila, Philip- pines on 13-14 March 2018. The meeting was attended by 14 participants from 8 countries in the Asia sub-Region, 6 tem- porary advisors and representatives from 2 partner agencies. The meeting discussed the way forward for accelerating control and elimination of NTDs with focus on foodborne and zoonotic diseases and also discussed the draft Regional Framework for Elimination and Control of NTDs in the Western Pacific from the Asia sub-regional perspective. Group photo of the Programme Managers Meeting on Neglected Tropical Diseases in the Pacific in Nadi, Fiji on 20-22 February 2018 Group photo of the Programme Managers Meeting on Neglected Tropical Diseases in the Asia sub-Region in Manila, Philippines on 13-14 March 2018 © W H O © W H O
ISSUE NO. 09 | JULY TO DECEMBER 2018 Malaria, other vectorborne and parasitic diseases WHO Western Pacific Regional Office Email: wpromvp@.who.int NTD News NEGLECTED TROPICAL DISEASES NEWSLETTER Palau, Wallis and Futuna (France) and Viet Nam have eliminated Lymphatic Filariasis as a Public Health Problem After over a decade of efforts, Palau, Wallis and Futuna (France) and Viet Nam have eliminated lymphatic filariasis as a public health problem. Dr Tedros Adhanom Ghebreyesus, WHO Director-General and Dr Shin Young-soo, WHO Regional Director for the Western Pacific Region, congratulated representatives from the three countries and territories for this historical achievement during the sixty-ninth session of the WHO Regional Committee for the Western Pacific 2018 in Manila, Philippines. 2 Western Pacific Region Neglected Tropical Diseases Western Pacific Region Neglected Tropical Diseases 1 NEWS FROM MEMBER COUNTRIES American Samoa IThe Department of Health American Samoa organized a nationwide mass drug administration (MDA) campaign to accelerate elimination of lymphatic filariasis (LF) in September- October 2018, using the triple drug therapy strategy recently recommended by WHO. Support was provided by the United States Centers for Disease Control and Prevention (USCDC), the Pacific Island Health Officers Association (PIHOA) and WHO. Prior to the MDA campaign, there were intensive media campaigns, social mobilization and training of health staff, all aimed at achieving high treatment coverage. Approximately 30 314 people were treated, and the reported drug coverage, using 2010 census data, was 55%. A coverage survey conducted in February 2019 in 30 clusters across 24 of the 74 villages indicated overall 88.7% coverage, ranging from 48.6% to 100%, depending on the village. In November 2018, the National Helminth Control Programme, supported by WHO, assessed the status of soil-transmitted helminth (STH) infections among 651 school-aged children in 12 primary schools in six provinces. These were Oddar Meanchey, Svay Rieng, Kep, Kampong Chhnang, Mondulkiri and Pailin. Overall prevalence of infection was found to be 19.3%. The National Helminth Control Program was launched in November 2018 through Population Service International in Cambodia. An STH survey was made among pre-school and school-aged children and women of childbearing age living in plantations in five north-eastern provinces of Cambodia, namely Kratie, Kampong Thom, Stung Treng, Ratanakiri and Mondulkiri. The results are awaited. Cambodia In July and November 2018, the National Helminth Control Programme continued to implement CL-SWASH (Community- Led initiatives to eliminate Schistosomiasis by combining deworming with WASH interventions) in 10 schistosomiasis- endemic villages (eight in Kratie and two in Stung Treng) with WHO support. There were monitoring and supervision visits by the CL-SWASH teams, composed of national and local interdisciplinary staff, to review the outcomes in these 10 villages and assess progress in sanitation coverage. In each province, there was a one-day CL-SWASH provincial meeting after the monitoring and supervision visit to the CL- SWASH villages. The aim of these meetings was to share the latest information about outcomes and lessons learnt in the implementation of CL-SWASH activities, and discuss plans to expand them to other villages. China The 7th International Forum for Sustainable Vector Management (IFSVM 2018) was held jointly by the China Preventive Medicine Association (CPMA) and Chinese Centre for Disease Control and Prevention (China CDC) on 22-24 October 2018 in Ningbo, China. More than 450 participants from 13 countries attended the conference. The forum aimed to provide a high-level exchange platform for experts and professionals from various countries to discuss sustainable vector management for the protection of human health and well-being. Monitoring and supervision visit for CL-SWASH activities in Kratie and Stung Treng Provinces, 2018. ©WHO Meetings of the CL-SWASH team members in Stung Treng and Kratie Province, 2018. ©WHO 2 Western Pacific Region Neglected Tropical Diseases 3Western Pacific Region Neglected Tropical Diseases Fiji The national lymphatic filariasis elimination programme conducted the 14th MDA round in the Eastern division and Taveuni subdivision, and also completed its 4th targeted round on Malolo Island after a high number of positive cases had been found in the transmission assessment survey of 2015. The national programme also did a coverage survey using the WHO Coverage Supervision Tool (CST), which confirmed more than 85% access to the treatment through the Direct Observed Treatment strategy. The CST survey also singled out the use of mass media and health staff awareness campaigns prior to the MDA as effective ways to get MDA information out to the general public. Preparations for the upcoming integrated MDA to tackle scabies, LF and STH, scheduled for July 2019, are making good progress in the Western division. Zone nurses, health centre team leaders, sub-divisional nursing managers, peer educators and health inspectors attended sessions on microplanning of MDA campaigns in each of the four subdivisions of the Northern Division in November 2018. Microplanning promoted better understanding among the Northern Division’s MDA implementation team, while providing an opportunity to talk about potential operational challenges and the resources needed to optimise coverage. Community deworming for control of STH on Vatulele Island continued with 100% coverage among all eligible populations. Through strong community participation and inter- governmental collaboration, the prevalence of infection has declined over the years from 88.3% to 66.0%. WASH activities such as installing water filters and tanks to improve access to safe and clean drinking water were also included. The Northern Division conducted the third LF transmission The disease burden of rabies is high in China, with 516 human rabies cases reported in 2017. In order to reduce the burden in China and achieve the global rabies elimination goal of “Zero by 2030”, China CDC held a workshop on rabies elimination on September 28, 2018 in Beijing. A total of 35 participants representing various stakeholders attended the workshop and discussed strategies and action priorities for the elimination of the disease in China. Better dog management and wider dog vaccination were decided to be the core strategy. The National Health Commission of the People’s Republic of China published its Report on the National Survey of Important Human Parasitic Disease in China (2015) on 14 December 2018. The Director of the National Institute of Parasitic Diseases under China CDC presented the report at a press conference in Yujiang district of Jiangxi province. The national survey covered 31 provinces (autonomous regions/ municipalities) of China. assessment survey in October 2018, covering 80 randomly selected schools in Bua, Cakaudrove and Macuata subdivisions. 2 780 students were tested using Filariasis Test Strips, of whom 30 were found antigen-positive, compared to the critical cut-off threshold of 16. The NTD Taskforce will hold its review and planning meeting in January 2019 to discuss the next steps to accelerate LF elimination in the Northern division. Awareness programmes were conducted in 18 health- promoting schools and their communities. There was health education on the prevention of STH and importance of improving water sanitation and hygiene in schools and households. Water purification tablets were also distributed to schools and households. French Polynesia The Ministry of Health of French Polynesia conducted LF TAS 2 in Tahiti rural area, namely Tahiti Iti Moorea, Tuamotu , Australes and north Marquesas islands, using the Filariasis Test Strips. The total of 2,343 children aged 6-7 years were tested from October to the end of December 2018 and no one was found positive. The 7th International Forum for Sustainable Vector Management (IFSVM), Ningbo, China, 22-24 October 2018. © National Institute for Communicable Disease Control and Prevention, China CDC The workshop on rabies elimination held in Beijing, 28 September, 2018. ©China CDC The press conference on the Report on the National Survey of Important Human Parasitic Disease in China (2015) held by the National Health Commission, China, December, 2018. ©National Institute of Parasitic Diseases, China CDC 4 Western Pacific Region Neglected Tropical Diseases Western Pacific Region Neglected Tropical Diseases Kiribati Implementtion of LF TAS 3 continued in the Gilbert Islands; Abaing Island in July 2018 and Banaba Island and Kuria Islands in September 2018. A total of 498 children were tested using Filariasis Test Strips and all were found negative. A follow-up survey and contact tracing of two lymphoedema (leg) patients in Kiritimati Island, who were identified during TAS, was also conducted from 8 to 18 October 2018. The patients and their families were tested with Firariasis Test Strips and all were found negative. Kiribati will start development of a dossier for validation of elimination of LF as a public health problem. Nationwide MDA for elimination of trachoma was conducted in July 2018, achieving 85% national coverage. Impact survey to determine whether MDA can be stopped is planned in June 2019. The second round of biannual deworming was conducted in September 2018, targeting at preschool-aged children, school- aged children and women of child-bearing age. The national coverage achieved was 51% for preschool-aged children, 56% for school-aged children and 23% for women of child-bearing age. The Lao People’s Democratic Republic In July 2018, malaria and environmental health staff from the central, provincial and district levels, together with the district vice-governor, made a monitoring visit to six villages where CL- SWASH is only being implemented with some difficulties. Their purpose was to encourage and assist households still without latrines to to build them. On 29 September 2018, the Department of Livestock and Fishery in the Ministry of Agriculture and Forestry and the Department of Communicable Diseases Control in the Ministry of Health organized a celebration of World Rabies Day. The purpose was to spread awareness of rabies and encourage school-aged children,. All health staff involved in MDA were given training courses in October 2018, before carrying out MDA in December 2018. The training module focused on severity of diseases, transmission, prevention, benefits of taking medicines, possible side effects of medicines and prevention and management of adverse events. An NTD annual meeting was held on 21 - 22 November 2018, with the Vice Minister of Health in the chair. Participants came from diverse sectors, including those responsible for animal health, and human health and education. They were from all provinces across the country as well as the central level. They discussed progress and lessons learnt from implementation of various NTD control activities in 2017 and 2018. On 19 October 2018, integrated MDA against STH and schistosomiasis for school-age children was launched in co-endemic areas, with albendazole and praziquantel administered at the same time, a first for the country. A delegation of Rotary International 2650, based in Japan’s Kansai Region, visited schistosomiasis-endemic communities in Champasak province to participate in and support MDA campaign work and CL-SWASH monitoring activities. The field mission took place on 14 December 2018. 23 members from three sub-clubs of Rotary International 2650 took part. Rotary International 2650 began supporting national efforts to eliminate schistosomiasis in Lao PDR in 2017, in consultation with the WHO Country Office, the Ministry of Health, and the Ministry of Education and Sports. Malaysia An LF TAS was conducted from September to November 2018 in 69 implementation units (IU) throughout Malaysia. Three IUs that conducted TAS 1 after two additional cycles of enhanced MDA, Lawas, Sundar and Bangkalalak, passed TAS 1 and began post-MDA surveillance. Among 16 IUs that conducted TAS 2, Debak in Sarawak State failed with five antibody positives using PanLF against the critical cut-off of three, while the remaining 15 IUs passed TAS 3. In summary, of 127 endemic IUs in Malaysia, a total of 87 (68.5%) across Malaysia have passed TAS 3 so far. Ongoing surveillance using the test and treat approach in areas that have already passed TAS 3 and in those between TAS surveys continued, using the Brugia Rapid test to maintain low prevalence. Mongolia The National Center of Zoonotic Diseases in the Ministry of Health held a multidisciplinary stakeholders meeting to develop the national action plan for control of echinococcosis in Mongolia. It took place on 29-30 October 2018, in Ulaanbaatar, with WHO support. The meeting was attended by public health, veterinary and clinical sectors relevant to echinococcosis control and treatment, at all levels, along with echinococcosis control experts from Australia, China and Switzerland. The participants discussed the priority action points to be included in the multisectoral action people to have their domestic dogs vaccinated against rabies. Stool examination among school-aged children was conducted in eight sentinel sites from September to October 2018 to monitor the prevalence and intensity of STH. It was found to range between 3% and 93%. The prevalence of hookworm infection was the highest. The intensity of infection was found both in heavy and moderate levels. From September to October 2018, stools from school aged children? were examined in seven sentinel sites and eight spot check sites in order to monitor the prevalence and intensity of schistosomiasis. The prevalence of schistosomiasis ranged from 2% to 7.3% at sentinel sites, and 1% to 3.7% at spot check sites. The intensity on infection was found both in heavy and moderate levels at sentinel sites whereas at spot check sites only at moderate and light levels. New materials were developed to train outreach teams to perform MDA against STH and schistosomiasis, targeting 4 Western Pacific Region Neglected Tropical Diseases 5Western Pacific Region Neglected Tropical Diseases plan, with a focus on initiating veterinary interventions and on strengthening human and animal surveillance and case management within the health system. On 31 October 2018, the National Center of Zoonotic Diseases held an informal meeting to examine the status of rabies control in Mongolia and agree on priority actions towards the elimination of dog-mediated human rabies in Mongolia. New Caledonia With the support of WHO, the Directorate of Health and Social Affairs of New Caledonia carried out two surveys to assess current transmission levels and prevalence of LF infection in the country: the transmission assessment survey in Loyalty Islands, and the cross-sectional survey among adults across the Northern province, formerly the highly endemic areas. The surveys were completed in December 2018. The results, and the next steps for LF elimination in New Caledonia, are under discussion. Palau On 11 and 12 July 2018, the Bureau of Public Health in the Ministry of Health Palau held a two-day workshop to discuss the post-validation surveillance of LF and develop policy for LF elimination among migrant workers from LF-endemic countries. The workshop was attended by representatives of bodies responsible for communicable disease control, environmental health and community health centres, along with the Bureau of Nursing, the Bureau of Clinical Service, and the Belau National Hospital under the Ministry of Health, the Bureau of Immigration and the Bureau of Labour under the Ministry of Justice, and private clinics. Based on the outcomes of the workshop, the dossier to claim elimination of LF as a public health problem was finalized for official submission to WHO. Palau received official WHO acknowledgement for having achieved elimination of LF as a public health problem at the sixty-ninth session of the WHO Regional Committee for the Western Pacific held from 8 - 12 October 2018 in Manila, Philippines. Dr Tedros Adhanom Ghebreyesus, WHO Director- General and Dr Shin Young-soo, WHO Regional Director for the Western Pacific Region, congratulated the Minister of Health for this historical achievement at the opening ceremony. Papua New Guinea TOn 11 September 2018, The National Department of Health of Papua New Guinea organized a stakeholders meeting in Port Moresby to finalize micro-planning of the LF MDA campaign using the triple drug therapy for the first time, in New Ireland Province. The meeting discussed the impacts and safety of the new WHO recommendation on triple drug therapy and the rationale and benefits of combining LF MDA with azithromycin treatment for elimination of yaws. This was done in the context of operational research to demonstrate the safety and feasibility of programmatic integration of LF and yaws MDA. The National Department of Health implemented the province- wide LF MDA campaign, using the triple drug therapy for the first time, in New Ireland Province, in December 2018. The MDA campaign was preceded by training for community health workers and a social mobilization campaign. The campaign was originally planned to start in October 2018. However, due to a polio outbreak in the country and a nationwide polio mass vaccination campaign beginning on 1 October 2018, the MDA campaign was rescheduled between repeated rounds of mass vaccination campaigns in the province. Despite numerous difficulties, treatment coverage reached 62.4%. A mop-up campaign in low-coverage areas is being planned for April-May 2019. New Ireland Province completed three rounds of MDA between 2014 and 2018 with over 75% reported coverage. Philippines The Department of Health (DOH) through the Integrated Helminth Control Program (IHCP) developed its Monitoring and Evaluation Framework. The plan is anchored to the overall goals of the 2016-2022 Philippine Health Agenda: better health outcome, zero catastrophic cost and more responsive health service delivery network. It ultimately aims to have a zero STH prevalence to be able to achieve an STH-free Philippines. As an initial step towards expansion of deworming services among the vulnerable groups, the IHCP, with support of WHO, has begun developing guidelines specific for women of childbearing age (WCBA), pregnant women, military and para-military groups and indigenous communities. The draft guideline is expected to be submitted and reviewed by March 2019. The Schistosomiasis Control and Elimination Program developed its seven-year national strategic plan towards transmission interruption of schistosomiasis in the Philippines (2019-2025). Its highlight is the stratification of endemic areas based on the prevalence at village level, and different packages of interventions on the human, animal and snail aspects designed for each group of endemic villages in three classes of schistosomiasis prevalence (low, moderate, high). Wider introduction of the NTD Management Information System (MIS) moved ahead, as developed in 2016 with technical support of WHO and financial support of the Bill and Melinda Gates Foundation, already piloted in Region 7 and National Capital Region in 2017. In 2018 it was fine-tuned and expanded in Regions 2, 5, 10 and 13. The refined version is being disseminated to end-users via SMS messages, e-mails and video tutorials posted in the log-in page. Additionally, DOH is continuously coordinating with the Department of Education for official adoption of NTD-MIS in schools. Rabies continues to be a public health problem in the 6 Western Pacific Region Neglected Tropical Diseases6 Western Pacific Region Neglected Tropical Diseases Philippines. The Department of Health held the 2018 National Rabies Summit on September 27, 2018 in Manila on the occasion of World Rabies Day. The theme was “Rabies can be prevented. Be a responsible Pet Owner. Share the Message. Save a life”. Over 400 representatives from the Department of Health & Department of Agriculture regional offices, the Department of Education, non-government organizations, the private sector and Local Government Unit officials attended the day. The summit highlighted the good practices of the local government units and gave awards for various achievements, such as 18 provinces maintaining zero human rabies cases for the past 5 years or more, one additional province achieved zero human rabies cases in 2018 for the first time. Samoa After completing the second of two additional rounds of MDA in May 2017, the Samoa Ministry of Health implemented TAS 1 in North-West Upolu, along with TAS 2 in the two other EUs between July and October 2017. TAS failed in all three EUs, demonstrating the need to restart MDA nationwide. The Ministry of Health of Samoa, with support from WHO, the Australia Department of Foreign Affairs and Trade, and the Task Force for Global Health, carried out the nationwide LF MDA campaign in August 2018, using the triple drug therapy strategy newly recommended by WHO. Prior to the MDA campaign, there were intensive media campaigns, social mobilization and training of health staff to achieve high treatment coverage. The nationwide treatment coverage rate reached 81.1%. Solomon Islands As a prelude to expanding the STH deworming program to other provinces apart from Honiara and Guadalcanal, the STH consultation and planning meetings were held in Makira, Choiseul, Temotu and Central Islands Province in October 2018. The consultation meetings were attended by the provincial health director, nursing director, chief education officer, nutrition officer, environmental health officer, EPI officer, health promotion officer and zone supervisors at provincial and zone level, along with the national team including the NTD coordinator, health promoting schools coordinator and WHO representatives. Guadalcanal Province held a successful training session for teachers for Zone 6 on 17 October 2018. It was facilitated by the national NTD coordinator and the health promoting schools coordinator and held prior to the deworming operation. Subsequently school deworming was carried out in the province. The treatment report is awaited. Vanuatu Yaws case investigation and focal treatment continued routinely throughout 2018. The proportion of confirmed yaws cases to total reported cases has declined from 13.7% in 2017 to 11.6% in 2018. Most cases are from three provinces, Tafea, Shefa, and Malampa. A similar pattern was observed in the number of suspected yaws cases (clinically diagnosed) reported from the health information system (HIS). 686 people were treated with azithromycin during the focal treatment in 2018. The number of reported scabies cases in 2018 had dropped by 25% by November 2018, from 3 138 in 2017 to 2 328 in 2018. Scabies screening was usually done jointly with yaws screening, either in schools or communities. The national coverage of the second round of STH deworming, which continued till November 2018, was 40 %. The target population group for deworming was enlarged in 2018 to preschool-aged children above one year of age and school- aged children. Deworming activities have been implemented in conjunction with other public health activities such as NTD screening at community and school levels, malaria net distributions, and MCH outreach. The three-month health education activities were completed in November 2018 in the 12 selected villages. They received lively support and participation from health workers, village chiefs, health committees and communities. The majority of these villages have successfully improved their environment by fencing off domestic animals, holding routine clean-up activities, building and using tippy taps for hand washing with soaps, and building ventilated improved pit latrines (VIP). They requested that the work be maintained in their villages to ensure sustained behaviour changes and the ensuing benefits regarding disease transmission. Viet Nam Viet Nam received official WHO acknowledgement for having achieved elimination of LF as a public health problem at the sixty-ninth session of the WHO Regional Committee for the Western Pacific held from 8 to 1 October 2018 in Manila, Philippines. Dr Tedros Adhanom Ghebreyesus, WHO Director- General and Dr Shin Young-soo, WHO Regional Director for the Western Pacific Region, congratulated the Minister of Health for this historical achievement at the opening ceremony. On World Rabies Day, the Ministry of Health (MOH), Ministry of Agriculture and Rural Development (MARD), Food and Agriculture Organization of the United Nations (FAO), WHO 6 Western Pacific Region Neglected Tropical Diseases6 Western Pacific Region Neglected Tropical Diseases 7Western Pacific Region Neglected Tropical Diseases and other One Health partners called for everyone’s support with the message, ‘Rabies: Spread the Message, Save a Life’ . The event took place in Lao Cai on 4 October, 2018. MOH and MARD advocated jointly for rabies prevention, control and elimination before over 1,000 participants made up of policy makers, animal and public health professionals, dog owners, and the general public. Wallis and Futuna Wallis and Futuna received official WHO acknowledgement for having achieved elimination of LF as a public health problem at the sixty-ninth session of the WHO Regional Committee for the Western Pacific held from 8 to 1 October 2018 in Manila, Philippines. Dr Tedros Adhanom Ghebreyesus, WHO Director- General and Dr Shin Young-soo, WHO Regional Director for the Western Pacific Region, congratulated the Minister of Health for this historical achievement at the opening ceremony. 2 REGIONAL NEWS The Meeting to Accelerate Prevention and Control of Foodborne Parasitic Zoonoses in Selected Asian countries was organized jointly by WPRO, SEARO, FAO and OIE on 16-18 October 2018 in Luang Prabang, Lao PDR. National representatives responsible for NTD, animal health, food safety and WASH from 14 high-burden countries in the Western Pacific and Southeast Asian Region joined the meeting to discuss joint actions for the control of foodborne parasitic zoonoses in their respective countries, and identify major challenges and support needs from the Tripartite organizations to step up control. The ASEAN-Tripartite Rabies Meeting was jointly organized by the ASEAN Secretariat, FAO, OIE, SEARO and WPRO on 4-6 De- cember 2018 in Hanoi, Viet Nam. The meeting hosted rabies focal points from human health and animal health sectors in all ASEAN Member States along with donors and partners supporting rabies elimination efforts in the ASEAN region. Participants reviewed the progress of rabies control since the launch of the ASEAN Rabies Elimination Strategy in 2016 with its target to control and eliminate rabies in ASEAN Member States by 2020, and discussed action priorities to further en- hance collaborative efforts between human and animal health sectors to achieve the global target ‘Zero by 30’. The Programme Managers Meeting on Neglected Tropical Diseases in the Asia sub-Region was held in Manila, Philip- pines on 13-14 March 2018. The meeting was attended by 14 participants from 8 countries in the Asia sub-Region, 6 tem- porary advisors and representatives from 2 partner agencies. The meeting discussed the way forward for accelerating control and elimination of NTDs with focus on foodborne and zoonotic diseases and also discussed the draft Regional Framework for Elimination and Control of NTDs in the Western Pacific from the Asia sub-regional perspective.