M & E of Neglected Infectious Diseases/PCT - overview Region of the Americas Regional Program for Neglected Infectious Diseases Pan American Health Organization/World Health Organization 6 th NTD STAG Global Working Group meeting on M&E of PC February 9, 2014, Geneva

17 out of 23 priority countries have NID plans, strategies programs 6 countries launched NID integrated PoA – Honduras, Brazil, Guatemala, Colombia, El Salvador and Nicaragua + 3 countries have a draft Honduras has 8 subnational operational plans NID control and elimination program AMRO, NID control and elimination program AMRO, Strategic plan & Resolution CD49.19/2009 Graphic 1. Number & proportion of countries with Single versus Multi –NID integrated program, plan project or strategy in AMRO,

1 TIPAC training workshop conducted (Brazil, March, 2014) 1 NID Program Managers training workshop for 7 countries (Ecuador, December, 2014) 12 countries using the “Joint Application Package” – 8 requesting medicines 6 Modules for the Integrated Monitoring of public health interventions – develop by Immunization & NID programs NID Integrated Plans of Action, including costing & M&E 2014 highlights …In the pipeline for TIPAC training workshop for 3 countries & Integrate NID/IDM+Malaria costing tools Adjust NID Program Manager Modules –online version & training workshop in Brazil Scale up the number of countries using the “JAP” 1 integrated monitoring training workshop for 7 priority countries Regional disease elimination consultation NID atlas and online databank (in development)

…& advocate for an integrated approach to tackle NID in the region of the Americas NIDs factsheets by disease NID, Vector borne diseases Info graphic Epidemiological profiles by countries Success stories (on development) Available at:

PC for Lymphatic filariasis in the Region of the Americas, LF endemic countries 12 M people at risk of LF (92% in Haiti) 7.1 M people treated (99% in Haiti), countries classified as non endemic, countries receive drug donation (Not Brazil) > 80% programatic coverage in Haiti since 2008

Lymphatic filariasis in the Region of the Americas 2014 highlights …In the pipeline for TAS training Workshop ( Brazil, March 2014 ) 3 countries conducted TAS ( Brazil, Haiti, Dominican Republic ) 1 Morbidity Management & Disability Prevention (MMDP) training workshop –Lymphedema ( Guyana, November, 2014 ) 15 th LF regional PM & RPRG meetings + 1 Workshop to analyze lessons learned and next steps for NPELF and formerly endemic countries- ( Costa Rica, August, 2014 ) LF regional PM & RPRG meetings Workshop to analyze lessons learned and next steps for NPELF and formerly endemic countries 1 country conducting TAS - Haiti Nord, Nippes & Nord Oeust departments 1 country compiling a dossier for requesting validation/verification of the LF elimination- Brazil 1 MMDP training workshop – Lymphedema - Dominican Republic PM meeting – emphasis on TAS surveillance and LF dossiers (Recife, Brazil, June 2015, unfunded ) Regional consultation on LF, Leishmaniasis & Leprosy MMDP ( Washington, unfunded )

Soil transmitted Helminths in the Region of the Americas, out of 35 countries have children at risk of STH infection 46 M children under 15 years old requiring PC ( 13.1 M PSAC & 33.3 M SAC ) 29 M children treated in 12 countries ( 6.2 M PSAC & 22.7 SAC) in countries receiving drug donation for Brazil & Guyana have enough stock from previous years donations. Belize & Mexico are purchasing medicines locally.

Soil transmitted Helminths in the Region of the Americas 2014 highlights…In the pipeline for 2015 Dominican Republic*, Haiti & Nicaragua implemented STH (*&SCH) surveys – reports available in 2015 Paraguay & Mexico developed a protocol of STH & STH + Malaria survey – to be implemented in 2015 Paraguay, El Salvador & Colombia developed operational guidelines for the control of STH (+M&E component) Resources Mobilization – Izumi /CWW, BMGF & Sabin granted 4 country proposals (Paraguay, Nicaragua, Honduras & Mexico) to expand STH control program integrated with WASH activities & EPI – to be implemented in 2015 Dominican Republic will conduct monitoring of STH PC coverage after the MDA campaign – May, countries strengthening the M&E component of the STH program – including an anthelmintic drug efficacy study. 2 countries will develop integrated monitoring for several NIDs through sentinel sites & spot check sites ( unfunded ) + 3 countries will conduct an STH (& other NIDs) survey (unfunded)

PC for Schistosomiasis in the Region of the Americas, endemic countries and territories 1.6 M people requiring PC in 2 countries (Brazil and Venezuela) 2 countries may have residual transmission in some foci (Suriname and Saint Lucia) 6 countries & territories may have eliminated the transmission (Puerto Rico, Montserrat, Martinique, Guadalupe, Antigua and Barbuda and Dominican Republic) 2 countries implementing targeted treatment

Schistosomiasis in the Region of the Americas 2014 highlights …in the pipeline 2015 Dominican Republic conducted an STH & SCH survey – report available in 2015 Schistosomiasis regional meeting – to define the road map towards the elimination of SCH in AMRO Schistosomiasis regional meeting (Puerto Rico, August, 2014) 1 SCH & STH lab diagnosis & morbidity management training workshop, along with a CME session (Saint Lucia, August, 2014) Systematic review on schistosomiasis prevalence and intensity of infection Systematic review on schistosomiasis prevalence and intensity of infection Compile evidence on SCH elimination of the transmission for Puerto Rico & Dominican Republic; and Martinique & Guadalupe Support 3 countries to update their epidemiological status in order to address the required PH interventions - Venezuela, Suriname and Saint Lucia (unfunded) Systematic review on PZQ MDA in SCH and cysticercosis co- endemic areas and its possible adverse effects (unfunded)

PC for Blinding trachoma in the Region of the Americas, endemic countries (Brazil, Colombia, Guatemala & Mexico) 11 M people living in endemic areas 178 K people were treated in Brazil Targeted PC Colombia No PC MDA Guatemala No PC MDA Mexico Case manag. Source: data reported by countries to the Regional program of Neglected Infectious Diseases, , PAHO/WHO

Blinding trachoma in the Region of the Americas 2014 highlights...in the pipeline 2015 Mexico has compiled a dossier to request the verification of elimination of blinding trachoma Colombia implemented its 3 rd MDA and 4 th TT surgery campaign Brazil implements SAFE strategy in the areas where there are active foci, with targeted PC – Conducted an integrated campaign for STH, leprosy & trachoma (in 2015, SCH) Publication of PAHO/WHO manual on Trichiasis Surgery for Trachoma in Spanish and Portuguese 3rd Regional Meeting of program3rd Regional Meeting managers for the elimination of Blinding trachoma (Brazil, August, 2014) Mexico implement a protocol to confirm absence of blinding trachoma in municipalities know as non endemic in Chiapas Guatemala will finalize & implement a protocol to evaluate impact of MDA round in Sololá department (unfunded) Colombia and Brazil will continue SAFE strategy Colombia will implement a trachoma baseline survey (TF&TT) in 6 departments bordering the known focus of trachoma Pilot the protocol of active searching of TT cases in unknown areas of trachoma in 2 countries (unfunded)

PC for ONCHOCERCIASIS in the Region of the Americas, endemic countries (Brazil, Venezuela, Guatemala, México) 22,046 people requiring PC in 2 countries (Yanomami population) >85% PC coverage since 2003

Onchocerciasis in the Region of the Americas 2014 highlights…in the pipeline 2015 Colombia and Ecuador received the verification of elimination in 2013 and 2014 Mexico completed the elimination dossier & requested the verification of elimination to PAHO/WHO Guatemala achieved the elimination and compiled the elimination dossier Venezuela and Brazil signed a collaboration agreement to treat Yanomami population at the border area during the WHA in May 2014 Guatemala requests the verification of onchocerciasis elimination Organize and coordinate an International Verification Team to verify onchocerciasis elimination in Mexico & Guatemala Bi-national meeting to complete an operational plan of action to treat Yanomami population at risk at the border between Venezuela and Brazil

Priority needs Needs & Opportunities Strengthening M&E –at the regional and national level Published and implement the toolbox on integrated monitoring of public health interventions – vaccination and STH deworming Define criteria & procedures for validation/verification of elimination of NID for which the region of the Americas is ready: TRA, LF, SCH Continue advocacy (& resource mobilization) on integrated approached to tackle NID, strengthening the M&E component– e.g.; identify call for grant proposals; create “Ciro de Quadros Prize” on innovative integrated interventions and M&E towards the elimination of diseases (unfunded)

Priority needs Needs & Opportunities Strengthening M&E –at the regional and national level Increase the feedback to the countries – NID atlas and online database in development Recommendations about new diagnostic tools for M&E and make them available for the countries (specially for SCH, LF & TRA) Continue updating & adjusting tools and guidelines to scale down MDA, implement on going surveillance after MDA, integrated monitoring, IVM and scale up MMDP Expand donations of required in- kinds for M&E, e.g.; tests –Kato Katz kits, ICT, FTS, CCA, etc. Resources Mobilize resources (seed funds) for unfunded 2015 activities – in order to implement surveys, develop integrated NID surveillance through SS and SC, etc. To sustain presence & support in the Region by keeping the staff at regional level for NID technical cooperation, advocacy, resource mobilization, and capacity building – unfunded staff for 2015

Schistosomiasis Regional meeting Puerto Rico, October, 2014 Gracias! Gracias! More information at: TAS training workshop Recife, Brazil, March, LF/STH Mass drug administration Port au Prince, Haiti, 2014 MÉSI ANPIL! Merci! MÉSI ANPIL! Merci! MMDP training workshop Guyana, November, 2014 Thanks! Thanks!