1. NTDs and eye health: lessons learnt and opportunities for collaboration Adrian D Hopkins Director: Mectizan Donation Program Task Force for Global Health Emory University; Atlanta, USA

2. NTDs and Eye Health Trachoma Strategy for eliminating blinding Trachoma –Surgery of Trichiasis –Antibiotic MDA –Facial cleanliness –Environmental Change

3. NTDs and Eye Health Onchocerciasis Strategy for elimination of the disease –MDA –(Rehabilitation of the blind)

4. Other NTDs and MDA Lymphatic Filariasis –Strategy for Elimination –MDA –Morbidity control Shistosomiasis –MDA –Water and Sanitation –?? Snail control STH –MDA –Water and Sanitation

5. Community Directed Treatment with Ivermectin (CDTI) in action

6. Mectizan treatments approved for Onchocerciasis

7. Mectizan treatments approved for Lymphatic Filariasis

8. Other NTDs NTDs without community diagnosis methods NTDs with difficult or toxic treatments NTDs with complicated individual diagnostic tools These diseases require Intensified Disease Management (IDM) for case finding, laboratory diagnosis and individual care HAT, Leprosy, Chagas Disease, Leishmaniasis, Leprosy, Buruli Ulcer and others

9. What are NTDs and relationship to Blindness Both diseases of the poor –More prevalent in the “bottom billion” –Occur where health services are inaccessible –The two major causes of infectious blindness are NTDs for MDA –No simple strategies for some diseases. Disease management strategies –Community diagnosis –Require community mobilisation –Require a multi-sectorial approach

10. Community involvement

11. Linking CBR, VHWs, and CDDs Same community but different programmes and different workers. WHY? –Why are there different vertical programmes with different funding sources and controls? –Is it impossible to coordinate eye care with other activities? Why is CBR not empowering enough to become CDR?

12. Advocacy Clear simple messages –Tool ready strategies –Simple cost strategies –Clear results –Defined impact Success in what you can do leads to research funding for what you cannot do Long-term commitment. –NO 3 year programmes.

13. Needs for Political Commitment Need wide stakeholder input at international and national level, WHO, governments (MoH M of Finance, M of Education) with NGDOs and WHO in country. Need peer pressure between governments, using regional meetings (success of APOC) Need to involve local governments. Local priority setting Need strong advocacy to medical authorities.

14. Challenges with Integration Morbidity Control and prevention –Emphasis on MDA - pill packages & coverage –Who will attend to the visually impaired –Who will care for eyes and limbs –Who will do the health education –Who will attend to water and sanitation Specificity –Reduction to lowest common denominator –No flexibility for alternative drug regimens –What about specific control/elimination parameters

15. Let’s finish the job properly!