Officials from Member States
Regional Technical Advisory Group Members
Advisors
Donor and Technical Partner Agencies
Colleagues and Friends
Good morning and welcome to this Regional Meeting of the National Programme Managers for Lymphatic Filariasis Elimination and the Regional Technical Advisory Group (RTAG).
Neglected Tropical Diseases (NTDs) significantly impact morbidity and mortality in marginalized communities worldwide, hindering development and impeding our efforts to leave no one behind.
Our WHO South-East Asia Region bears the world's highest burden of many NTDs, including lymphatic filariasis (LF), leprosy, snakebite envenoming, soil-transmitted helminths and rabies. The number of individuals requiring interventions or care for NTDs in 2022 was 1.62 billion globally. 833 million, or 52%, were in our Region, with at least one NTD endemic in each of our 11 Member States.
Since 2014, eliminating NTDs, including LF, has been a Flagship Priority for the Region, resulting in rapid and sustained progress. Notably, Maldives, Thailand, Sri Lanka, and Bangladesh have eliminated LF as a public health problem and are in the post-validation surveillance phase, to sustain the elimination status and further progress towards interruption of transmission of the disease. Timor-Leste is currently implementing post-Mass Drugs Administration (MDA) surveillance. India, Indonesia, Myanmar, and Nepal are actively implementing triple-drug therapy, known as IDA, to accelerate LF elimination efforts.
Despite our progress and achievements, challenges continue to emerge in the LF elimination programme. While the endemicity map continues to shrink across the Region, many countries are struggling to get to hard-to-reach and vulnerable populations, and enhance and sustain community compliance to MDA. Innovative and evidence-based approaches are needed to identify the specific population groups that are not participating in MDA - such as adult males, urban settings and religious and cultural minorities - and address the socioeconomic and cultural factors to enhance their participation.
WHO is publishing new M&E guidelines for LF, which demand operationally challenging LF surveys in the field to monitor and assess impacts of interventions. There is an urgent need of orientation on the new guidelines, capacity building and cross-sharing of country experiences.
Due to suboptimal performance of the currently WHO-recommended Rapid Diagnostic Tests (RDTs) for both Wuchereria bancrofti and brugian filariasis, progress on implementation of LF surveys have been forced to delay in countries. Meanwhile, new RDTs for both species are being validated by WHO, hopefully to be recommended for operational use soon.
Countries endemic for Brugian filariasis are struggling with persistent or newly emerging transmission, even after WHO validation of elimination as a public health problem. This is potentially due to its zoonotic transmission. Today we are pleased to have participation of Malaysia and Brunei Darussalam to share experience, cross learn and jointly strategize how to address transmission of Brugian filariasis across Asia.
The absence of clear WHO guidance on effective post-validation surveillance strategy leaves countries independently navigating post-validation surveillance. A wealth of data has been generated, both from case surveillance and xenomonitoring, from several countries. This has however not always been thoroughly analyzed to deploy most optimum and cost-effective methods.
Additionally, more and more countries are detecting LF infections among migrant workers from endemic countries in recent years. This demands cross-learning for the clear way forward across the Region and beyond.
Finally, all nine countries are implementing morbidity management and disability prevention (MMDP) interventions. However, there is a critical need to further strengthen and sustain the quality of care as part of the PHC-centered health system, and even expand the scope of the MMDP services to encompass rehabilitation and psychosocial care.
Ladies and Gentlemen,
Over the next three days, you will review the progress of Member States, discuss challenges, and seek expert advice from RTAG members to address each of these critical challenges and accelerate the progress in all countries. I would like to ask RTAG members to carefully review the current situation and provide actionable guidance.
Before closing, I extend my sincere appreciation for the continued support of RTAG members, partners, and donors, including GSK, Eisai, the Mectizan Donation Program, the Gates Foundation, and USAID for our decade-long achievements in LF elimination. Your generosity and partnership are greatly appreciated and valued.
Together, let us work to eliminate NTDs and LF in every community, everywhere.
I wish you an engaging, informative meeting and a pleasant stay in Kathmandu.
Thank you.