Integrated preventive chemotherapy implementation

The selection of anthelminthic medicines recommended by WHO for use in public health programmes is designed to control and eliminate select helminth infections of public health importance. Many of these medicines are broad-spectrum, allowing several diseases to be tackled simultaneously. Preventive chemotherapy (PC) interventions should therefore be based on the optimal, coordinated use of available medicines rather than targeting specific forms of helminthiasis. Where operationally feasible and epidemiologically justified, WHO recommends the integrated and coordinated delivery of combinations of anthelminthic medicines to target multiple diseases.

Joint mechanism and tools to support integrated preventive chemotherapy implementation

As part of global efforts to accelerate expansion of PC for elimination and control of lymphatic filariasis (LF), schistosomiasis (SCH) and soil-transmitted helminthiases (STH), WHO facilitates the supply of the following medicines donated by the pharmaceutical industry: diethylcarbamazine citrate, albendazole, mebendazole, and praziquantel. WHO also collaborates to supply ivermectin for onchocerciasis (ONCHO) and lymphatic filariasis elimination programmes.

A joint mechanism and a set of forms have been developed to facilitate the process of application, review and reporting as well as to improve coordination and integration among different programmes.

• Joint Request for Selected PC Medicines (JRSM) – designed to assist countries in quantifying the number of tablets of the relevant medicines required to reach the planned target population and districts in a coordinated and integrated manner against multiple diseases during the year for which medicines are requested.
• Joint Reporting Form (JRF) – designed to assist countries in reporting annual progress on integrated and coordinated distribution of medicines across diseases in the reporting year in a standardized format.
• PC Epidemiological Data Reporting Form (EPIRF) – designed to standardize national reporting of epidemiological data on lymphatic filariasis, onchocerciasis, soil-transmitted helminthiases and schistosomiasis. National authorities are encouraged to complete this form and submit it to WHO on a yearly basis, together with the JRF.

All donations are subject to review and/or availability of medicines. In addition, use of donated medicines must be adequately reported to WHO upon completion of treatment activities.

Submission of the Joint Application Package

The reports generated in the JRSM and in the JRF (SUMMARY worksheets) must be printed and signed by the NTD coordinator or a Ministry of Health representative to formally endorse the country’s request for these medicines and the reported annual progress of the national programme(s). The date of signature must also be included. Once signatures have been obtained, the scanned copies of SUMMARY worksheets, together with the full Excel versions of the JRSM, the JRF and the EPIRF can be submitted to WHO.

Note that all the forms should be submitted to the WHO Representative of the concerned WHO Country Office with electronic copies to PC_JointForms@who.int and the concerned Regional NTD focal point. The relevant JAP submission deadline depends on the time of planned implementation dates as follows:

• During the implementation year, the JRF can be prepared and partially completed after each round of mass drug administration (MDA), when treatment data become available. The final report should be submitted within 3 months after the last round was implemented and no later than 31 March of the next implementation year.
• To ensure the medicines are delivered on time, the request for PC medicines should be submitted at least 9 months before the first date of MDA planned in the calendar year of the request. For example, if a country plans to conduct two MDA rounds in May and October 2023, the request should be submitted by August 2022. This lead time is required for reviewing and approval of the request, placing orders, manufacturing PC medicines and shipment to the country. Some countries that have specific procedures requiring more time should apply earlier, taking into consideration the required additional time, for example, pre-shipment inspection.
• The EPIRF is a part of the JAP and should be submitted annually together with the other Forms. If epidemiological surveys have not been conducted during the reported year, the submitted form should remain blank.

The JAP, and in particular the JRSM, will not be approved without submission of the final version of the JRF. If PC was not implemented as planned during the implementation year, the JRF should be submitted with complete data provided in COUNTRY_INFO and a written explanation of the reasons in the additional information box in the SUMMARY worksheet.

Data reporting and collection at community and district levels

Recording and collecting reliable information on the use of medicines (i.e. drug coverage) at peripheral and district levels and compiling such information at the national level is essential for completion of the JRF.