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THE DISEASES − CHAPTER 4
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The STAG-NTD Working Group on Access to Quality Assured Medicines coordinates the
supply of donated praziquantel through WHO and harmonizes partner activities. In 2012
and 2013, it supplied 125 million and 181 million tablets respectively to countries. Donated
praziquantel is expected to increase to 250 million tablets per year by 2016, an amount sufficient
to treat 100 million schoolchildren. Partners, who pledged 305 million tablets for 2014, should
continue to supply praziquantel to meet requirements for other age groups.
As treatments are scaled up, the efficacy of praziquantel should be monitored using the
standard operating procedures published by WHO in 2013 (9) and in use in Brazil, Cameroon,
Mali, the Philippines and the United Republic of Tanzania.
To ensure implementation, 75% of countries requiring preventive chemotherapy for
schistosomiasis have national control plans (i.e. 39 of 52 countries). Capacity-building for
national programme managers at central and decentralized levels is ongoing in many countries.
In 2014, WHO supported country-level training (Ethiopia and Nigeria) and regional-level
training (Eastern Mediterranean Region).
Resolution WHA65.21 on the elimination of schistomasiasis, adopted by the Sixty-fifth
World Health Assembly in 2012, encouraged “Member States and the international community
to make available the necessary and sufficient means and resources, particularly medicines,
and water, sanitation, and hygiene interventions, to intensify control programmes in most
disease-endemic countries and initiate elimination campaigns, where appropriate”. This
requires a paradigm shift from morbidity control to a comprehensive approach that ensures
all those infected are treated every year. Delineation of endemic foci is required. The WHO
African Region is leading mapping in sub-Saharan Africa: 51% of countries are fully mapped
and completion is expected by the end of 2015.
Inclusion of WASH will require collaboration with sectors responsible for infrastructure
and social development. For snail control, training is essential because experience is limited.
The priority is to ensure that molluscicides are available; only niclosamide (Bayluscide) has
WHOPES specifications. Guidelines for evaluating molluscicide efficacy are under review, and
those for snail control will be updated in 2015.
Resolution WHA65.21 called on WHO to prepare guidance for Member States on initiating
elimination campaigns and on procedures for verifying the interruption of transmission.
Procedures for elimination are being aligned with the WHO Guidelines Review Committee.
As few countries have eliminated schistosomiasis, the evidence base is small; procedures will
therefore be based initially on expert opinion. The discussion by the World Health Assembly
was requested by a Member State with documented interruption of transmission. Another
country requested assessment to determine elimination but has yet to compile a dossier on the
evolution of the control programme.
Completion of mapping and scale up of interventions require strengthened monitoring and
evaluation to ensure that progress is aligned with the Strategic Plan. Advocacy should ensure
that the necessary resources are available to implement comprehensive control interventions,
including snail control and WASH.
In 2015, preparations will be made for the mid-term review of the Strategic Plan.