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22 THIRD WHO REPORT ON NEGLECTED TROPICAL DISEASES
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spraying are targeted for areas of South-East Asia in which malaria programmes are not
already active – areas with a population of about 35 million people in 2015. This report does
not yet include targets for vector control against lymphatic filariasis, although integrated
vector management is promoted to support the elimination strategy.
Population targets for surveillance after preventive chemotherapy has been stopped are
based on the administration of three surveys within 3–6 years of stopping the intervention
for lymphatic filariasis, onchocerciasis or trachoma.
Populations targeted for coverage with treatment and care
For the purposes of this chapter, population targets for coverage with treatment and
care are based on the historic relationship between notification rates and GDP per capita.
Fig. 2.3 displays targets for the number of people targeted for coverage, including financial
protection. These targets aim to prevent death and disability as well as indebtedness and
impoverishment among the more than 500 000 households still affected by Buruli ulcer,
human African trypanosomiasis, the leishmaniases and leprosy each year.
If expressed relative to the total populations within endemic countries, these targets
imply that by 2020, incidence would be less than 1 per 10 000 people for leprosy, gambiense
human African trypanosomiasis and visceral leishmaniasis. It is difficult to set population
targets for Buruli ulcer given the extent of under-reporting and unexplained year-over-year
fluctuations in the number of cases reported – the targets displayed in Fig. 2.3 (panel A) are
effectively flat over time. The number of people targeted for coverage by treatment and care
of gambiense human African trypanosomiasis in 2030 exceeds a recently set target for zero
incidence, but is consistent with the expectation that coverage will need to be maintained
during confirmation of the interruption of transmission.
Population targets for active case-finding for Buruli ulcer and leprosy are based on the
population targets for treatment and care and targets for the number of contacts to be
traced. Active case-finding for human African trypanosomiasis is based on populations
living in high and very high risk areas targeted for annual mobile teams and on moderate
risk areas targeted for 3-yearly mobile teams. Camp-based or house-to-house screening for
visceral leishmaniasis is limited to parts of Bangladesh and India. Assumptions behind the
targets for morbidity management and disability prevention are available from the technical
appendix. 1
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1
The technical appendix and related code using the free software R will also be made available via http://www.who.int/
neglected_diseases/en/