The impact of climate change and population mobility on neglected tropical disease elimination

Abstract

The WHO has established targets for the global or regional eradication or elimination of 11 neglected tropical diseases (NTDs) diseases by 2020. Other NTDs, such as soil transmitted helminths (STH), are the focus of intensified control efforts in specific countries. Two key strategies are being implemented to achieve these goals: preventive chemotherapy through repeated community-based mass drug administration (MDA) and intensified disease management. This presentation will present an update on NTD elimination efforts in sub-Saharan Africa, examining in par-ticular the challenges posed by climate change and migration on MDA campaigns, including for lymphatic filariasis, onchocerciasis, schistosomiasis, STH and trachoma. While increasingly researchers are identifying (and predicting) health impacts from climate change (notably, how changes in temperature, precipitation and vegetation phenology impact malaria and certain arbovirus vectors), relatively less attention has been paid to the impact of climate change on NTDs in particular, or the challenges climate change related migra-tion, which may also be associated with conflict or shifting labor migration, may pose to NTD elimination efforts. In addition to challenges in achieving high coverage rates for MDA, migration can complicate the assessment of transmission interruption and post-MDA disease surveillance, putting in doubt the verification of elimination. Achieving high coverage rates of mobile populations, whether for surveillance or MDA efforts, is a broader concern than for NTD programs. In the context of increasing health impacts of climate change, and in support of sustainable development goals and the push for universal health coverage, more emphasis should be put on the development of effective strategies to reach mobile populations across various public health, outbreak response, dis-ease control and elimination programs and on documenting and sharing lessons learned.